Maternal-Child Nursing
Nursing 264
Lynn M. Miller, RN, MSN
Framework for Maternal Newborn Nursing

Primary goal is production and maintenance of optimal family health to ensure cycles
of optimal family health to ensure cycles of optimal childbearing and childrearing.

The goals are very broad because the scope of practice is so broad.
-Preconception health care
-Care of women during 3 trimesters of pregnancy and the 6 weeks after
childbirth (puerperium).
-Care of children during the prenatal period.
-Care of children from infancy through adolescence
-Care in settings as varied as the birthing room, pediatric intensive care unit, and
the home.
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Keeping the family at the center of care delivery is an essential goal.

Family is considered the primary unit of care
Philosophies:

Family centered
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Community centered research centered

Research oriented

Nursing theory and evidence based practice

Advocate
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Independent nursing functions

Promoting health

Stress

Personal, cultural and religious attitudes and beliefs

Challenging role

Promote high level wellness in families
Standard of practice:

Promotes consistency and ensures quality nursing care

In maternal child health, standards were developed in1980 by the Division of
Maternal –Child Health Nursing Practice of the American Nurses Association

This provides guidelines for planning care and devising outcome criteria for the
evaluation of nursing care

Health Promotion

Health maintenence

Health restoration

Health rehabilitation
Steps of the Nursing Process:
-Assessment
-Nursing diagnosis
-Outcome identification
-Outcome evaluation
Evidence-Based Practice:

Involves the use of research of controlled investigation of a problem using a scientific
method in conjunction with clinical experience as acquired through experience and
practice as a foundation for action.

Nursing research is the controlled investigation of problems that have implications for
nursing practice.

This is the method by which the foundation of nursing grows, expands and improves,
thus providing evidence for practice.

Provides justification for implementing activities for outcomes achievement.

Development of a questioning attitude regarding current nursing practice and think of
ways to incorporate research findings into care.
Theory of practice

One of the requirements of a profession is that the concentration of a discipline’s
knowledge flows from a base of established theory.

Nursing theorist address:
-ways to view clients and nurses so nursing activities meet clients needs
-how nurses should viewed or what the goals of nursing care should be
-activities of nursing care
Morbidity:

Number of sick persons or cases of disease in relationship to a specific population.

Immunizations have decreased the number of childhood communicable diseases

HIV

Other infectious diseases
Mortality:

Number of deaths in infants from birth to 1 year of age per 1,000 live births.

The year 2000-6.9 per 1000

80% of women receive prenatal care
Causes- pre maturity, low birth weight, congenital anomalies, SIDS, respiratory distress
syndrome.
Standards of Care :

Nursing standards of care

Managed care

Alternative settings and styles for health care

Ambulatory care

Shortening hospital stays

Including the family in health care setting

Intensive care units

Home care

Technology
Interplay of the process:

Health care concerns and attitudes

Increased health care costs

Preventive care

Family-cantered care

Quality of life

Individuality of clients

Empowerment of health care consumers

Trends
Managed Care
-Alternative settings and styles modalities
-Comprehensive care

Advance practice roles
-Women’s health nurse practitioner
-Family Nurse practitioner
-Neonatal nurse practitioner
-Pediatric nurse practitioner
-Nurse midwife
-Clinical nurse specialist
-Case manager
Legal considerations

Care is often given to an “unseen client”

Client under the legal age for giving consent for medical procedures

Labor, delivery, and birth of a neonate are considered “normal” events

Informing clients about their rights and responsibilities
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Documentation (21 years)

Informed consent for invasive procedures and the pregnant women are aware of any
risk to the fetus

Divorce or blended families

Personal liability insurance

Legal responsibilities for reporting another practitioners incident

Failure to report can lead to a charge of negligence or breach of duty
Ethical considerations of practice :
Some of the most difficult decisions in health care involve children and their families.

Conception issues

Abortion

Fetal rights versus rights of the mother

Use of fetal tissue for research

Resuscitation

Pain

Quality of Life

Number of procedures or degree of pain a child should be ask to endure to achieve a
degree of better health

Balance between modern technology and quality of life
Legal and ethical aspects of issues are intertwined which makes the decision making
process complex.
Nurses help by providing factual information, supportive listening and clarification of the
family values