maternal framework

• Obstetrics


  The care of women during childbirth, derived from the Greek word obstare, which means "to keep watch"
• Pediatrics


  The care of children, derived from the Greek word pais, meaning "child"
• The care of childbearing and childrearing families is a major focus of nursing practice, because to have healthy adults you must have healthy children
• Preconceptual and prenatal care are essential contributions to the health of a woman and fetus and to a family's emotional preparation for childbearing and childrearing
• As children grow, families need continued health supervision and support
• As children reach maturity and plan for their own families, a new cycle begins and new support becomes necessary
• The nurse's role in all these phases focuses on promoting healthy growth and development of the child and family in both health and illness
• The full scope of nursing practice in this area is not two separate entities but rather a continuum: maternal and child health nursing
• 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
• Major philosophical assumptions about maternal and child health nursing


  • The health of each stage of the individual impacts the next stage and the health of the family to which the individual belongs
  • Healthy pregnancy will lead to healthy newborn who will grow up to become healthy children who will comprise the healthy family
• The range of practice in maternal and child health nursing


  • Preconceptual health care
  • Care of women during three trimesters of pregnancy and the puerperium
  • Care of infants during the perinatal period
  • Care of children from birth through adolescence
  • Care in settings as varied as the birthing room, the pediatric intensive care unit, and the home
• Keeping the family at the center of care or considering the family as the primary unit of care is an essential goal in maternal and child health nursing
• Philosophy of maternal and child health nursing


  • Maternal and child health nursing is family centered; assessment must include both family and individual assessment data
  • Maternal and child health nursing is community centered; the health of families depends on and influences the health of communities
  • Maternal and child health nursing is evidence based, because this is the means whereby critical knowledge increases
• Roles of 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
• Standards of maternal and child health nursing practice


  • Assessment
  • Diagnosis
  • Outcome Identification
  • Planning
  • Implementation
  • Evaluation
  • Quality of Care
  • Performance Appraisal
  • Education
  • Collegiality
  • Ethics
  • Collaboration
  • Research
  • Resource Utilization
• Maternal and child health nursing can be visualised within a framework in which nurses, using nursing process, nursing theory, and evidence-based practice, care for families during childbearing and childrearing years through four phases of health care: health promotion, health maintenance, health restoration, and health support
• Nurse


  • Contributes to the professional development of peers, colleagues, and other health care providers
• Standard V: Ethics


  The nurse's assessment, actions, and recommendations on behalf of children and their families are determined in an ethical manner
• Standard VI: Collaboration


  The nurse collaborates with the child, family, and other health care providers in providing client care
• Standard VII: Research


  The nurse contributes to nursing and pediatric health care through the use of research methods and findings
• Standard VIII: Resource Utilization


  The nurse considers factors related to safety, effectiveness, and cost in planning and delivering patient care
• Maternal and child health nursing


  Nurses, using nursing process, nursing theory, and evidence-based practice, care for families during childbearing and childrearing years through four phases of health care
• Four phases of health care


  • Health promotion
  • Health maintenance
  • Health restoration
  • Health rehabilitation
• Health promotion


  Educating clients to be aware of good health through teaching and role modelling
• Health promotion


  • Family planning, teach the importance of safe sex practice, importance of immunizations
• Health maintenance


  Intervening to maintain health when risk of illness is present
• Health maintenance


  • Encourage prenatal care, importance of safeguarding homes by childproofing it against poisoning
• Health restoration


  Diagnosing and treating illness using interventions that will return client to wellness fast
• Health restoration


  • Care of child during illness, care of woman during pregnancy complications
• Health rehabilitation


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


  • Encourage continuous therapies and medications
• 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
• Evidence-based practice


  The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of patients
• Levels of evidence


  • 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
• Use of evidence-based practice helps to move all health care actions to a more solid, and therefore safer, scientific base
• 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
• Examples of current questions that warrant nursing investigation in the area of maternal and child health nursing


  • What is the most effective stimulus to encourage women to come for prenatal care or parents to bring children for health maintenance care?
  • How much self-care should young children be expected (or encouraged) to provide during an illness?
  • What is the effect of market-driven health care on the quality of maternal-child nursing care?
  • What active measures can nurses take to reduce the incidence of child or intimate partner abuse?
  • How can nurses best help families cope with the stress of long-term illness?
  • How can nurses help prevent violence such as homicide in communities and modify the effects of violence on families?
  • What do maternal-child health nurses need to know about alternative therapies such as herbal remedies to keep their practices current?
• Nursing theory


  Nursing theorists offer helpful ways to view clients so that nursing activities can best meet client needs
• With health promotion as a major nursing goal, teaching, counseling, supporting, and advocacy are also common roles