Chapter 1

21st Century
Maternity Nursing

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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
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Integrative health care
Complementary and alternative therapies
Acupuncture
Macrobiotics
Herbal medicines
Massage therapy
Biofeedback
Medication
Yoga
Chelation therapy
Contemporary Issues and Trends
(Cont.)
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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.)
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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.)
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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.)
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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
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Evidence-based practice
Association of Womens 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
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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
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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.)
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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
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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
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Innovations and allocation of resources
Intrauterine fetal surgery
Fetoscopy
Therapeutic insemination
Genetic engineering
Stem cell research
Surgery for infertility
Surrogate childbearing
Treatment of very lowbirth weight babies
Ethical Issues in Perinatal Nursing
(Cont.)
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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
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Question 1
To assess a mothers risk of having a lowbirth 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.
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