Maternal and Child Health o Care of children

Nursing during the

 Involves the care of the perinatal period
woman and family (6 weeks before
throughout pregnancy and conception to 6
childbirth and the health weeks after birth)
promotion and illness o Care of children
care of women, children from birth
and families through
Obstetrics Nursing adolescence
 Means care of women o Care in setting as
during childbirth varied as the
 Derived from the Greek birthing room, the
word Obstare ; to keep pediatric
watch intensive care
Pediatrics unit, and the
 Refers to the child home
 Came from the Greek Philosophy of Maternal and
word Pias; child Child Birth
PRIMARY GOAL OF MCN 1. MCM is family oriented
 Promotion and  Family is
maintenance of optimal considered as
family health to ensure primary unit of
cycles of optimal care
childbearing and  Assessment data
childrearing includes the
The Goal of MCHN care is family and each
necessarily broad because the member
scope of practice is so broad  The nurses see
 The Range of practice the family as a
includes; whole and as a
o Preconception partner in the care
health care of the mother and
o Care of woman child
during 3 trimester  The level of
of pregnancy and family
the puerperium (6 functioning
weeks after birth, affects the health
sometimes status of
termed the 4th individuals,
trimester of because if the
pregnancy) family’s level of
 functioning is knowledge. The
low, the care given is
emotional, based on the
physical, and product of
social health and research
potential of
individuals in the 4. Both Nursing theory and
family can be evidence-based practice
adversely provide a foundation for
affected nursing care
 A health family 5. MCH nurse serves as an
establishes an advocate to protect the
environment rights of all family
conducive to members including the
growth and health fetus
promoting 6. MCHN includes a high
behaviors that degree of independent
sustain family nursing functions,
members during because of independent
crisis nursing functions,
 The health of because teaching and
individuals and counseling are so
his or her ability frequently required
to function 7. Promoting health is an
strongly important nursing role
influences the because this protects the
health of the health of the next
family members generation
and overall 8. Pregnancy or childhood
family illness can be stressful
functioning and can alter family in
2. MCM is community both subtle and extensive
centered ways
 The health of the 9. Personal, cultural, and
family is affected religious attitudes and
and influence by beliefs influence the
the health of meaning of illness and its
community impact on the family
3. MCHN is research  MCH nurse
oriented respects personal,
 A means that cultural and
increases critical spiritual attitudes
 and beliefs as
they strongly
influence the
meaning and
impact of
childbearing and
childrearing
Common Measures to Ensure
Family - Centered Maternal
and Child Health Care
Principles
 The family is the basic
unit of society
 Families represent racial,
ethnic, cultural and
socioeconomic diversity
 Children grow both
individual and as part of a
family
Nursing Interventions
 Consider the family as a
whole as well as
individual members
 Encourage families to
reach out to their
community so that family
members are not isolated
from their community or
from each other
 Encourage family
bonding through
rooming-in both maternal
and child health hospital
settings
 Participate in early
hospital discharge
programs to reunite
families as soon as
possible
 Encourage family and
siblings’ visits in the
hospital to promote
family contacts
 Assess families for
strength as well as
specific needs or
challenges
 Respects diversity in
families as a unique
quality of that family
 Encourage families to
give care to a newborn or
ill child
 Include development
stimulation in nursing
care
 Share or initiate
information on health
planning with family
members so that care is
family - oriented
Standard of Care
I. Assessment - Collection
of patient health data
(subjective/objective)
II. Diagnosis - analysis of
the assessment data
III. Outcome Identification -
identification of outcome
IV. Planning - development
of plan care
V. Implementation -
implementation of
intervention identified in
the care plan
Standard of Professional
Performance
I. Quality of Care - nurse
evaluates quality and
effectiveness of care
II. Performance Appraisal
- nurse evaluates his/her
own nursing practices in
