Lesson 1 Introduction On MCHN

Lesson 1
INTRODUCTION ON MATERNAL AND CHILD HEALTH

NURSING
Topic Outline
Learning Objectives
Introduction
Activating Prior Knowledge
Discussion of Concepts
Key Terms
A. History of Maternal and Child Health

• The Past
Course Code and Title

• The Present
• The Future
• Nursing’s Contribution to Maternal and Child Nursing
B. Maternal and Child Health Goals
C. Healthy People 2030
D. Update of Global Health Plans Concerning Maternal and Child Health Towards
COVID 19
• Global Health Goals
• The Philippine Health Goals
E. Goals and Philosophies of Maternal and Child Health Nursing
F. Major Philosophical Assumptions About Maternal and Child Health Nursing Care
G. Standard of Maternal and Child Health Nursing Practice
• QSEN: A National Standard of Nursing Care
H. Measures to Ensure Family-centered Maternal and Child Health Care
• Principles
• Nursing Interventions
I. Framework of Maternal and Child as Family-Centered Nursing
1. Nursing Process
2. Evidence-based Practice
• The Nursing Process and Critical Thinking
• Process of Critical Thinking
• The Nursing Process
• The Nursing Care Plans
3. Nursing Research
4. Nursing Theory
J. Four (4 Phases of Health Care)
K. Trends in the Maternal and Child Health Nursing Population
• Trends in Maternal and Child Health Care and Implications for Nurses
• Statistical Terms Used to Report Maternal and Child Health
• Major Causes of Death in Childhood
• Trends in Health Care Environment
• Health Care Concerns and Attitudes
• Advanced-Practice Roles for Nurses in Maternal and Child Health
L. Cultural Considerations
M. Legal Considerations of Maternal-Child Practice
N. Ethical Considerations of Practice
Summary
References
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Learning Objectives
After studying this guide, you will be able to:
1. Explain common key terms, and statistical terms use in maternal health nursing
2. Recall the contributions of person in history to the fields maternal and child health
nursing
3. Relate the global health goals with the Philippine Health goals particularly towards
Maternal and Child Health.
4. State the goals and philosophy of maternal and child health nursing
5. Recognize the evolution, scope, and professional roles for nurses in maternal and
child health nursing.
6. Recognize the implications of the common standards of maternal and child health
nursing and the health goals for the nation for maternal and child health nursing.
7. Relate the interplay of nursing process, evidence-based practice, and nursing theory as
they relate to the future of maternal and child health nursing practice.
8. Use critical thinking to identify areas of care that could benefit from additional research

or application of evidence-based practice.
9. Demonstrate concepts of family- centered care to maternal and child health nursing.
10. Demonstrate and integrate knowledge in the maternal and child health care goals,
philosophies, trends with the nursing process to achieve quality maternal and child
health nursing care.
Introduction
Maternity Nursing
The care of childbearing and childrearing families is a major focus of nursing practice,
because to have healthy adults you must have healthy children. To have healthy children, it is
important to promote the health of the childbearing woman and her family from the time before
children are born until they reach adulthood. Both preconceptual and prenatal care are essential
contributions to the health of a woman and fetus and to a family’s emotional preparation for
childbearing and childrearing. As children grow, families need continued health supervision and
support. As children reach maturity and plan for their families, a new cycle begins and new
support becomes necessary. The nurse’s role in all these phases focuses on promoting healthy
growth and development of the child and family in health and in illness.
Although the field of nursing typically divides its concerns for families during childbearing
and childrearing into two separate entities, maternity care and child health care, the full scope of
nursing practice in this area is not two separate entities, but one: maternal and child health
nursing, which includes: care of the pregnant woman, child, and family during a prenatal visit,
wherein a maternal child health nurse assesses that a pregnant woman’s uterus is expanding
normally; and, during a health maintenance visit, a maternal child health nurse assesses a child’s
growth and development.
Activating Prior Knowledge

Short Video Presentation with a Title Celebrating Maternal and Child Health nurses
Improving
https://www.youtube.com/watch?v=RDuOmJco9c4&t=23s
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Discussion of Key Concepts
Key Terms
Clinical nurse specialists (CNS)

Evidence-based practice (EBP)
Family nurse practitioner (FNP)
Fertility rate
Maternal and Child Health Nursing
Mortality Rate
Neonatal Nurse Practitioner
Nurse-midwife
Nursing research
Pediatric nurse practitioner
Standard of Practice
Scope of Practice

Nursing Intervention
Nursing Diagnosis
Nursing Activity
Patient
Maternity – is the period in which a woman is pregnant or has just given birth to a child. for
mothers during and after childbirth or for the care of their newborn babies.
Nursing- According to the International Council for Nurses, 2002(ICN,2002), nursing

encompasses autonomous and collaborative care of individuals of all ages, families, groups and
communities, sick or well and in all settings.
- Nursing includes the promotion of health, prevention of illness, and the
care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research,
participation in shaping health policy and in patient and health systems management, and
education are also key nursing roles.
Maternity Nursing involves care of childbearing women & their families.
− According to American Nurses Association (ANA), MCHN is a specialized area of
nursing focused on the health needs and identifiable response of women, their
partners, and families to real or potential health problems associated with
childbearing and childrearing.
− Maternal and Child Health Nursing emphasizes health promotion and prevention of
disease.
Nurses- or Nurses practitioners, and nurse-midwives are the providers of care to women during
the prenatal period, and teach classes to help women families get ready for childbirth.
o Nurses care for childbearing families during labor, and birth in hospitals, in birthing center,
and in the home.
o Nurses with special training provides intensive care for high risk neonates in special care
units and high risk mothers in antepartum unit, critical care obstetric units, or at home.
o Maternity Nurses teach about pregnancy; the labor, birth, and, recovery process;
parenting skills; they provide continuity of care throughout the childbearing cycle –
(Antepartum/Prenatal, Intrapartal, Post-partal/Puerperium Periods).
Furthermore, the word obstetrics is derived from the Latin term obstetrix, which means
“stand by”. It is the branch of medicine that pertains to the care of women during pregnancy,
childbirth, and the postpartum period (puerperium). Maternity nursing is the care given by the
nurse to the expectant family before, during, and following birth.
Obstetrican, a physician specializing in the care of women, during pregnancy, labor,
birth, and the postpartum period
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Pediatrics is defined as the branch of medicine that deals with the child’s development
and care and the disease of childhood and their treatment. The word derived from the Greek
word pais, paidos meaning “child”, and iatria, meaning “cure”.
Family-centered recognizes the strength and integrity of the family and places it at the
core of planning and implementing health care. The family members as caregivers and decisions
makers are an integral part of both obstetric and pediatric nursing. The philosophy, goals,
culture, and ethic practices of the family contribute to their ability to accept and maintain control
over the health care of family members. This control is called empowerment. The nurse’s role in
maternity and pediatric family-centered care is to enter a contract or partnership with the family
to achieve the goals of health for its members.
With the decline of the Roman Empire and the ensuring Dark Ages, scientific exploration
and associated medical improvement came to a halt. During the 19 th century, however, Karl
Crede (1819-1892)
A. History Maternal and Child Health

