Chapter 1 21st Century Maternity Nursing All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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 2 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Integrative health care  Complementary and alternative therapies Acupuncture Macrobiotics Herbal medicines Massage therapy Biofeedback Medication Yoga Chelation therapy Contemporary Issues and Trends (Cont.) 3 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

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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.) 5 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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.) 6 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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.) 7 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

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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 9 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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 10 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

11 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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 12 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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.) 13 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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 14 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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 15 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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.) 16 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 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 17 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

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. 18 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.