High-risk Infants The Need for Nursing Follow-up

The goal of perinatal care can no longer focus only on the medical management of mother and infant, but instead must take a more global approach and focus on the entire family. One aspect of family care is to provide comprehensive nursing follow-up to the high-risk family at the time of the mother's and infant's discharge. To meet this need, a program was developed to educate all interested community nurses to the specific needs of the high-risk family. Evaluation indicates that the program helped nurses to provide consistent comprehensive care to these families, who were very grateful for home visits by a community nurse.     

The Use of Homemaker-Home Health Aides'' Perinatal Care of High-risk Infants

The Homemaker-Home Health Aide program for high-risk neonates started in late 1982. Funded by a grant from the March of Dimes Birth Defects Foundation, several agencies in Pinellas County, Florida, set up a special training program for the aides in the care of high-risk infants and their families during the difficult transition period after release from the neonatal intensive care unit.     

Evaluation of a Discharge Planning Tool for Use with Families of High-risk Infants

The effectiveness of using a discharge planning tool for families with high-risk infants in a special care nursery is evaluated. Consistent use of the discharge planning tool resulted in parents' increased feeling of preparedness for discharge of their high-risk infants. Implications that resulted from the evaluation are presented.     

Nursing Response to Mothers of Stillborn Infants

The emotional trauma of stillbirth presents a unique challenge to the obstetrics nurse. Her understanding of each stage of the grief process as it relates to stillbirth will enable her to communicate more effectively with the bereaved mother and father. The nurse's role is important and therapeutic; her empathic understanding of this aspect of patient care promotes the concept of treating the whole person.     

Community Hospital-Based Obstetrical Primary Nursing

A 200-bed community hospital in Seattle, Washington, delivering approximately 2.000 infants per year, was the site of a pilot project in expanded nursing care for childbearing families. Obstetrical primary nursing provides a one-to-one nurse-patient relationship beginning in early pregnancy and continuing as long postpartum as a need exists. Project development, implementation, and results are discussed.     

Preparing Leaders in Maternal-Child Health Nursing

ObjectiveTo describe leadership and patient outcomes from an international leadership development program undertaken by a nursing organization (Sigma Theta Tau International Honor Society of Nursing) in partnership with Johnson & Johnson Corporate Contributions to strengthen the leadership base of maternal-child bedside nurses.DesignPretest/posttest design with no control group program evaluationSettingHealth care facilities, academic institutions, and public health clinicsParticipantsMentor/fellow dyads (N = 100) of the Maternal-Child Health Nurse Leadership Academy (MCHNLA).Intervention/MeasurementsThe MCHNLA engaged participants in an 18-month mentored leadership experience within the context of an interdisciplinary team project. Each mentor/fellow dyad was paired with a faculty member during the program.ResultsOne hundred dyads have participated and conducted projects to improve health care for childbearing women and children up to age 5 years during the past decade. For the two cohorts for which consistent data were obtained, mentors and fellows enhanced leadership knowledge, skills, and behaviors. Review of 2010 to 2011 cohort project reports revealed they had the potential to influence more than 1000 students, 4000 nurses, and 1300 other health care students or professionals during the project period.ConclusionsThis leadership development model is replicable in other areas of nursing and other professions.     

Integrative Review of Mental Health and Feeding Styles in Parents of Bottle-Fed Infants

ObjectiveTo review the literature regarding the relationship between symptoms of anxiety and depression and feeding styles in parents of bottle-fed infants.Data SourcesWe conducted literature searches in PubMed, CINAHL, Scopus, and PsycINFO.Study SelectionWe used Covidence systematic review management software during the selection process to allow for full blinding of decisions by team members. Articles were eligible for inclusion if they were reports of primary research, written in English, and focused on the relationship between symptoms of anxiety or depression and feeding styles in parents of term, bottle-fed infants younger than 12 months of age. We placed no restriction on date of publication because of the sparse amount of published literature on this topic. We identified a total of 1,882 articles. After removing duplicates, we screened 988 articles and retained six articles that met criteria for our review.Data ExtractionWe used Whittemore and Knafl’s integrative review methodology to guide data extraction and reporting. We extracted relevant data from all primary data sources and compiled the data into a matrix. We used the Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies to assess the quality of the studies.Data SynthesisUsing an a priori coding scheme, we summarized the data using categorization of established parental feeding styles in infancy applicable to bottle-feeding. We synthesized the data into two broad categories: responsive and nonresponsive feeding styles.ConclusionAlthough research on the topic is limited, our findings suggest that symptoms of postpartum depression may be associated with nonresponsive feeding styles in parents of bottle-fed infants. We suggest several areas for future research and recommend increased emotional and feeding support in practice for parents of bottle-feeding infants.     

Health Care for all Mothers and Infants by 2000 AD

Although the future health of a nation depends largely on the health care provided for mothers and infants, little emphasis is placed on maternal and child health (MCH) care in the health programs of most countries. In some developing countries up to 70% of women fail to receive any form of health care during pregnancy and childbirth, and the newborns are left to the care of their mothers. Even in developed countries there are pockets of population which remain untouched by such programs. In Singapore, increased literacy, greater health consciousness, and a successful family planning program have contributed to a decline in the crude birth rate from 42.7 to 16.9 between 1967-78 and a decrease in the mean birth order to 1.75. Maternal mortality rates, like infant and perinatal mortality rates, vary widely in different countries and within countries, and leave room for improvement almost everywhere. Childbrith remains the main cause of death in women aged 14-45 years in the developing world, where anemia and intercurrent infections contribute to obstetric complications. Nearly 1 billion people in the developing world are trapped in a vicious circle of poverty, malnutrition, disease and despair. There are 4 major reasons for the failure of countries to provide MCH care: 1) shortage of resources 2) maldistribution of existing manpower 3) poor utilization of existing facilities, and 4) inadequate or inappropriate training of health manpower. Because of perceived health manpower shortages, 493 new medical schools were established throughout the world between 1955-75, 350 of them in developing countries. 608 of the world's 1124 medical schools are now in developing countries, but despite the effort and money invested, the ratio of physicians to population has not imporved significantly and the gross maldistribution of available health personnel within countries continues. The total health manpower available is 1/130 population in developed countries, 1/500 in developing countries, and 1/2400 in the least developed countries. Migration of physicians has aggravated the shortage in some countries. The infant mortality rate in most developing countries ranges from nearly 100 to 200/1000, compared to 10-20 in developed countries. Malnutrition, infectious diseases, and high fertility are 3 major causes of high infant and child mortality. Community participation is crucial if MCH care is to be available to rural communities. Health care should become a part of the total socioeconomic development of a country. All existing health personnel including traditional practitioners should be utilized and, if necessary, retrained. Training should be objective and task of oriented.     

Community Nursing Centers: Models of Nurse Managed Care

Changes in health care that have resulted in an increase in community-based nursing practice and new models for nurse managed care are developing. One of these models is the academic community nursing center. The development and characteristics of academic community nursing centers are described, using examples from one academic nursing center. Strategies for development, administration, collaboration, and funding are outlined, including the changes needed in nursing education to prepare nurses for new roles in community-based care.