• The Past
a. Obstetrics

The skill and related to obstetrics have evolved over centuries. The earliest concerning
childbirth are in the Egyptian (circa 1550 BC). Soranus, a Greek physician who practiced in
Rome in the 2nd century and who is known as the father of obstetrics, made later advances.
He instituted the practice of pediatric version, a procedure used to rotate a fetus to a breech
or feet-first, position. Podalic version, is important in the vaginal delivery of the second
infant in a set of twins. In this procedure, the physician reaches into the uterus and grasp
one or both of the infant’s feet to facilitate delivery. Planned cesarean birth is used today, as
it is safer than pediatric version.
With the decline of the Roman Empire and the ensuring Dark Ages, scientific exploration
and associated medical improvement came to a halt. During the 19 th century, however, Karl
Crede (1819-1892) and Ignaz Semmelweis (1818-1865) made contributions that improved
the safety and the health of mother and child during and after childbirth. In 1884 Crede’
recommended instilling 2% sliver nitrate into the eyes of newborns to prevent blindness
caused by gonorrhea Crede’s innovation has saved the eyesight of incalculable member s of
babies.
Semmelwels’ story is a classic in the history of maternity care. In the 1840s, he worked
as an assistant professor in the maternity ward of the Vienna general hospital. There he
discovered a relationship between the incidence of puerperal fever (or “childbed fever”),
which caused many deaths among women in lying-in wards, and the examination of new
mothers by student doctors who had just returned from dissecting cadavers. Semmelweis
deduced the puerperal fever was septic, contagious and transmitted by the unwashed hands
of physicians and medical students. Semmelweis’ outstanding work, written in 1861, is titled
The Causes, Understanding and Prevention of Childbed Fever. Tragically, his teaching was
not finally accepted until 1890.
Louis Pasteur (1822-1895), a French chemist, confirmed the puerperal fevr was caused
by bacteria and could be spread by improper hand washing and control with contaminated
objects. The simple, but highly effective, procedure of hand washing continues to be one of
the most important means of preventing the spread of infection in the hospital and the home
today.
Joseph Lister (1827-1912), a British surgeon influenced by Pasteur, experimented with
chemical means of preventing infection. He revolutionized surgical practice by introducing
antiseptic surgery.
b. Pediatrics
Methods of child care have varied throughout history. The culture of a society has a
strong influence on standards of child care. Many primitive tribes were nomads. Strong
children survived, whereas the weak were left to die. This practice of infanticide (French and
Latin infans, “infant” and caedere, “to kill”) helped to ensure the safety of the group. As
tribes became settled, more attention was given to children, but they were still frequently
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valued only for their productivity. Certain peoples, such as the Egyptians and the Greeks,
were advanced to their attitudes. The Greek physician Hippocrates (460-370BC) wrote about
illnesses peculiar to children.
In the Middle Ages, the concept of childhood did not exist. Infancy lasted until about age
7 years at which time the child was assimilated into the adult world. The art of the time
depicts children wearing adult clothes and wigs. Christianity has a considerable impact on
child care. In the early 17th century, Saint Vincent de Paul founded several children’s
asylums. Many of these eventually became hospitals, although their original concern was for
abandoned children. The first children’s hospital was founded in Paris in 1802. In the United
States, the Children’s aid Society, founded in New York City 1853, cared for numerous
homeless children. In 1855, the first pediatric hospital in the United States, Children’s
Hospital of Philadelphia, was founded.
Abraham Jacobi (1830-1919) is known as the father of pediatrics because of his many
contributions to the field. The establishment of pediatric nursing as a specialty paralleled the
establishment of departments of pediatrics in medical schools, the founding of the children’s
hospitals, and the development of separate units for children in foundling homes and general
hospitals. By the 1960’s separate pediatric unit were also common in hospitals Parents were

restricted by rigid visiting hours that allowed parent-infant contact for only a few hours each
day, when medically indicated, nursing mothers were allowed to enter the pediatric unity for
1 hour at a time to breastfeeds their infants.
• The Present
A family- centered childbearing, the family is recognized as a unique system.
Every family member is affected by the birth of a child, therefore family involvement during
pregnancy and birth is seen as constructive and necessary for bonding and support. To
accommodate family needs, alternative birth centers, birthing rooms, rooming-in units, and
mother-infant coupling have been developed. These arrangements are alternatives to the
previous standard of separate areas for labor and delivery, which made it necessary to
transport a mother from one area to another and fragmented her care.
The three separate sections of the maternity unit-labor/delivery, postpartum and
newborn nursery- have merged. The whole sequence of events may take place in one suite
of labor, delivery, and recovery (LDR) rooms. The patient is not moved from one area to
another, but received care during labor and delivery in one room and then remains in the
same room to recover and care for her new infant. These rooms are often decorated to look
homelike.
Freestanding birthing centers outside the traditional hospital setting are popular with low-
risk maternity patients. These birthing centers provide comprehensive care including
antepartum, labor/delivery, postpartum, mothers’ classes, lactation classes, and follow-up
family planning. Home birth using midwives is not currently a widespread practice because
malpractice insurance is expensive and emergency equipment for unexpected complications
is not available.
• The Future
The revolution in health care involves the conflict between cost containment and
quality of care. When health care became a profitable business industry, cost containment
and managed care were born. Managed care openly and continuously evaluates care given
and can result in increased quality. Quality assurance committee are investigating the
routine management of patients, especially in the area of preventive care and test.
The federal government enacted health care reform plans in 2010 and 2017 to
attempt to reduce the cost of health care in the United States, while making it more
accessible to all people. Access to care also depends on the availability of resources within a
community. Health insurance has played an important role in health care delivery. Having
health insurance does not necessarily ensure access to care because the insurance company
often must approve (or deny) the expenditure before a test or care is provided. Historically,
families that could not afford health insurance often did not seek preventive health care such
as prenatal care, infant immunizations, and well-baby check-ups. The ACA of 2010 facilitated
access to health that was previously unavailable for preventive care and follow-us. The
United States spends thousands of dollars per person annually on the health care, in contrast
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to Somalia, which spends $33 per person (blink, 2016), but some believe that waste and
inefficiencies block goals of lower cost and increased accessibility to preventive and
therapeutic care for all. Future reforms and re- modelling of the US health care system
continue to be proposed. Nurses are involved as patient advocates in the health care reform
movement to ensure quality care.
Nursing’s Contribution to Maternal and Child Health

