Trends in Pediatrics and Ped Nsg

8/6/2019 Trends in Pediatrics and Ped Nsg

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TRENDS IN PEDIATRICSTRENDS IN PEDIATRICSAND PEDIATRIC NURSINGAND PEDIATRIC NURSING


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Current statistics related to child

health Perinatal mortality rate (PMR)

late fetal and early neonatal deaths

weighing over 1000 gm at birth

PMR= --------------------------------------------- x 1000

total live birth weighing over 1000 gm at birth

PMR in India 33 / 1000 total births, (2003)Rural- 36

Urban- 20


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Risk factors of PMR:

Low socio-economic factors High or low maternal age

High parity

Short staturemother

Bad obestetrical history

Maternal malnutrition

Severe anemia

Multiple pregnancy etc


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Neonatal mortality rate

no. of deaths of children under 28 daysof age in a year

NMR = ---------------------------------------- x 1000

total live birth in the same year

NMR in India (2003)=37/1000 live birth

55-60%-within neonatal period

50%-first week of life

Neonatal deaths occurring during the neonatalperiod, ie, from birth to 28 completed days of

life.


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Common causes ofNMR

LBW

Postnatal asphyxia

Birth injury

Difficult labor Congenital anomalies

Hemolytic diseases of newborn

Conditions of placenta and cord


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Infant mortality rate (IMR)

no. of deaths of children less than 1 yr ofage in a year

IMR=------------------------------------------------x 1000

no. of live births In the same year.IMR in India (2004)=58/1000 live birth

Orissa=77, Kerala=12

The ratio of infant death registered in a given yr,

to the total no. of live birth registered in the

same yr.


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Causes of IMR

LBW

ARI

Diarrhoeal diseases Congenital malformations

Infections


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Under-five mortality rate (child

mortality rate)

Annual no. of deaths of children aged under 5

yrs, expressed as a rate per 1000 live births.

no. of deaths of children less than 5 years

of age in given year.

CMR=-------------------------------------------x1000

no. of live births in the same year.

Global CMR (2004)=79/1000live birth

India 85 / 1000 (2004), 242/1000 (1960)


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TRENDS IN MATERNAL AND CHILD

HEALTH NURSING POPULATION

CAUSES OF CHANGE:

CHANGES IN SOCIAL STRUCTURE

VARATION

S IN

FAMILY

L

IFESTYL

E INCREASED HEALTH CARE COSTS

IMPROEMENT IN MEDICAL TECHNOLOGY

CHANGING PATTERN OF ILLNESS


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Some of the social changes which

leads to alteration in h. care :-

Small family

Single parents

Working mothers

Homeless family/ mobile homes

Abuse

More health conscious. Cost of living


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TRENDS IN HEALTH CARE ENVIRONMENT

1. MANAGED CARE

FOCUS ON REDUCING THE COST OF H. CARE BY

CLOSELY MONITERING THE

COST OF PERSONNEL,

USE AND BRANDS OF SUPPLIES,

LENGTH OF HOSPITAL STAYS,

NUMBER OF PROCEDURES CARRIED OUT,

NO. OF REFERRALS REQUESTED etc.


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Under managed care the agency receives

a certain sum of amount for the clientcare, no matter how many supplies,

procedures, or personnel are used in

care. Nurses have an important role:

Use generic brand spplies,

never breaking into kits to remove

single item

Use disposable supplies.


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Effects of managed care:

Limits the no. hospital days,

Distribution of personnel

Increased accountability and responsibility ofRN

Created role of advanced practice case

managers.


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Rules to follow while delegating:

Right task for the situation

Right person to complete the task

Right communication concerning what is to be

done.

Right feedback or evaluation that the task was

completed.


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2. Alternative settings and styles for

health care. Home delivery to hospital delivery.

40% live birth occurred in hospitals by 1940and it increased to 98% by 2000.

Now more families are choosing alternativebirth settings other than hospitals.

It provided expanded roles for nsg

practitioners. Hospitals catered consumers demand by

refitting labor & delivery room envt as laborsuites and birthing room.


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Health care setting for children:

The home

Community centers Out patient clinics

Well baby clinics

Schools


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3. Strengthening the ambulatory care

system Reduce incidence of separation and it has a

positive effect in childs development.


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4. Shortening hospital days.

Treatment without requiring an

overnight stay.

Short hospital stay require intensivehealth teaching by the nurse and follow

up by the home care nurses.

Teach the parents to watch the dangersigns.


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5. Including family in the health care

setting

Open visiting hours.

Allow one parent with child.

Encourage parents to give some care.

Encourage room-in


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6. Increase in the number of intensive

care units.

Increase in no. ofNICU and PICU


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7. Regionalization of intensive care.

Regionalization


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Increased reliance on comprehesive


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Documents

Trends in Pediatrics and Ped Nsg