Antepartum 1

amprevel's version from 2016-10-24 21:35

Chapter 1: 12-14 Maternity and Women’s Health Care Today

Current trends affecting perinatal nursing and women's health nursing, such as:
Question Answer
cost containmentprospective payments. Facility, provider, and payers agree in advance on fixed amt to change for specifically diagnosed conditions. Ex. diagnosis-related groups (DRG)s.
Effect of cost containment on LOS and implicationsMay result in shorter LOS. Normal vag birth w/in 48hrs “drive through deliveries” or 96 h post CS. Shorter stays have resulted in costly maternal and infant problems, readmissions. Difficult for nurses to provide teaching on self- and infant-care w/in this timeframe
outcomes managementsystematic method to ID pt outcomes and focus care on into that will accomplish stated outcomes for specific case types such as the woman who has just given vaginal birth. Tools used to ID and meet stated outcomes include clinical pathways, critical/clinical paths, collaborative POC, anticipated recovery paths, multidisciplinary action plans. Variances may occur either in timeline or expected outcomes.
evidence-based practice change in focus in which research based clinical practice guidelines to provide safe/effective care. Rely on research data rather than tradition to guide best practice and achieve both quality and outcomes of patient care.
community-based careWomen and families taught to manage less sever problems at home under supervision of a nurse, being admitted only for exacerbation.
Community facilities: neighborhood health centers, shelters, school-age mother programs, postpartum care centers. Provide care.
Home care: antepartum, postpartum and neonatal, high-risk neonates. Acute-care setting is most expensive for delivery of hc services.
advances in technologyinc. knowledge, gov involvement, consumer demands
increased use of complementary and alternative medicineIncreased use, safety/regulation concerns. Nurses must be aware of prevalence of use of CAM. Possible dangers include delay of treatment, herbal remedies/substances that are harmful or interact with meds.
downward trends in infant and maternal mortality ratesimproved overall rate, sanitation, increased medical knowledge, improve,meets in HC, ABX, public H facilities, increased prenatal care. downward trend is greater for whites than blacks.
infant mortality rates among specific racial groupshigher rates amongst non-hispanic blacks than whites. Also greater risk of prematurity, low birth weight. Inc risk of respiratory disorders, dev. Delays, SIDS.
infant mortality rates among nationsUS 27th among developed nations. Top countries: Iceland, Sweden, Finland, Japan, Greece, Norway, Czech, Italy, Portugal...
Healthy ppl 2020 goals r/t maternal care1. Reduce perinatal mortality
2. Reduce infant mortality
3. Reduce neonatal mortality
4. Reduce percentage of low birth wt infants
***target 77% prenatal care