PastCurrent Trends in MaternalChild Nursing

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Past/Current Trends in Maternal/Child Nursing

• Historically-Child birth high risk
• Risk for hemorrhage- infection-exhaustion
• Large families a necessity
• Current trends-Family centered carecooperative
  effort
• Nursing promotes-trust,respect, informed consent,
  empowerment, collaboration.

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Health Care Indicators

• Healthy People 2010-Examine areas of health care
  that need improvement.
• Infant mortality- deaths per 1000 births
• Maternal mortality- deaths per 100,000
• Most cause are preventable
• Rank 21st in maternal mortality
• Rank 27th in fetal mortality

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Health Care Indicators

• Women of color
• Pre conceptual counseling
• Access to care
• Research with women subjects

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Disparity of Health Care in the United States

• Access to care
• Racial disparities
• Insurance
• Health habits- Cardiovascular disease
• Poverty- majority are women
• Financial
• Cultural
• Violence- Nursing must assess

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Legal/Ethical Issues

• Guidelines established by Nurse Practice Act,
  ANA, hospital policy and procedures.
• Ethically bound by nonmaleficence- DO NO HARM
• Abortion
• Fetal surgery
• Substance abuse

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Community Based Nursing

• More RNs working in CBN
• Setting- ambulatory, home health, long term care
• Contributing factors- shorter stays, lower cost.
• Benefits of CBN

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CBM for Women and Infants

• Prenatal care- early intervention and on going
  assessment- Technology
• Labor and Delivery- Setting for delivery
• Postpartum/ Newborn- Shorter stay. Family
  Centered Care
• Womens Health Care- Screening, Counseling,
  Education

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Levels of Care

• Primary- Prevention. ExampleNeural Tubal Defects
• Secondary- Treatment of condition, promote
  wellness Example HIV
• Tertiary-Limit disease process, live with
  disability. Example Spinal cord injury, Violence

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Impact of Culture

• Respect/appreciation for culturally diversity
• Time-Concept not important to all cultures
• Personal space-Varies among cultures
• Family orientation- Matriarchal/Patriarchal
• Who makes health care decision?
• Language-Develop therapeutic relationship
• Get interpreter

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Characteristics of Culturally Competent Care

• Combine nursing knowledge with cultural knowledge
  to improve care
• Cultural self awareness- know yourself, beliefs,
  values, prejudices
• Cultural knowledge- Utilize resources to increase
  knowledge
• Cultural skills- Assess and practice
• Cultural Encounter-Participate in cultural
  encounter.

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Complimentary and Alternative Medicine

• Not widely accepted but widely practiced.
• Complimentary- combined with conventional
  medicine
• Alternative- In place of conventional medicine
• Nursing- Assess for use. Education
• Maternal/Child- use cautiously, may cross placenta

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