Florence Nightingale, the founder of modern nursing, was called to the Crimean War in
1854 by the British Secretary of War in 1854 by the British Secretary of War task was to
improve the conditions of the British soldier. Within 6 months, Nightingale and her group of
nurses lowered the hospital mortality rate from 42% to 2%. Her establishment of sanitary
measures, nutrition guidelines, and exercise programs formed the historical basis for
nursing’s current role in health promotion (Novak), 1988). She emphasized putting the
soldier in the best possible condition for nature to act on him. Nightingale’s success during
the Crimean War gave her further credibility in developing programs for mothers and
children. She emphasized the importance of teaching mothers in the home and discussed
accurate characteristics of child development decades before the field had been established

(Novak, 1988).
In the United States, nurses have a strong, history of influencing the health of families
and children. Visiting nursing (later known as public health nursing) began its development
in Philadelphia in 1839. The same year, two nurses, Lilian Wald and Mary Brewster,
established the Women’s Branch of the New York City Mission to care for indigent families. In
1892, demand for their services resulted in a move. To larger quarters, which became known
as the Henry Street Settlement House. By 1902 the Henry Street staff numbered 37 nurses
who conducted infant immunization clinics, performed case findings, and provided health
promotion education to families. In, 1912, at Wald’s suggestion, the American Red Cross
established a rural nursing service to provide nurses to care for the sick and to give
instruction in sanitation and hygiene in the home of people living in rural areas (Kalisch and
Kalisch, 1986).
Lilian Wald was also instrumental in the development of school nursing. In 1902,
concerned about the extensive absenteeism of children because of illness, she offered one of
the Henry Street nurses to serve as a school nurse for 1 month. The experiment was a
success, and the New York Board of Health son appointed dozens of school nurses to assist
in schools (Kalisch, and Kalisch, 1986).
In 1910, nurse Margaret Sanger began her fight for the right of families to limit their size,
the rights of women to health care and personal choice, and the rights of children to be loved
and wanted (Sanger, 1922). In 1916, Sanger organized the Planned parenthood foundation
of America, which established hundreds of family planning centers throughout the United
States.
Nurse midwifery began in the United States in the 1930’s. In 1925, Mary Breckenridge, a
nurse midwife, organized the frontier Nursing Service in rural southeastern Kentucky.
Because no quality nurse midwifery until the 1930’s, the early nurse midwives received their
training in England and Scotland. The Frontier Nursing Service began training public health
nurses in midwifery in 1932. Nurse midwives from these programs gave prenatal, labor, and
deliver, and postpartum care provided child-health visits to the urban and rural (Varney,
1987). Nurse midwives continue to provide such care to low-income families throughout the
United States. Over the last decade a growing number of health maintenance organizations
(HMO’s) have established nurse midwifery services that provide care to childbearing families.
B. Maternal and Child Health Goals
Currently, the world is facing a global health crisis unlike any other, COVID-19 is
spreading human suffering, destabilizing the global economy and upending the lives of
billions of people around the globe.
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Before the pandemic, major progress was made in improving the health of millions of
people. Significant strides were made in increasing the life expectancy and reducing some of
the common killers associated with child and maternal mortality. Though more efforts are
needed to fully eradicate a wide range of diseases, specifically address many different
persistent and emerging health issues concerning maternal and child. By focusing on
providing more efficient funding or health systems, improved sanitation and hygiene and
increased access to physician, significant progress can be made in helping to save the lives
of millions.
Health emergencies such as COVID-19 pose a global risk and have shown the critical
need for preparedness. The United Nations Development Program highlighted huge
disparities in countries’ abilities to cope with and recover from the COVID-19 crisis. The
pandemic provides a watershed moment for health emergency preparedness and for
investment in critical 21st century public services.
C. Healthy People 2030

Healthy People 2030 updates the previous decade’s statement of national health
promotion and disease prevention objectives facilitated by the federal government (US
Department of Health and Human Services, 2016). The report identifies objectives designed
to use the vast knowledge and technology of health care that was developed in the 20th
century to improve the health and quality of life for Americans in the 21 st century. The
objectives fall under broad categories of effort; health promotion, health protection,
preventive care for all Americans. Some priority areas include maternal and infant health,
immunizations, prevention of sexually transmitted infections, oral health, nutrition, and
physical fitness. It is a “vision for the new century”, to achieve a nation of healthy people.
The Healthy People 2010 gal of reducing the maternal mortality of 3.3 per 100,000 was not
achieve, as the maternal mortality rate was 17.8 per 100,000 in 2011, CDC 2017). More
coordination and effort are needed to achieve this goal by 2030.
D. Update of Global Health Plans concerning Maternal and Child Health Towards
COVID 19
Strategic Preparedness and Response Plan

The World Health Organization (WHO) have been leading the global effort to tackle
COVID-19, and together with partners, outlines the health public health measures that
countries should take to prepare for and respond to COVID-19produces the strategic plan.
The strategy Update of April 2020 provides further guidance for the public health response to
the COVID-19 at national and subnational levels, and highlights the coordinated support that
is required from the international community to meet the challenges of Covid-19.
Global Health Goals
Though the pandemic is an unprecedented wake-up call, disrupting and exposing failures
that are addressed in the 2030 Agenda for sustainable development. The World Health
Organization (WHO) and United Nations (UN) 2030 steps steer the world back on track
towards the Sustainable Development Goals for a recovery that leads to the improvement of
health worldwide. As with 2030 Health Goals concentrate in further improvement of women
and children because increasing the health of these two population have a long-range effects
on the general health(WHO,2015). These 2030 Global Health Goals to address maternal and
child health;
• Reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
• End preventable deaths of newborns and children under 5 years of age, with all
countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live
births and under-5 mortality to at least as low as 25 per 1,000 live births.
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• End the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and
combat hepatitis, water-borne diseases and other communicable diseases.
• Reduce by one third premature mortality from non-communicable diseases through
prevention and treatment and promote mental health and well-being.
• Strengthen the prevention and treatment of substance abuse, including narcotic drug
abuse and harmful use of alcohol.
• Ensure universal access to sexual and reproductive health-care services, including for
family planning, information and education, and the integration of reproductive health
into national strategies and programs.
• Achieve universal health coverage, including financial risk protection, access to quality
essential health-care services and access to safe, effective, quality and affordable
essential medicines and vaccines for all.
• Substantially reduce the number of deaths and illnesses from hazardous chemicals
and air, water and soil pollution and contamination.
• Strengthen the implementation of the World Health Organization Framework
Convention on Tobacco Control in all countries, as appropriate.
• Support the research and development of vaccines and medicines for the

