Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 1

Chapter 1Chapter 1

Contemporary Maternity Nursing and Contemporary Maternity Nursing and Women’s Health CareWomen’s Health Care

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Contemporary Issues and TrendsContemporary Issues and Trends

Problems with U.S. health care systemProblems with U.S. health care system High costHigh cost Limited accessLimited access Status of nursingStatus of nursing Integrative health careIntegrative health care Childbirth practicesChildbirth practices

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Contemporary Issues and TrendsContemporary Issues and Trends

Certified nurse-midwivesCertified nurse-midwives Family leaveFamily leave International concernsInternational concerns Health of womenHealth of women

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Contemporary Issues and TrendsContemporary Issues and Trends

Healthy People 2010Healthy People 2010 Goals Goals Trends in fertility and birth rateTrends in fertility and birth rate Number of low-birth-weight infantsNumber of low-birth-weight infants Infant mortality in the U.S.Infant mortality in the U.S. International infant mortality trendsInternational infant mortality trends Maternal mortality trendsMaternal mortality trends

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Contemporary Issues and TrendsContemporary Issues and Trends

Involving consumers and promoting self-careInvolving consumers and promoting self-care Efforts to reduce health disparitiesEfforts to reduce health disparities Health literacyHealth literacy Emphasis on high-technology careEmphasis on high-technology care Community-based careCommunity-based care Increase in high risk pregnanciesIncrease in high risk pregnancies

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Trends in Nursing PracticeTrends in Nursing Practice

Nursing Interventions Classification (NIC)Nursing Interventions Classification (NIC) Evidence-based practiceEvidence-based practice

Cochrane Pregnancy & Childbirth DatabaseCochrane Pregnancy & Childbirth Database Joanna Briggs InstituteJoanna Briggs Institute Outcomes-oriented practiceOutcomes-oriented practice Global perspectiveGlobal perspective Millennium development goalsMillennium development goals

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Standards of Practice Standards of Practice and Legal Issuesand Legal Issues

StandardsStandards ANAANA AWHONNAWHONN ACNMACNM NANNNANN

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Standards of Practice Standards of Practice and Legal Issuesand Legal Issues

Risk managementRisk management System of checks & balances to minimizeSystem of checks & balances to minimize

risk for injuryrisk for injury Sentinel eventsSentinel events Failure to rescueFailure to rescue

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Ethical Issues in Perinatal NursingEthical Issues in Perinatal Nursingand Women’s Health Care and Women’s Health Care

Reproductive technologyReproductive technology Scarce resourcesScarce resources Older age pregnanciesOlder age pregnancies Third-party payersThird-party payers Induced ovulation and in vitro fertilizationInduced ovulation and in vitro fertilization Multifetal pregnancy reductionMultifetal pregnancy reduction

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Ethical Issues in Perinatal NursingEthical Issues in Perinatal Nursingand Women’s Health Care and Women’s Health Care

Innovations and ethicsInnovations and ethics Intrauterine fetal surgeryIntrauterine fetal surgery FetoscopyFetoscopy Therapeutic inseminationTherapeutic insemination Genetic engineeringGenetic engineering Stem cell researchStem cell research Surgery for infertilitySurgery for infertility ““Test tube” babiesTest tube” babies Treatment of very low-birth-weight (VLBW) infantsTreatment of very low-birth-weight (VLBW) infants

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Research in Perinatal NursingResearch in Perinatal Nursingand Women’s Health Careand Women’s Health Care

Guidelines for ethical nursing researchGuidelines for ethical nursing research Must protect rights of human subjectsMust protect rights of human subjects Ensure that subjects are fully informed and aware Ensure that subjects are fully informed and aware

of rightsof rights Be sensitive to ethical issues in perinatal researchBe sensitive to ethical issues in perinatal research

Analysis of benefits and risksAnalysis of benefits and risks ANA ethical guidelines in conduct, dissemination, ANA ethical guidelines in conduct, dissemination,

and implementation of nursing researchand implementation of nursing research

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Key Points Key Points

Maternity nursing focuses on women and Maternity nursing focuses on women and their infants and families during the their infants and families during the childbearing cyclechildbearing cycle

Women’s health nursing focuses on the Women’s health nursing focuses on the special physical, psychologic, and social special physical, psychologic, and social needs of women throughout their life spansneeds of women throughout their life spans

Nurses caring for women can play an active Nurses caring for women can play an active role in shaping health care systemsrole in shaping health care systems

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Key Points Key Points

Childbirth practices have become more Childbirth practices have become more focused on the family and alternativesfocused on the family and alternatives

Home care cost-effective alternative site Home care cost-effective alternative site Healthy People 2010Healthy People 2010 sets goals for maternal sets goals for maternal

and infant healthand infant health Variety of factors, including race, aging, and Variety of factors, including race, aging, and

violence, affect women’s healthviolence, affect women’s health

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Key Points Key Points

Canada ranks 24Canada ranks 24thth and the U.S. ranks 27 and the U.S. ranks 27thth among industrialized nations in infant among industrialized nations in infant mortality ratesmortality rates

Evidence-based practice and outcomes Evidence-based practice and outcomes orientation emphasizedorientation emphasized

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Key Points Key Points

Ethical concerns have multiplied with Ethical concerns have multiplied with increased use of technology and scientific increased use of technology and scientific advancesadvances

Research plays vital role in establishing Research plays vital role in establishing scientific base for carescientific base for care

Integrative medicine: body, mind, spiritIntegrative medicine: body, mind, spirit Risk management and sentinel events can Risk management and sentinel events can

improve quality of careimprove quality of care