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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 care=cooperative effort Nursing promotes-trust,respect, informed consent, empowerment, collaboration.

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

Health Care Indicators

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

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

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

Community Based Nursing

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

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

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

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

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.

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