communicable and noncommunicable diseases that primarily affect developing
countries, provide access to affordable essential medicines and vaccines, in
accordance with the Doha Declaration on the TRIPS Agreement and Public Health,
which affirms the right of developing countries to use to the full the provisions in the
Agreement on Trade Related Aspects of Intellectual Property Rights regarding
flexibilities to protect public health, and, in particular, provide access to medicines for
all.
• Substantially increase health financing and the recruitment, development, training
and retention of the health workforce in developing countries, especially in least
developed countries and small island developing States.
• Strengthen the capacity of all countries, in particular developing countries, for early
warning, risk reduction and management of national and global health risks.
The goal is committed to end poverty, protect the planet and all people enjoy peace and
prosperity.
The Philippine Health Goals
The goal of the Philippine Strategy for Sustainable Development (PSSD) is to achieve
economic growth with adequate protection of the country's biological resources and its
diversity, vital ecosystem functions, and overall environmental quality. The PSSD has for its
core a number of implementing strategies. This is aimed at resolving and reconciling the
diverse and sometimes conflicting environmental, demographic, economic and natural
resource use issues arising from the country development efforts. The strategies are: 1)
integration of environmental considerations in decision-making; 2) proper pricing of natural
resources; 3) property rights reform; 4) establishment of an integrated protected areas
system; 5) rehabilitation of degraded ecosystems; 6) strengthening of residuals
management in industry (pollution control); 7)integration of population concerns and social
welfare in development planning; 8) inducing growth in rural areas; 9) promotion of
environmental education; and 10) strengthening of citizen's participation and constituency
building.
E. Goals and Philosophies of Maternal and Child Health Nursing

The primary goal of maternal and child health nursing care can be stated simply as the
promotion and maintenance of optimal family health to ensure cycles of optimal childbearing
and childrearing. The goals of maternal and child health nursing care are broad because the
scope of practice is so broad. The range of practice includes;
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• Preconceptual health care
• Care of women during three trimesters of pregnancy
and the puerperium (the 6 weeks after childbirth, sometimes termed the fourth
trimester of pregnancy)
• Care of children during the perinatal period (6 weeks
before conception to 6 weeks after birth)
• Care of children from birth through adolescence
• Care in settings as varied as the birthing room, the pediatric intensive care unit, and
the home
F. Major philosophical assumptions about maternal and child health nursing are:
1. Maternal and child health nursing is family- centered; assessment data must include a
family and individual assessment.
2. Maternal and child health nursing is community- centered; the health of families
depends on and influences the health of communities.
3. Maternal and child health nursing is research- oriented, because research is the
means whereby critical knowledge increases.

4. Both nursing theory and evidence-based practice provide a foundation for nursing
care.
5. A maternal and child health nurse serves as an advocate to protect the rights of all
family members, including the fetus.
6. Maternal and child health nursing includes a high degree of independent nursing
functions, because teaching and counseling are so frequently required.
7. Promoting health is an important nursing role, because this protects the health of the
next generation.
8. Pregnancy or childhood illness can be stressful and can alter family life in both subtle
and extensive ways.
9. Personal, cultural, and religious attitudes and beliefs influence the meaning of illness
and its impact on the family. Circumstances such as illness or pregnancy are
meaningful only in the context of a total life.
10. Maternal and child health nursing is a challenging role for a nurse and is a major
factor in promoting high-level wellness in families.
G. Standards of Maternal and Child Health Nursing Practice
Keeping the family at the center of care delivery is an essential goal. Maternal and child
health nursing is always family -centered; the family is considered the primary unit of care. The
level of family functioning affects the health status of individuals, because if the family’s level of
functioning is low, the emotional, physical, and social health and potential of individuals in that
family can be adversely affected. A healthy family, on the other hand, establishes an environment
conducive to growth and health-promoting behaviors that sustain family members during crises.
Similarly, the health of an individual and his or her ability to function strongly influences the health
of family members and overall family functioning. For these reasons, a family-centered approach
enables nurses to better understand individuals and, in turn, to provide holistic care.
QSEN: A national Standard of Nursing Care

Quality and Safety Education for Nurses (QSEN), a project established in 2005, is
designed to assure that all nurses have knowledge, skills and attitudes (KSAs)necessary
to improve the quality and safety of the health care system (QSEN, 2011).
1. Client-centered care. The patient or designee is thought of as the source of
control and full partner in the provision of compassionate and coordinated care
based on respect for the patient’s preferences, values and needs.
Knowledge: Taking clients detailed admission history; including family’s
composition, and documenting the roles of family members and who will be the
chief childcare provider.
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Skills. Provide health education by encouraging client’s family support towards
client care.
Attitude. Consider client decision, respect and consider their responses
2. Teamwork and Collaboration. Nurses function effectively within nursing and
interprofessional teams, fostering open communication, mutual respect, and
shared decision making as they achieve quality patient care.
Knowledge. Nurses function effectively within nursing and inter professor teams,
fostering open communication, mutual respect and shared decision making as they
achieve quality patient care.
Skills. Discuss and collaborate with other member of the healthcare team to
effectively perform client-centered care.
Attitude. Consider and respect patient as integrative member of health care team.
3. Evidence-based Practice. Nurses integrate the best current evidence with
clinical expertise and patient/family preferences and values for delivery of optimal
health care.
Knowledge. Read journal articles related to new evidence about health of client,
and family’s health to be better prepared to help client seamiessly transition from

