1. The Nurse's Role in a Changing Child Health Care Environment
Chapter 1

2. The Development of Pediatrics
Arthur Jacobi
Recognized as the father of pediatrics
Helped found the American Pediatric Society in 1888
Joseph Brennaman
Suggested that the infants suffered from a lack of stimulation
Ren Spitz
Coined the terms “hospitalism” and “anaclitic depression”

3. The Development of Pediatrics (cont.)
John Bowlby
Explored the subject of maternal deprivation
Revealed the negative results of the separation of child and mother due to hospitalization
Marshall Klaus and John Kennell
Carried out studies on the effect of the separation of newborns and parents
Established that early separation may have long- term effects on family relationships

4. Current Trends in Child Health Care
Regionalized care
Involves the centralization and regionalization of maternity and pediatric services
Often takes the patient and family far from home, emphasizing the importance of family- centered care

5. Advantages of Family-Centered Care
Pays attention to each child’s unique emotional development and social, scholastic, and physical needs
Helps family members alleviate fears and anxiety
Helps family members function normally
Facilitates understanding of the child’s condition and the role of family in the healing process

6. Demographic Trends Influencing the Delivery of Child Health Care
Shift in focus from the needs of women and children to those of the elderly
Growing percentage of minority populations
Poverty
Cost containment

7. Cost Containment Strategies
Prospective payment systems
Managed care
Capitation
Cost sharing
Cost shifting
Alternative delivery systems

8. Cost Containment Strategies Implemented by Nurses
Health promotion
Case management
Critical care paths

9. Types of Payment for Health Services
Private insurance
Federally funded sources
Medicaid
State Child Health Insurance Program
Specialized services

10. Child Health Today Infant health status
Child and adolescent health status

11. Addressing Child Health Status
National Commission to Prevent Infant Mortality
Healthy People 2010

12. The Nurse’s Changing Role in Child Health Care
Primary thrust of health care is toward prevention
Nurses at all levels are legally accountable for their actions
Advance practice nurses have taken a significant place in caring for childbearing and child-rearing families
Health teaching is an important aspect of promoting wellness

13. Critical Thinking
Use of clinical judgment and purposeful thought and reasoning
Nurses become more proficient and effective at meeting the needs of the patient
Based on a systemic process and used as the nurse follows the nursing process

14. Steps of the Nursing Process
Assessment
Nursing diagnosis
Outcome identification and planning
Implementation
Evaluation
Documentation

15. Types of Nursing Diagnoses
Actual nursing diagnoses
Identify existing health problems
Risk nursing diagnoses
Identify health problems to which the patient is especially vulnerable
Wellness nursing diagnoses
Identify the potential of a person, family, or community to move from one level of wellness to a higher level

16. Types of Nursing Actions
Independent nursing actions
Actions that may be performed based on the nurse’s own clinical judgment
Dependent nursing actions
Actions that the nurse performs as a result of a physician’s order
Interdependent nursing actions
Actions that the nurse must accomplish in conjunction with other health team members