 relation to professional
practice standards
III. Education - Nurse
acquire and maintain
knowledge level
IV. Collegiality - nurse
contribute to the
professional development
of peers and colleagues
V. Ethics - nurse decisions
in behalf of the patient are
determined by ethical
manners
VI. Collaboration - nurse
collaborate the patient
significant others and
health care professionals
VII. Research - nurse uses
findings in practice
VIII. Resource utilization -
nurse considers factors
related to safety,
effectiveness, and cost in
planning and delivering
patient care
IX. Practice Environment -
nurse contributes to the
environment of care
delivery within the
practice of setting
X. Accountability - the
nurse is professionally
and legally accountable
for his/her practice
Theories Related to Maternal and
Child Nursing
Nursing Theory - this is
organized, knowledge - based
concepts that essentially define
the scope of practice
 What constitutes nursing
 What nurses are typically
tasked with
 Reasons why their task
are in place
Mercer’s Maternal Role
Attainment Theory
 Ramona Mercer, head
nurse in pediatrics and
staff in intrapartum,
postpartum, and newborn
nursery units, has a great
deal of experience in
nursing care of mothers
and infants. This gave her
a strong foundation for
creating her Maternal
Role Attainment Theory
for Nursing
 Maternal Role Attainment
theory was developed to
serve as a framework for
nurses to provide
appropriate health care
interventions for
nontraditional mothers in
order for them to develop
a strong maternal identity
 This mid-range theory
can be used throughout
pregnancy and postnatal
care, but is also
beneficials for adoptive or
foster mothers or others
who find themselves in
the maternal role
unexpectedly
 This process used in this
nursing model helps
mothers develop
attachment to the infants
which in turn helps the
infant form a bond with a
 mother. Thus, helps relying on the
develop the mother - child advice of others
relationship as the infant in making
grows decisions
 The primary concept of 3. Informal Stage - is when
this theory is the the mothers develop by
development and her own methods of
interactional process, mothering which are not
which occurs over a conveyed by a social
period of time system
o The mother bonds  She finds what
with their infant work for her and
acquires the child
competence in 4. Personal Stage - is the
general joy of motherhood
caretaking tasks,  In this stage, the
and then concept mother finds
to express joy and harmony,
pleasure in her confidence, and
role as a mother competence in the
The NURSING PROCESS in the maternal role
Maternal Role Attainment Theory  In some cases,
follows 4 stages of acquisition she may find
1. Anticipatory Stage - is herself ready for
the social and looking forward
physiological adaptations to another child
to the maternal role
 This includes Roy’s Adaptation Model or
learning Nursing
expectation and  The adaptation model of
can involve Nursing developed by
fantasizing about Sister Callista Roy in
the role 1976. After working with
2. Formal Stage - is the Dorothy E. Johnson, Roy
assumption of the become convinced of the
maternal role at birth importance describing the
 In this stage, nurture of nursing as
behaviors are service to the society
guided by others  This prompted her to
in the mother’s begin developing her
social system or model with the goal of
network and
 nursing being to promote
adaptation
 She first began organizing
her theory of nursing as
the developed course
curriculum for nursing
students at Mount St.
Mary’s College. She  A person is a biophysical-
introduced her ideas as a
basis for an integrated
nursing curriculum
 The factors that
influenced the
development of the model
included  The model includes
o Family,
Education,
Religious
Background,
Mentors and
Clinical
Experience  Health is an inevitable
 Roy’s Model asks the
questions;
o Who is the focus
of nursing care?
o Who is the target
of the nursing
care?
o When is nursing
care indicated?  The environment has 3
 Roy explained the
adaptation occurs when
people respond positively
to environmental changes,
and it is the process and
outcome of individuals
and groups who use
conscious awareness,
self-reflection and choice
to create human and
environment integration
 The key concept of Roy’s
Adaptation Model is
made up to 4 components
 Person
 Health
 Environment
 Nursing
social being in constant
interaction with a
changing environment.