one setting to the next.
Skills. Implement evidence-based practice so client and family are confident that
care is based on credible research.
Attitude. Value the need for change based on new evidence to confidently perform
nursing care.
4. Quality Improvement. Nurses use data to monitor the outcomes of care and use
improvement methods to design and test changes to continuously improve the
quality and safety of health care system.
Knowledge. View Quality Improvement (QI) as an important role for all health care
professionals beginning with prelicensure students.
Skills. Use of aids such as checklists, flow sheets, or patient information forms,
necessary in order to provide seamless nursing care from nursery admission to
home.
Attitude. Appreciate continuous QI is an essential part of successful working with
and respecting families.
5. Safety. Nurses minimize the risk of harm to patients and providers through both
system effectiveness and individual performance.
Knowledge. Learn the requirements for a safe health care setting for a vulnerable
clients.
Skills. Being certain client receives developmental stimuli as well as is cared for in
an environment that promotes a sense of security and is as free from pain as
possible.
Attitude. Recognizes client and family are under stress do not “hear” instructions
well and so may need these repeated or provided in a written form as well as orally.
6. Informatics. Nurses use information and technology to communicate, manage
knowledge, mitigate error, and support decision making.
Knowledge. Keep records and documentation current so various health care
providers can keep informed in order to provide seamless care shifts and setting
shifts in care.
Skills. Document care in an electronic health record so it can be available to various
health care providers.
Attitude. Recognize that documentation must be complete to be complete to be
valuable in audit reviews, what wasn’t documented as being done is considered as
not done.
H. Measures to Ensure Family-Centered Maternal and Child Health Care
Principles
a. The family is the basic unit of society.
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b. Families represent racial, ethnic, cultural, and socioeconomic diversity.
c. Children grow both individually and as part of a family.
Nursing Interventions
a. Consider the family as a whole as well as its individual members.
b. Encourage families to reach out to their community so that family members are not
isolated from their community or from each other.
c. Encourage family bonding through rooming-in in both maternal and child health hospital
settings.
d. Participate in early hospital discharge programs to reunite families as soon as possible.
e. Encourage family and sibling visits in the hospital to promote family contacts.
f. Assess families for strengths as well as specific needs or challenges.
g. Respect diversity in families as a unique quality of that family.
h. Encourage families to give care to a newborn or ill child.
i. Include developmental stimulation in nursing care.
j. Share or initiate information on health planning

I. Framework of Maternal and Child Health Nursing Care
1. Nursing Process
According to Carpenito (2004), Nursing care, is designed and implemented in a thorough
manner, using an organized series of steps, to ensure quality and consistency of care. The
nursing process, is a proven form of problem solving based on the scientific method, serves
as the basis for assessing, making a nursing diagnosis, planning, organizing, and evaluating
care. That the nursing process is applicable to all health care settings, from the prenatal clinic
to the pediatric intensive care unit, is proof that the method is broad enough to serve as the
basis for all nursing care.
2. Evidence-Based Practice
Evidence-based practice involves the use of research or controlled investigation of a
problem in conjunction with clinical expertise as a foundation for action. Bodies of professional
knowledge grow and expand to the extent that people in that profession plan and carry out
research.
Evidence-based practice starts when the nurses uses the best evidence obtained from
current, valid, published research. When the nurse combines that information with his or her
critical thinking process, experiences, and patient’s needs, the nurse I able to plan safe,
effective nursing care for the patient.
Critical thinking organizes the approach to discovery and involves the reflection and
integration of information that enables the nurse to arrive at a conclusion or make a judgment.
An example of critical thinking would modifying the steps in a clinical procedure or skills so
that the individual patient’s needs are met but the basic principles of the skills are not violated
(e.g. sterile technique). With critical thinking, problem solving is effective, and problem
prevention occurs. General thinking can occur naturally, but critical thinking is a skill that must
be learned. Critical thinking can improve can improved the care nurses give to patients,
improve test scores (through critical thinking about a scenario in the question), and improve
working conditions by enabling the nurse to analyze and find creative ways to improve existing
policies and practices
The Nursing Process and Critical Thinking

The nursing process (assessment, diagnosis, outcomes identification, planning,
implementation and evaluation) is a tool for effective critical thinking. When the nurse uses
nursing process in critical thinking, a clinical judgment can be made that is specific to data
collected and the clinical situation. In every clinical contract, a nurse must identify actual and
potential problems and make decisions about a plan of action that will result in a positive
patient outcome, know why the actions are appropriate, differentiate between the problems
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that the nurse can handle independently and problems that necessitate contacting other
members of the health care team, and prioritize actions.
Process of Critical Thinking

1. Identify the problem.
2. Differentiate fact from assumption.
3. Check reliability and accuracy off data
4. Distinguish relevant from irrelevant.
5. Identify possible conclusions or outcomes.
6. Set priorities and goals.
7. Evaluate response of the patient.
The Nursing Process

The nursing process was developed in 1963. This term referred to a series of steps
describing the systematic problem-solving approach nurses used to identify, prevent, or
treat actual or potential health problems. In 1973, the ANA developed standards relating
to the nursing process that have been nationally accepted and include the following:

a. Assessment: Collection of patient data, both subjective and objective.
b. Diagnosis: Examination of data in terms of nursing needs of the individual patient
or family that can be managed by nursing knowledge, skills and action
interventions.
c. Planning. Preparation of a plan of nursing care designed to achieve stated
outcomes.
d. Outcome identification. Identification of individualized expected patient
outcomes.
e. Implementation. Carrying out of nursing interventions identified in the plan of
care.
f. Evaluation. Evaluation of outcome progress and redesigning of the plan if
necessary.
The nursing process is a framework of action designed to meet the individual needs of
patients. If a problem-oriented and goal-directed and involves the use of critical thinking, problem-
solving and decision making. The nursing process is expressed I an individualized nursing care
plan.
Nursing Care Plans

The Nursing care plan is developed as a result of the nursing process. It is a written
communication among staff members that focuses on individualized patient care.
A nursing care plan is a “picture” of a typical clinical situation that may be encountered
by the nurse. Specific data concerning the patient are obtained. These data can be used as clues
to solve the mystery or problems of the patient (this phase is called collection). These clues help
the nurse identify the problems of the patient. By organizing all the clues and identifying several
problems, the nurse then prioritizes the problems identified. This phase of care planning is called
nursing diagnosis. When the priority is identified, the nurse can used knowledge, skills, and
resources such as textbooks, journals, or the internet to decide on a plan of action to solve the
identified problem. This phase is called planning. The actual nursing activities necessary to solve
the problem are called nursing interventions. The nursing interventions are planned with
specific outcome or goals in mind. An outcome or goal is the positive resolution of the patient’s
problem. The nursing interventions are basis of the nursing or bedside care provided to the patient.
After the nursing care is provided, the nurse reevaluates the original problem to determine
whether the goal was met or the outcome achieved. If goals have not been met, the nurse
suggests revision of interventions.
Steps in Preparing Nursing Care Plan

1. Collect data from chart, medical order sheet, laboratory reports, history and
physical examination, progress notes, and so on.
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2. Review medical diagnosis of patient.
3. Collect patient data and interview patient
4. Determine appropriate nursing diagnosis and note the etiology and the evidence to
related each choice.
5. Select measurable nursing goals for patient care. Identify nursing
actions/interventions that will assist in meeting goals/outcomes of planned nursing
care.
6. Evaluate outcomes; revise care planned care
3. Nursing Research
Nursing research is a controlled investigation of problems that have implications for nursing
practice, provides evidence for practice, upon which the foundation of nursing grows, expands,
and improves. In addition, evidence- based practice provides the justification for implementing
activities for outcome achievement, ultimately resulting in improved and cost-effective patient
care.
4. Nursing Theory
Theory is integral to the research process where it is important to use theory as a framework
to provide perspective and guidance to the research study. Theory in the maternal and child health

nursing primary purpose is to improve the nursing practice by positively influence the health and
quality of life of the childbearing and childrearing family.
Both Nursing theory and evidenced-based practice provide a foundation for nursing care.
A maternal and child health nurse serves as an advocate to protect the rights of all family
members, including the fetus.
J. Four (4) Phases of Health Care

