McKinney: Maternal-Child Nursing, 4th Edition
Chapter 1: Foundations of Maternity, Women’s Health, and Child Health Nursing
Key Points - Print
•Maternity and child health nursing has changed dramatically because of increasing
knowledge about the care of women, children, and families; changes in the health care system;
federal involvement; and consumer demands.
•Recently, the government, insurance companies, hospitals, and health care providers have
tried to reform health care delivery and control health care costs. This trend has changed where
and how money is spent.
•According to the basic principles of family-centered maternity care, childbirth is usually
a normal, healthy event in the life of a family. Childbirth affects the entire family and requires a
restructuring of family relationships. Families are capable of making decisions about care when
they have adequate information and professional support. Family-centered care increases the
responsibilities of nurses.
•Prospective payment plans control health care costs by negotiating reduced charges with
providers and restricting patient choice of providers. Prospective payment plans have had major
effects on maternal and infant care, primarily in relation to the length of stay.
•Capitated plans allow a predictable amount of money to be budgeted for health care, and
patients do not have unexpected financial burdens from illness. However, patients lose freedom
of choice regarding who will provide their care. Some health care providers and consumers fear
that cost constraints might affect treatment decisions.
•In case management, a case manager focuses on both quality of care and cost outcomes
and coordinates patient and family services. Nurses who provide case management evaluate
patient and family needs, establish needs documentation to support reimbursement, and may be
part of long-term care planning in the home or a rehabilitation facility.
•Clinical pathways identify patient outcomes, specify timelines to achieve them, direct
appropriate interventions and sequencing of interventions, include interventions from a variety of
disciplines, promote collaboration, and involve a comprehensive approach to care. As in
managed care and case management, the purpose is to provide quality care while controlling
costs.
•With advances in portable and wireless technology and monitoring devices, home nursing
care has grown dramatically. Services include telephone calls, home visits, information lines, and
lactation consultations.
•Historically, mortality rates among women and infants have been high. With
improvements in the health of the general population, sanitation, and medical knowledge,
mortality rates fell. However, racial inequality of maternal and infant mortality rates continues.
•Nurses must be informed about the abortion issue from a legal and ethical standpoint,
know the regulations and laws in their state, and acknowledge the sincere convictions and strong
emotions of people on all sides of the issue.
•Maternal-child health nurses must know how to approach the ethical and social issues
that affect families knowledgeably and systematically.
