Chapter 1

21st CenturyMaternity Nursing

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Healthy People 2020 10-year national objectives 4 over arching goals 33 related to maternal, infant, and child health

United Nations Millennium Development Goals 8 goals to be achieved by 2015

Contemporary Issues and Trends

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Integrative health care Complementary and alternative therapies

• Acupuncture• Macrobiotics• Herbal medicines• Massage therapy• Biofeedback• Medication• Yoga• Chelation therapy

Contemporary Issues and Trends (Cont.)

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Problems with U.S. health care delivery system Structure of the system Reducing medical errors High cost of health care Limited access to care Health care reform Health literacy

Contemporary Issues and Trends (Cont.)

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Trends in fertility and birth rate Maternal mortality Maternal morbidity

Obesity Regionalization of perinatal services High technology care Social media

Contemporary Issues and Trends (Cont.)

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Community based care Institution to ambulatory or home setting

Childbirth practices Prenatal care Family-centered care Midwives and doulas

International concerns Involving consumers

Contemporary Issues and Trends (Cont.)

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Institute of Medicine assessment and transformation of the nursing profession Nurses should practice to the full extent of their

education and training Nurses should achieve higher levels of education Nurses should be full partners, with physicians and

other health care professionals Effective workforce planning and policy making

The Future of Nursing

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Evidence-based practice Association of Women’s Health, Obstetric and

Neonatal Nurses (AWHONN) Cochrane Pregnancy and Childbirth Database Joanna Briggs Institute A global perspective - World Health Organization

(WHO) Outcomes oriented practice

Trends in Nursing Practice

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Standards of practice in perinatal nursing American Nurses Association (ANA) AWHONN American College of Nurse-Midwives (ACNM) National Association of Neonatal Nurses (NANN)

Standards of Practice and Legal Issues

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Risk management Minimizes the risk of injury The Joint Commission reporting of sentinel events

• Unexpected outcomes involving death or serious injury Failure to rescue

• Evaluation of quality indicators of nursing care relative to outcomes

Quality and safety education for nurses (QSEN)

Standards of Practice and Legal Issues (Cont.)

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SBAR Situation background assessment recommendation

technique is a framework for communication. TeamSTEPPS

Provides an evidence-base to improve communication and teamwork skills

Teamwork and Communication

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Reproductive technology Induced ovulation In vitro fertilization Multifetal pregnancy reduction Menopausal women A woman who is HIV positive Rights of the embryo Cloning

Ethical Issues in Perinatal Nursing

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Innovations and allocation of resources Intrauterine fetal surgery Fetoscopy Therapeutic insemination Genetic engineering Stem cell research Surgery for infertility Surrogate childbearing Treatment of very low–birth weight babies

Ethical Issues in Perinatal Nursing (Cont.)

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Ethical guidelines for nursing research Must protect rights of human subjects Ensure that subjects are fully informed and aware of

rights Analysis of risks and benefits to both mother and

fetus ANA ethical guidelines in conduct,

dissemination, and implementation of nursing research

Research in Perinatal Nursing

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Question 1

To assess a mother’s risk of having a low–birth weight (LBW) infant, the most important factor for the nurse to consider is:

a. African-American race.

b. cigarette smoking.

c. poor nutritional status.

d. limited maternal education.

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