Module 1 - Maternal

• Obstetrics


  Care of women during childbirth
• Pediatrics


  Greek word: pais - "child"
• Although the field of nursing typically divides its concerns for families during childbearing and childrearing into two separate entities, maternity care and child health care, the full scope of nursing practice in this area is not two separate entities but rather a Continuum: MATERNAL AND CHILD HEALTH NURSING
• Childbearing


  To have
• Childrearing


  To raise
• The PRIMARY GOAL of Maternal and Child Health Nursing Care


  • The PROMOTION AND MAINTENANCE OF OPTIMAL FAMILY HEALTH to ensure cycles of optimal childbearing and childrearing
  • The health of each stage of the individual impacts the next stage and the health of the family to which the individual belongs
• Goals of Maternal and Child Health Nursing Care


  • PRECONCEPTUAL health care
  • Care of women during three trimesters of pregnancy and the PUERPERIUM: the 6 weeks after childbirth, sometimes termed the fourth trimester of pregnancy
  • Care of infants during the PERINATAL period (6 weeks before conception to 6 weeks after birth)
  • Care of children from birth through adolescence
  • Care in settings as varied as the birthing room, the pediatric intensive care unit, and the home
• In all settings and types of care, keeping THE FAMILY AT THE CENTER OF CARE or considering the family as the primary unit of care is an essential goal
• Family functioning


  • Low level of Family functioning = adverse effect to the family
  • Healthy Family = environment conducive to growth and health -promoting behaviors that sustain family members during crises
• Philosophy of Maternal and Child Health Nursing


  • FAMILY CENTERED
  • COMMUNITY CENTERED
  • EVIDENCE BASED
• A Maternal and Child Health Nurse

  • Considers the FAMILY AS A WHOLE an as partner care when planning or implementing or evaluating the effectiveness of care
  • Serves as an ADVOCATE to protect the rights of all family members, including the fetus
  • Demonstrates a high degree of independent nursing functions because TEACHING AND COUNSELING are major interventions
  • PROMOTES HEALTH AND DISEASE PREVENTION because these protect the health of the next generation
  • Serves as AN IMPORTANT RESOURCE for families during childbearing and childrearing as these can be extremely stressful times in a life cycle
  • RESPECTS PERSONAL, CULTURAL AND SPIRITUAL ATTITUDES AND BELIEFS as these so strongly influence the meaning and impact of childbearing and childrearing
  • ENCOURAGES DEVELOPMENTAL STIMULATION DURING BOTH HEALTH AND ILLNESS so children can reach their ultimate capacity in adult life
  • ASSESSES FAMILIES FOR STRENGTHS as well as SPECIFIC NEEDS OR CHALLENGES
  • Encourages family bonding through ROOMING-IN AND FAMILY VISITING in maternal and child health care settings
  • ENCOURAGES EARLY HOSPITAL DISCHARGE options to reunite families as soon as possible in order to create a seamless, helpful transition process
  • ENCOURAGES FAMILIES TO REACH OUT TO THEIR COMMUNITY so the family can develop a wealth of support people they can call on in time of family crisis
• Differences among a midwife, nurse, and obstetrician


  • MIDWIFE - all about women of childbearing age
  • NURSE - can administer medication with the doctor's orders
  • OBSTETRICIAN - deals with abnormality and complications / performs operations & procedures
• Both Nurses and Midwife: care for women during the whole pregnancy and childbirth, can only perform vaginal delivery
• How to achieve optimal family health among women who have complication during pregnancy

  • Revert to normal state or prevent further complications
  • Compromising with the client, provide information about the pros and cons, risk and advantages but do not enforce
• Standards of Maternal and Child Health Nursing Practice


  • ASSESSMENT
  • DIAGNOSIS
  • OUTCOME IDENTIFICATION
  • PLANNING
  • IMPLEMENTATION
  • EVALUATION
• Standards of Professional Performance


  • QUALITY OF CARE
  • PERFORMANCE APPRAISAL
  • EDUCATION
  • COLLEGIABILITY
  • ETHICS
  • COLLABORATION
  • RESEARCH
  • RESOURCE UTILIZATION
• A Framework for Maternal and Child Health Nursing Care


  • HEALTH PROMOTION
  • HEALTH MAINTENANCE
  • HEALTH RESTORATION
  • HEALTH REHABILITATION
• Nursing Process


  • Organized series of steps to ensure quality and consistency of care
  • A form of problem solving based on the scientific method, serves as the basis for assessing, making a nursing diagnosis, planning, organizing, and evaluating care
  • Applicable to all health care settings, from the prenatal clinic to the pediatric intensive care unit
• Health Rehabilitation


  Preventing further complications from an illness, bringing client back to an optimal state of wellness, helping client accept inevitable death
• Health rehabilitation


  1. Prevent further complications and death through continuous medication, physical and occupational therapies

  2. Encourage continuous therapies and medications
• Nursing process

  Organized series of steps to ensure quality and consistency of care
• Nursing process


  A form of problem solving based on the scientific method, serves as the basis for assessing, making a nursing diagnosis, planning, organizing, and evaluating care
• The nursing process is applicable to all health care settings, from the prenatal clinic to the pediatric intensive care unit, is proof that the method is broad enough to serve as the basis for nursing care
• Nursing process steps

  • Assessment
  • Nursing Diagnosis
  • Planning
  • Organizing
  • Evaluating care
• Evidence-based practice


  Conscientious, explicit, and judicious use of current best evidence in making decisions about the care of patients
• Evidence-based practice evidence


  • Research
  • Clinical expertise
  • Patient preferences
• Evidence-based practice levels


  • Level I: Evidence obtained from at least one properly designed randomized controlled trial
  • Level II: Evidence obtained from well-designed controlled trials without randomization, well-designed cohort or case-control analytic studies, or multiple time series with or without an intervention
  • Level III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees
• Evidence-based practice helps to move all health care actions to a more solid, and therefore safer, scientific base
• The Cochrane Database of Systematic Reviews is an example of evidence-based practice
• Nursing research


  The controlled investigation of problems that have implications for nursing practice, provides evidence for practice and justification for implementing activities for outcome achievement, ultimately resulting in improved and cost-effective patient care
• Nursing theory


  One of the requirements of a profession (together with other critical determinants, such as member-set standards, monitoring of practice quality, and participation in research) is that the concentration of a discipline's knowledge flows from a base of established theory
• Global Strategy for Women, Children, & Adolescents


  • Survive - End preventable deaths
  • Thrive - Ensure healthy & well-being
  • Transform - Expanding enabling environments
• Client advocacy


  Safeguarding and advancing the interests of clients and their families, including knowing the health care services available in a community, establishing a relationship with families, and helping them make informed choices about what course of action or service would be best for them
• Crude birth rate (CBR)


  Measures how fast people are added to the population through births, greater than or equal to 45/1,000 live births implies high fertility, less than or equal to 20/1,000 live implies low fertility
• General fertility rate (GFR)


  More specific rate than CBR since births are related to the segment of the population deemed to be capable of giving birth, that is, the women in the reproductive age groups (15-44 years), high fertility rate is GFR of 200/1,000 women while 60/1,000 is low fertility rate
• Maternal mortality rate (MMR)


  Number of deaths of a female from any cause related to or aggravated by pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy
• Infant mortality


  Dying under 1 year of age
• Neonatal mortality rate


  Dying under 28 days
• Post natal mortality rate


  Dying after 28 days but less than 1 year of age
• Crude Birth Rate (CBR)

  Number of registered life births in a year x 1000 / Midyear population (all including male, female, children, & elderly)