1. Health Promotion - Educating clients to be aware of good health through teaching and
role modeling.
Example: Teaching women the importance of rubella immunization before pregnancy;
teaching children the importance of safer sex practices..
2. Health Maintenance - Intervening to maintain health when risk of illness is present
Example: Encouraging women to come for prenatal care; teaching parents the
importance of safeguarding their home by childproofing it against poisoning
3. Health Restoration- Promptly diagnosing and treating illness using interventions that
will return client to wellness most rapidly
Example: Caring for a woman during a complication of pregnancy or a child during an
acute illness
4. Health Rehabilitation- Preventing further complications from an illness; bringing ill
client back to optimal state of wellness or helping client to accept inevitable death.
Example: Encouraging a woman with gestational trophoblastic disease to continue therapy
or a child with a renal transplant to continue to take necessary medications
K. Trends in the Maternal and Child Health Nursing Population
The maternal and child population is constantly changing because of changes in social
structure, variations in family lifestyle, and changing patterns of illness. Over the past 20 to 30
years, social changes have occurred that have altered health care priorities for maternal and child
health nurses. Today, client advocacy a philosophy of cost containment, an increased focus on
health education, and new nursing roles are ways in which nurses have adapted to these changes.
Trends in Maternal and Child Health Care and Implications for Nurses
1. Families are smaller than in previous decades
Fewer family members are present as support in a time of crisis. Nurses must fulfill
this role more than ever before.
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2. Single parents are increasing in number.
A single parent may have fewer financial resources; this is more likely if the parent is
a woman. Nurses need to inform parents of care options and to provide a backup opinion
when needed.
3. An increasing number of women work outside the home.

Health care must be scheduled at times a working parent can bring a child for care.
Problems of latch-key children and the selection of child care centers need to be discussed
4. Families are more mobile than previously; there is an increase in the number of
homeless women and children.
Good interviewing is necessary with mobile families so a health database can be
established; education for health monitoring is important.
5. Abuse is more common than ever before.

• Screening for child or intimate partner abuse should be included in family
contacts. Be aware of the legal responsibilities for reporting abuse.

6. Families are more health-conscious than previously.
Families are ripe for health education; providing this can be a major nursing role.
7. Health care must respect cost containment.

Comprehensive care is necessary in primary care settings because referral to specialists
may no longer be an option.
L. Measuring Maternal and Child Health Statistical Terms Used to Report Maternal and
Child Health
Statistics refers to the process of gathering and analyzing numerical data. Statistical
concerning birth, illness (morbidity) provide valuable information for determining or projecting
the needs of a population or subgroup and for predicting trends. In the United States, vital
statistics are compiled for the country as a whole by the National Center for Health Statistics and
are published in the Center for Disease Control and Prevention (CDC) annual report, Vital
Statistics of the United States, and in the pamphlet Morbidity and Mortality Weekly Report
(MMWR). Each state’s bureau of vital statistics issues statistics as well. Other independent
agencies also supply statistics regarding various specialties.
A maternity nurse may use statistical data to observe reproductive trends, determine
populations at risk, evaluate the quality of prenatal care, or compare relevant information from
state to state and country to country.
Measuring maternal and child health is not as simple as defining a client as ill or well.
Individual clients and health care practitioners may have different perspectives on illness and
wellness. For example, some children with chronic but controllable asthma think of themselves as
well; others with the same degree of involvement consider themselves ill. Although pregnancy is
generally considered a well state, some women think of themselves as ill during this period. A
more objective view of health is provided by national health statistics.
Number of statistical terms are used to express the outcome of pregnancies and births and
to describe maternal child health. Statistics for these terms require accurate collection and analysis
so that the nation’s health can be described accurately. Such statistics are useful for comparisons
among states and for planning of future health care needs.
Statistical Terms Used to Report Maternal and Child Health

1. Birth rate: The number of births per 1,000 population.
2. Fertility rate: The number of pregnancies per 1,000 women of childbearing age.
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Fertility rate reflects what proportion of women who could have babies are having
−
them.
3. Fetal death rate: The number of fetal deaths (over 500 g) per 1,000 live births.
− Fetal death is defined as the death in utero of a child (fetus) weighing 500 g or
more, roughly the weight of a fetus of 20 weeks’ or more gestation.
− Fetal death rate is important in evaluating the health of a nation because it reflects
the overall quality of maternal health and prenatal care
− Causes of Fetal death: Maternal factors such as maternal disease, premature
cervical dilation, maternal malnutrition or fetal factors like fetal disease,
chromosome abnormality, poor placental attachment.
4. Neonatal death rate: The number of deaths per 1,000 live births occurring at birth or in
the first 28 days of life.
− Neonatal death rate reflects not only the quality of care available to women during
pregnancy and childbirth but also the quality of care available to infants during the
first month of life.
− Leading causes of neonatal death during the first 4 weeks of life are prematurity
(early gestational age), low birthweight (less than 2,500 g), and congenital

anomalies.
5. Perinatal death rate: The number of deaths of fetuses more than 500 g and in the first
28 days of life per 1,000 live births.
− The period is defined as the time beginning when the fetus reaches 500 g (about
week 20 of pregnancy) and ending about 4 to 6 weeks after birth.
− The perinatal death rate is the sum of the fetal and neonatal rates.
6. Maternal mortality rate: The number of maternal deaths per 100,000 live births that
occur as a direct result of the reproductive process.
7. Infant mortality rate: The number of deaths per 1,000 live births occurring at birth or
in the first 12 months of life.
− Infant Mortality Rate is an index of the country’s general health, because it measures
the quality of pregnancy care, nutrition, and sanitation as well as infant health.
− This rate is the traditional standard used to compare the state of national health care
with that of previous years or of other countries.
8. Childhood mortality rate: The number of deaths per 1,000 population in children, 1 to
14 years of age.
Major Causes of Death in Childhood
Under 1 Year
• Congenital malformations, chromosomal abnormalities