He or she uses innate and
acquired mechanism to
adapt
people as individuals, as
well as in groups such as
families, organization,
and communities. This
also includes society as a
whole
dimension of a person’s
life, and is represented by
a health-illness
continuum. Health is also
described as a state and
process of being and
becoming integrated and
whole
components
1. Focal - which is
internal or
external and
immediately
confronts the
person
2. Contextual -
which is all
stimuli present in
the situation that
 all contribute to  Casey’s Model of
the effect of the Nursing focuses on the
focal stimulus nurse working in
3. Residual - whose partnership with the child
effects in the and his or her family. It
correct situation was one of the earliest
are unclear attempts to develop
 The adaptive model nursing model designed
includes 6 step nursing specifically for child
process health nursing
1. The first level of  The 5 aspects of this
assessment, nursing theory are:
which addresses Child, Family, Health,
the patient’s Environment and the
stimuli nurse
2. The second level  The philosophy of
of assessment, Casey’s Model is that the
which address the best people to care for the
patient’s stimuli child are the members of
3. Diagnosis of the the family, with
patient’s health healthcare professionals
4. Intervention to assisting. This
take actions in necessitates a relationship
order to meet between the parents(s)
those goals and nurse
5. Evaluation of the Parse’s Human Becoming
results to Theory
determine if goals  Parse’s Human Becoming
were met Theory guides the
Casey’s Model in Nursing practice of nurse to focus
 Anne Casey is an English on quality of life as it is
nurse who developed a described and lived
nursing theory known as  The human becoming
Casey’s Model of theory if nursing presents
Nursing alternative to both the
 The model was developed conventional bio-medical
in 1988 while she was approach as well as the
working in pediatric bio-psycho-social-
oncology at the Great spiritual approach of most
Ormond Street Hospitals their theories and models
in London of nursing
 Parse’s model rated rhythmical
quality of life from each patterns
person’s own perspective 3. Transcendence -
as the goal of the practice explained that
of nursing human becoming
 Rosemarie Rizzo Parse, is co-
first published the theory transcending
in 1981 as the “Man- multidimensionall
living-health” theory, and y with emerging
the name was changed to possibilities. It
the “human becoming refers to racing
theory” in 1992 out and beyond
 The 3 major assumptions the limits a
about human becoming: person sets and
1. Meaning - that one
human becoming constantly
is freely choosing transforms
personal meaning  The nursing model
institutions in the defined that person
intersubjective (referred to as “man”
process of living throughout the theory) as
value priorities. an open being who is
Man’s reality is more than and different
given meaning from the sum parts. The
through lived environment is everything
experience. In in the person and his/her
addition, man and experiences. The
environment co- environment is
create inseparable from the
2. Rhythmicity - person, as well as
states that human complementary to the
becoming is co- evolving with the person
creating rhythmic Nightingale Environment
patterns of Theory
relating in mutual  As the founder of modern
process with nursing, Florence
universe, Man Nightingale’s
and environment Environment Theory
co-create changed the face of
(imaging, nursing practice
valuing,  She served as a nurse
language) in during the Crimean War,
 at which time she
observed a correlation
between patients who
died and their
environmental conditions.
As a results of her
observations, she
Environment Theory of
nursing was born
 10 major concepts of the
Environment Theory
1. Ventilation
2. Light and noise
3. Cleanliness of the
area
4. Health of houses
5. Bed and beddings
6. Personal
cleanliness
7. Variety
8. Offering of hope
and advice
9. Food
10. Observation
 According to Nightingale,
nursing is separate from
medicine. The goal of
nursing is to put the
patients in the best
possible condition in
order for mature to act
 Nursing is the “Activities
that promotes health
which occur ina ang
caregiving situations:
 Health is “not only to be
well, but to be able to use
well every power we
have”
 Nightingale’s Theory,
addresses disease in
literal level, explaining it
as the absence of comfort
 The environment
paradigm in Nightingale’s
model is understandably
the most important aspect.
Her observation taught
her that unsanitary
environments contribute
greatly to ill health, and
that the environment can
be altered in order to
improved conditions for a
patient and allow healing
to occur
 Nightingale’s model
nursing theory also
impaired nursing
education, she was the
first to suggest that nurses
be specifically educated
and trained for the
positions in healthcare.
This allows there to be
standard of care to field
of nursing, which helped
improve overall care of
patients