Neonatal and Perinatal nursing notes PDF

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Neonatal and Perinatal nursing notes...

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7100 – Perinatal Nursing Module 2: Perspectives on Perinatal and Neonatal Nursing http://www.perinatalservicesbc.ca/

Historical Perspective - In Canada at start of 20th century, birthing was moving from home and midwifery, into hospital care - Maternal and Infant morbidity and mortality rates were high (so moving to hospital was supposed to make this better)

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Routine use of analgesics, peri shaving and cleansing, enemas, separate facility per stage of labour, postpartum managing When formula was developed, breastfeeding declined and infants were separated from mom to aseptic nurseries who had scheduled times for feeding with mom Moms were on bedrest after birth up to 14 days

Nurses treated birthing moms as if they were sick - It was treated as a pathological process instead of a biological healthy and normal - Women’s rights groups and consumer activism then created a context that challenged maternity 1960’s – 1970’s - The International Childbirth Education Association (ICEA) lobbied for changes in delivery of maternity services - During this time, women became more powerful (more aware of their bodies, themselves, grew more assertive for rights) - Family centered care model began to evolve Premature infant care - First incubator used in 1880 in Paris - 1914 – small incubator unit opened in Chicago - Gavage feeding (NG tube) became standard method for premature infants - 1960 – First NICU opened in Yale-New Haven Hospital

Context of Maternity Care in Canada -

There are inequities in access, especially culturally diverse women and vulnerable populations (remote/rural living or aboriginal communities)

Birthing in Hospitals  Most Canadian women birth in hospitals with care from obstetrician, family physician or midwife  Two types of units: 1) Traditional units with separated labour/delivery, post-partum and newborn nursery 2) Single room maternity care where women birth and stay after in the same room  Healthy infants stay with their moms throughout postpartum period  Helps continuum of both care and health care providers for baby and mom  Most Canadian hospitals abandoned the observation nursery NICU   

Where infants require specialized care Units vary with policies and visiting hours, skin to skin, and support of BF Some units shift now to provide neonatal AND maternity care in NICU to keep moms and babies together

A National Birthing Initiative for Canada (2008)  Published by the Society of Obstetrics and Gynecologists of Canada (SOGC)

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Reported increased concern among Canadian HCPs about decline in quality and scope of maternity care 1) Increased infant mortality, perinatal mortality, maternal morbidity rates in Canada 2) More older women are giving birth 3) Decreased fertility rates 4) Increased multiple births 5) More babies require medical attention in ICU 6) Health human resource shortage in maternity HCPs

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Canada’s health organizations requested the Federal Government to commit maternity as a health care priority

Provincial Context -

Within B.C. the Perinatal Services BC (PSBC) is an agency of the Provincial Health Services Authority (PHSA) 1) Helps provide leadership, support, and coordination of strategic planning of perinatal services in BC 2) Collaborates with Ministry of Health, health authorities, and other key stakeholders 3) Central source for evidence-based perinatal information

Entering a New Specialty -

Childbearing is a unique transition for every family member Care shifted from separation of mother and baby to  emphasis on keeping them together This is difficult when both mom and baby require higher level of care

PERINATAL NURSING 

Perinatal faculty believe that labour and birth are normal physiologic processes and competent ethical nursing practice strives to promote, protect, and support normal birth  Childbearing is = a dynamic and transformational biological, psychological, social, spiritual process  Health during childbearing is influenced by: o Women’s health practices o Health status o Resources o Experiences, and perceptions  Includes practice throughout childbearing (from preconception to 3 months postpartum)  Practice includes = therapeutic care, health surveillance, health promotion, and prevention, shared decision-making, collaboration, and bereavement support.  Focus of perinatal care = to promote safety and wellbeing of the woman her family, and baby NEONATAL NURSING

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A subspecialty of nursing that works with newborns (can have variety of problems like prematurity, birth defects, infection, cardiac malformations, surgical problems) Neonatal period = first month of life Helps infants who experience complications right after birth, or even long-term problems May take care of babies up to 2 years of age Most neonatal nurses care for the newborn from time of birth to discharge Cornerstone of Neonatal Nursing: 1) Infants are holistic beings with subtle, but powerful communication and interactive/social abilities 2) Understanding infant vulnerability is critical to promoting health and preventing illness 3) Neonatal nurses work in partnership with infants and families, other HCPs to build trust and achieve long-term or short-term goals...