• Disorders related to short gestation age and low birthweight
• Sudden infant death syndrome
• Newborn affected by maternal complications of pregnancy
• Newborn affected by complications of placenta, cord, or membranes
• Unintentional injuries
• Respiratory distress of newborn Bacterial sepsis of newborn
• Diseases of the circulatory system
• Intrauterine hypoxia and birth asphyxia
1–4 Years
• Congenital malformations, chromosomal abnormalities Homicide
• Malignant neoplasms
• Diseases of the heart
• Influenza and pneumonia
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• Septicemia
• Chronic lower respiratory tract diseases
• Disorders originating in the perinatal period Benign neoplasms
5–14 Years
• Malignant neoplasms
• Congenital malformations, chromosomal abnormalities Homicide
• Suicide
• Chronic lower respiratory tract diseases
• Septicemia
• Cerebrovascular accident
• Influenza and pneumonia
15–24 Years

• Homicide
• Suicide
• Malignant neoplasm
• Congenital malformations, chromosomal abnormalities Chronic lower respiratory tract
diseases
• Human immunodeficiency virus (HIV) disease
• Diabetes mellitus
• Cerebrovascular diseases
Trends in Health Care Environment
1. Cost containment. Refers to reducing the cost of health care by closely monitoring the
costs of personnel, use and brands of supplies, length of hospital stays, number of
procedures carried out, and number of referrals requested, yet maintaining quality care
(Saunier, 2011).
E.g., Shifting costs to employees such as creating adequate staff schedules that
avoid overtime hours , reduction of waste and offering virtual care such as
telemedicine.
2. Alternative Settings and Styles for Health Care .Shifting in settings of maternal and
child care. An example of alternative setting and style sof health care are the increasing
number of families who chose to give birth at home or in alternative settings such as
lying-in instead of hospitals; use of alternative remedies such as herbal medicine.
3. Strengthening the Ambulatory Care System. Avoiding longer stay in the hospital, or
instead of being admitted to hospitals, they are being cared in an ambulatory clinic or at
home.
4. Including the Family in Health Care. Allowing open visiting hours, especially to
children admitted to minimize the effects of separation from parents when children must
be admitted for extended stays. Example; allowing them to administer oral medicine,
bath the child; and for mothers, room-in babies.
5. Increase in the Number of Intensive Care Units. Because of the increasing number
of patients in need of intensive care causes the increase of ICU settings and provides
better opportunity for advance-practice in nursing.
6. Shortening Hospital Stays. Shortening hospital stay for cost reduction, example a child
who undergo surgery, was discharge after 4 hours of stable recovery, however, families
requires intensive teaching, support and reassurance that the client is capable of this
level of care.
16
7. Regionalization of Intensive Care. Regionalization of health care, aims to improve the
quality and safety of health care delivery by directing patients to facilities with optimal
resources and experience for their particular health needs. Regionalization generally puts
specialized hospital care at a greater distance from rural residents. It also creates an
increased need for effective interfacility care coordination, including health information
technology that allows patient information to be transferred with the patient, and tools to
facilitate effective interfacility handoffs.
8. Increased Reliance on Comprehensive Care Settings. Comprehensive health care is
designed to meet all of a child’s needs in one setting. Each specialist would look at only
one area of the child’s needs rather than the whole child’s development. Without extra
guidance, parents would find themselves lost in a maze of visits to different health care
personnel.
9. Increased Reliance on Home Care. Community/Home-based Care, modifying
procedure home care to sustain clients morale and interest. Example, a patient with
pregnancy complication remain to stay home rather than in a hospital, and nurse needs
to assess hospital discharge to help plan the best type of continuing care, devise and
modify procedures for home care, and sustain clients’ morale and interest in health care

during such situations as home monitoring to prevent premature labor.
10. Increased Use of Technology. The use of technology is increasing in all health care
settings. The field of assisted reproduction (e.g., in vitro fertilization), with the
possibility of stem cell research, is forging new pathways ( Jain et al., 2004). Charting by
computer, seeking information on the Internet, and monitoring fetal heart rates by
Doppler ultrasonography are other examples
11. Increased Use of Alternative Treatment Modalities. There is a growing tendency for
families to consult providers of alternative forms of therapy, such as acupuncture or
therapeutic touch, in addition to, or instead of, traditional health care providers. Nurses
have an increasing obligation to be aware of complementary or alternative therapies,
which have the potential to either enhance or detract from the effectiveness of traditional
therapy (Fletcher & Clarke, 2004; Weier & Beal, 2004).
Health Care Concerns and Attitudes
1. Increasing Concern Regarding Health Care Costs

2. Increasing Emphasis on Preventive Care
3. Increasing Emphasis on Family-Centered Care
4. Increasing Concern for the Quality of Life
5. Increasing Awareness of the Individuality of Clients
6. Empowerment of Health Care Consumers
Advanced-Practice Roles for Nurses in Maternal and Child Health
1. Clinical nurse specialists are nurses prepared at the master’s degree level who are
capable of acting as consultants in their area of expertise, as well as serving as
role models, researchers, and teachers of quality nursing care. Examples of areas of
specialization are neonatal, maternal, child, and adolescent health care; childbirth
education; and lactation consultation.
2. Case manager is a graduate-level nurse who supervises a group of patients from
the time they enter a health care setting until they are discharged from the setting, or, in
a seamless care system, into their homes as well, monitoring the effectiveness,
cost, and satisfaction of their health care. Case management can be a vastly satisfying
nursing role, because if the health care setting is “seamless,” or one that follows people
both during an illness and on their return to the community, it involves long-term contacts
and lasting relationships (Peterson, 2004).
3. Women’s health nurse practitioner is a nurse with advanced study in the promotion
17
• of health and prevention of illness in women. Such a nurse plays a vital role in educating
women about their bodies and sharing with them methods to prevent illness; in addition,
they care for women with illnesses such as sexually transmitted infections, offering
information and counseling them about reproductive life planning. They play a large role
in. helping women remain well so that they can enter a pregnancy in good health and
maintain their health throughout life.
4. Family nurse practitioner (FNP) is an advanced- practice role that provides health care
not only to women but to total families. In conjunction with a physician, an FNP can provide
prenatal care for a woman with an un- complicated pregnancy. The FNP takes the health
and pregnancy history, performs physical and obstetric examinations, orders appropriate
diagnostic and laboratory tests, and plans continued care throughout the pregnancy and
for the family afterward. FNPs then monitor the family indefinitely to promote health and
optimal family functioning.
5. Neonatal nurse practitioner (NNP) is an advanced- practice role for nurses who are
skilled in the care of newborns, both well and ill. NNPs may work in level 1, level 2, or level
3 newborn nurseries; neonatal follow-up clinics or physician groups. They also transport ill
infants to different care settings. The NNP’s responsibilities include managing and carrying

