Copyright © 2018 by Elsevier Inc. All rights reserved.
1
HEALTH DISPARITIES
• By 2060 minority of population non-Hispanic Whites
• Other ethnic groups experience:
• Shorter life expectancy
• Higher infant and maternal mortality rates
• More birth defects
• More STIs
Copyright © 2018 by Elsevier Inc. All rights reserved.
2
HEALTH DISPARITIES (CONT.)
• Disparities linked to:
• Biologic factors
• Environment
• Socioeconomics
• Health behaviors
Copyright © 2018 by Elsevier Inc. All rights reserved.
3
INITIATIVES TO ELIMINATE
DISPARITIES
• Groups have specific initiatives
• HRSA: Health Resources and Services Administration
• NPA: National Partnership for Action to End Health Disparities
• IHI: Institute for Healthcare Improvement
• NIH: National Institutes of Health
• NINR: National Institute of Nursing Research
• CDC: Centers for Disease Control
• USDHHS: U.S. Department of Health and Human Services
Copyright © 2018 by Elsevier Inc. All rights reserved.
4
CONTEMPORARY ISSUES AND
TRENDS
• 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
Copyright © 2018 by Elsevier Inc. All rights reserved.
5
CONTEMPORARY ISSUES AND
TRENDS (CONT.)
• Millennium Development Goals
• 2030 Agenda for Sustainable Development
• 17 Sustainable Development Goals
• All relevant to childbearing and childrearing
Copyright © 2018 by Elsevier Inc. All rights reserved.
6
CONTEMPORARY ISSUES AND
TRENDS (CONT.)
• Integrative health care
• Complementary and alternative therapies
• Acupuncture
• Macrobiotics
• Herbal medicines
• Massage therapy
• Biofeedback
• Medication
• Yoga
• Chelation therapy
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7
CONTEMPORARY ISSUES AND
TRENDS (CONT.)
• Interprofessional Education
• Collaborative learning environment
• Faculty and students from two or more health professions
• Improved patient care
• 4 practice competencies
• SBAR
• TeamSTEPPS
Copyright © 2018 by Elsevier Inc. All rights reserved.
8
CONTEMPORARY ISSUES AND
TRENDS (CONT.)
• 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
• Accountable care organizations
• Health literacy
Copyright © 2018 by Elsevier Inc. All rights reserved.
9
CONTEMPORARY ISSUES AND
TRENDS (CONT.)
• Trends in fertility and birth rate
• Low birth weight and preterm birth
• International infant mortality trends
• Maternal mortality
• Maternal morbidity
• Obesity
Copyright © 2018 by Elsevier Inc. All rights reserved.
10
CONTEMPORARY ISSUES AND
TRENDS (CONT.)
• Regionalization of perinatal services
• Ambulatory prenatal care
• High technology care
• Telehealth
• Social media
Copyright © 2018 by Elsevier Inc. All rights reserved.
11
CONTEMPORARY ISSUES AND
TRENDS (CONT.)
• Community-based care
• Institution to ambulatory or home setting
• Childbirth practices
• Preconception care
• Prenatal care
• Family-centered care
• Certified Nurse Midwives
Copyright © 2018 by Elsevier Inc. All rights reserved.
12
CONTEMPORARY ISSUES AND
TRENDS (CONT.)
• Involving consumers
• Self-management
• International concerns
• Female genital mutilation
• Infabulation
• Female circumcision
• Human trafficking
Copyright © 2018 by Elsevier Inc. All rights reserved.
13
CONTEMPORARY ISSUES AND
TRENDS (CONT.)
• Women’s health
• Heart disease
• Breast cancer
• Race
• Age
• Violence
Copyright © 2018 by Elsevier Inc. All rights reserved.
14
THE FUTURE OF NURSING
• 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
Copyright © 2018 by Elsevier Inc. All rights reserved.
15
THE FUTURE OF NURSING
(CONT.)
• Trends in Nursing Practice
• Nursing specialization
• Advance practice nurses
• Nurse practitioners
• Nurse midwives
• Lactation consultants
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16
THE FUTURE OF NURSING
(CONT.)
• Nursing Interventions Classification (NIC)
• Common language
• 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)
• Quality and Safety Education for Nurses (QSEN)
Copyright © 2018 by Elsevier Inc. All rights reserved.
17
THE FUTURE OF NURSING
(CONT.)
• Outcomes oriented practice
• OASIS
• Outcome system
• NOC
• Identifies outcomes
• Global perspective
• HIV/AIDS
• Zika virus
• World Health Organization Collaborating Centers
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18
STANDARDS OF PRACTICE AND
LEGAL ISSUES
• Prevention of errors
• The Joint Commission
• “Do Not Use” list
• Sentinel events
• Unexpected outcomes involving death or serious injury
• Failure to rescue
• Evaluation of quality indicators of nursing care relative to
outcomes
Copyright © 2018 by Elsevier Inc. All rights reserved.
19
STANDARDS OF PRACTICE AND
LEGAL ISSUES (CONT.)
• Ethical issues
• Technologies
• Scientific advances
• Informed consent
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20
ETHICAL ISSUES IN PERINATAL
NURSING
• Reproductive technology
• Induced ovulation
• In vitro fertilization
• Multifetal pregnancy reduction
• Menopausal women
• A woman who is HIV positive
• Rights of the embryo
• Cloning
Copyright © 2018 by Elsevier Inc. All rights reserved.
21
ETHICAL ISSUES IN PERINATAL
NURSING (CONT.)
• 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
Copyright © 2018 by Elsevier Inc. All rights reserved.
22
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.