out patient care in an intensive care unit, conducting normal newborn assessments and
physical examinations, and providing high-risk follow-up discharge planning (Bissell,
2004).
6. Pediatric nurse practitioner (PNP) is a nurse prepared with extensive skills in
• physical assessment, interviewing, and well-child counseling and care. In this
• role, a nurse interviews parents as part of an extensive health history and performs
• a physical assessment of the child
7. Nurse-midwife, an individual educated in the two disciplines of nursing and midwifery
and licensed according to the requirements of the American College of Nurse-Midwives
(ACNM), has played an important role in assisting women with pregnancy and childbearing.
M. Cultural Considerations
Culture is a body of socially inherited characteristics that one generation hands down to
the next. Culture consists of values, beliefs and practices shared by members of the group.
Culture becomes a patterned expression of thoughts and action (called traditions) and effects
the way patients respond to health care.
The United States is a culturally diverse nation, and nurses must develop cultural
awareness and cultural sensitivity to practices and values that differ from their own. Only in this
way can nurses develop the cultural competence that will enable them to adapt health care
practices to meet the needs of patients from various cultures. Cultural awareness, sensitivity,
and competence are important in global health nursing.
The cultural background of the expectant family strongly influences its adaptation to the
birth experience. One way in which the nurse gains important information about an individual’s
culture is to ask the pregnant woman what she considers normal practice. Data collection
questions might include the following:
• How does the woman view her pregnancy (as an illness, a vulnerable time, or a
healthy time)?
• Does she view the birth process as dangerous ? why?
• Is birth a public or private experience for her?
• In what position does she expect to deliver (i.e., squatting, lithotomy, or some other
position?
• What type of help does she need before and after delivery?
18
• What role does her immediate or extended family play in relation to the pregnancy
and birth?
N. Legal Considerations of Maternal- Child Practice
Nurses are legally responsible for protecting the rights of their clients, including
confidentiality, and are accountable for the quality of their individual nursing care and that of
other healthcare team members Such responsibilities includes, identifying and reporting
incidents of suspected abuse in children; performed proper documentation essential in
protecting and justifying his or her actions ( e.g. informed consent); reporting inappropriate or
insufficient care provided by another practitioner.
O. Ethical Considerations of Practice
The following are just a few of the major potential conflicts:
1. Conception issues, especially those related to in vitro fertilization, embryo transfer,

ownership of frozen oocytes or sperm, cloning, stem cell research, and surrogate
mothers.
2. Abortion, particularly partial-birth abortions.
3. Fetal rights versus rights of the mother.
4. Use of fetal tissue for research.
5. Resuscitation (for how long should it be continued?)
6. The number of procedures or degree of pain that a child should be asked to endure to
achieve a degree of better health.
7. The balance between modern technology and quality of life
Summary
• Maternal and child health nursing focuses on women, and their child and families during
childbearing and childrearing cycle.
• Standards of maternal and child health nursing practice have been formulated by the
American Nurses Association to serve as guidelines for practice.
• QSEN competencies, combined with the nursing process, provide a sound method of
care for expanding areas of practice.
• Nursing Research and use of evidence-based practice are methods by which maternal
and child health nursing expands and improves.
• The most meaningful and important measure of maternal and child health is the
infant mortality rate, which is the number of deaths among infants from birth to 1
year of age per 1,000 live births. It is an index of country’s general health.
• Trends in health care environment includes, cost containment, Alternative Settings
and Styles for Health Care, Strengthening the Ambulatory Care System, Including the
Family in Health Care, Increase in the Number of Intensive Care Units, Shortening
Hospital Stays, Regionalization of Intensive Care , Increased Reliance on
Comprehensive Care Settings, Increased Reliance on Home Care, Increased Use of
Technology, Increased Use of Alternative Treatment Modalities
• Nursing has a strong history of improving the United States. From the 1930’s through
the 1930’s nursing pioneers established public health nursing, school nursing, and
nurse midwifery. During the same period a nurse founded Planned parenthood,
Nurses were also instrumental in establishing the first federal programs to improve
the health and lives of pregnant women, children, and families
19
• Practice roles in maternal and child health nursing are expanding rapidly as nurses
become more versed in evidence-based practice and technologic skills.
• Maternal and child health care have both legal and ethical considerations and
responsibilities over and above those in other areas of practices because of the role of
the fetus and child.
Readings and References
• Carpenito, L. J. (2004). Handbook of nursing diagnosis (10th ed.).

Philadelphia:Lippincott Williams & Wilkins.
• Maternal and Child Health Nursing; Care of the Childbearing and Childrearing Family
7th Edition, 2014 by Adele Pilliteri
• Introduction to Maternity and Pediatric Nursing 8th Edition by Gloria Leifer
• Study Guide for Maternal and Child Nursing Care 5th Edition by Karen A. Piotrowski &
David Wilson
• Ingalls & Salermo’s Maternal and Child Health Nursing 8th Edition Novak & Broom
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Lesson 1 Introduction On MCHN

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Lesson 1

INTRODUCTION ON MATERNAL AND CHILD HEALTH

A. History of Maternal and Child Health

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Activating Prior Knowledge

Clinical nurse specialists (CNS)

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Nursing- According to the International Council for Nurses, 2002(ICN,2002), nursing

A. History Maternal and Child Health

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Nursing’s Contribution to Maternal and Child Health

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B. Maternal and Child Health Goals

C. Healthy People 2030

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Strategic Preparedness and Response Plan

Global Health Goals

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The Philippine Health Goals

E. Goals and Philosophies of Maternal and Child Health Nursing

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G. Standards of Maternal and Child Health Nursing Practice

QSEN: A national Standard of Nursing Care

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H. Measures to Ensure Family-Centered Maternal and Child Health Care

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The Nursing Process and Critical Thinking

Process of Critical Thinking

The Nursing Process

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Nursing Care Plans

Steps in Preparing Nursing Care Plan

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J. Four (4) Phases of Health Care

K. Trends in the Maternal and Child Health Nursing Population

3. An increasing number of women work outside the home.

5. Abuse is more common than ever before.

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7. Health care must respect cost containment.

Statistical Terms Used to Report Maternal and Child Health

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Major Causes of Death in Childhood

• Congenital malformations, chromosomal abnormalities

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Trends in Health Care Environment

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Health Care Concerns and Attitudes

1. Increasing Concern Regarding Health Care Costs

Advanced-Practice Roles for Nurses in Maternal and Child Health

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N. Legal Considerations of Maternal- Child Practice

O. Ethical Considerations of Practice

The following are just a few of the major potential conflicts:

1. Conception issues, especially those related to in vitro fertilization, embryo transfer,

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Readings and References

• Carpenito, L. J. (2004). Handbook of nursing diagnosis (10th ed.).

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