TARLAC STATE UNIVERSITY

COLLEGE OF SCIENCE- NURSING DEPARTMENT

NCM 107 - CARE OF THE MOTHER, CHILD AND

ADOLESCENT (WELL CLIENTS)

Maternal and Child

Health Nursing
This course deals with concepts, principles, theories and
techniques in the nursing care of individuals and families
during childbearing and childrearing years toward health
promotion, disease prevention, restoration and
maintenance and rehabilitation. expected to provide
appropriate and holistic nursing care to clients utilizing the
nursing process.

COURSE DESCRIPTION
GOALS AND PHILOSOPHIES OF MATERNAL AND
CHILD HEALTH NURSING

The primary goal of maternal and child health

nursing care can be stated simply as the
 promotion and maintenance of optimal family
health to ensure cycles of optimal childbearing
and childrearing.
CHAPTER I. FRAMEWORK FOR MATERNAL AND CHILD
HEALTH NURSING
CHAPTER OUTLINE
1. Goals and Philosophies of Maternal and Child Health Nursing
2. Maternal and Child Health Goals and Standards
3. Theories related to Maternal and Child Health Nursing
4. Roles and Responsibilities of Maternal Child Nurse
5. WHO’s 17 Sustainable Development Goals.
I. LEARNING OUTCOMES
At the end of the chapter, the students are expected to:
1. Integrate the goals and philosophy of maternal and child health
nursing.
2. Discuss the implications of the common standards of maternal and
child health nursing and the health goals for the nation.
3. Apply concepts of family-centered care to maternal and child health
nursing.
4. Integrate knowledge of trends in maternal and child health care with
the nursing process to achieve quality childbearing and childrearing.
5. Apply maternal concepts and principles holistically and
comprehensively.
Introduction:
What is Maternal and Child Health Nursing?
Maternal and Child Health Nursing is one of the Scope of nursing
practice referring to the care of Childbearing and childrearing families
which is the major focus of nursing practice because to have healthy
adults you must have healthy children and to have a healthy children,
it is important to promote the health of a childbearing woman and her
family.
Major philosophical assumptions about maternal
and child health nursing

The goals of maternal and child health nursing care are necessarily broad
because the scope of practice is so broad. The range of practice includes
 Preconceptual health care
 Care of women during three trimesters of pregnancy and the
puerperium (the 6 weeks after childbirth, sometimes termed the fourth
trimester of pregnancy)
 Care of children during the perinatal period (6 weeks before
conception to 6 weeks after birth)
 Care of children from birth through adolescence
 Care in settings as varied as the birthing room, the pediatric intensive
care unit, and the home In all settings and types of care, keeping the
family at the center of care delivery is an essential goal.
 A FRAMEWORK FOR MATERNAL AND CHILD
HEALTH
NURSING CARE

Maternal and child health nursing can be visualized within a framework in which nurses,
using nursing process, nursing theory, and evidence-based practice, care for families
during childbearing and childrearing years through four phases of health care:
 Phases of health care:

1. Health promotion – health teaching and role modeling to parents to follow sound health practices.
Telling the passengers beside you not to smoke inside the public utility vehicle.

2. Health maintenance- intervening to maintain health when risk of illness is present. Example: teaching
parents to keep away any poisonous substances from their children

3. Health restoration- early identification of symptoms of illness and early interventions are begun to
return client to wellness immediately. Example: Orthopedic cases- casting, PT.

4. Health rehabilitation – helping client prevent any complications from illness, helping client achieve
optimal state of wellness and independence and accepting inevitable death. Example: regular therapy
for stroke patients.
PHILOSOPHY OF MATERNAL AND CHILD HEALTH NURSING

 Maternal and child health nursing is family centered;

assessment data must include a family and individual
assessment.
 Maternal and child health nursing is community centered; the
health of families depends on and influences the health of
communities.
 Maternal and child health nursing is research oriented, because
research is the means whereby critical knowledge increases.
 Both nursing theory and evidence-based practice provide a
foundation for nursing care.
 A maternal and child health nurse serves as an advocate to
protect the rights of all family members, including the fetus.
PHILOSOPHY OF MATERNAL AND CHILD HEALTH
NURSING

 Maternal and child health nursing includes a high degree of independent nursing
functions, because teaching and counseling are so frequently required.

 Promoting health is an important nursing role, because this protects the health of
the next generation.

 Pregnancy or childhood illness can be stressful and can alter family life in both
subtle and extensive ways.

 Personal, cultural, and religious attitudes and beliefs influence the meaning of
illness and its impact on the family. Circumstances such as illness or pregnancy are
meaningful only in the context of a total life.

 Maternal and child health nursing is a challenging role for a nurse and is a major
factor in promoting high-level wellness in families.
COMMON MEASURES TO ENSURE FAMILY-CENTERED
MATERNAL AND CHILD HEALTH CARE PRINCIPLE

Principles
 The family is the basic unit of society.
 Families represent racial, ethnic, cultural, and
socioeconomic diversity.
 Children grow both individually and as part of a
family.
 Nursing Interventions
1. Consider the family as a whole as well as its individual members.
2. Encourage families to reach out to their community so that family members are not isolated
from their community or from each other.
3. Encourage family bonding through rooming-in in both maternal and child health hospital
settings.
4. Participate in early hospital discharge programs to reunite families as soon as possible.
5. Encourage family and sibling visits in the hospital to promote family contacts.
6. Assess families for strengths as well as specific needs or challenges.
7. Respect diversity in families as a unique quality of that family.
8. Encourage families to give care to a newborn or ill child.
9. Include developmental stimulation in nursing care.
10.Share or initiate information on health planning with family members so that care is family
oriented.
 STANDARDS OF MATERNAL AND CHILD HEALTH NURSING PRACTICE

STANDARDS OF CARE

 Standard I: Assessment. The nurse collects patient health data.

 Standard II: Diagnosis. The nurse analyzes the assessment data in
determining diagnoses.
 Standard III: Outcome Identification The nurse identifies expected
outcomes individualized to the child and the family.
 Standard IV: Planning. The nurse develops a plan of care that
prescribes interventions to obtain expected outcomes.
 Standard V: Implementation . The nurse implements the interventions
identified in the plan of care.
 Standard VI: Evaluation. The nurse evaluates the child’s and family’s
progress toward attainment of outcomes.
 STANDARDS OF PROFESSIONAL PERFORMANCE

 Standard I: Quality of Care

The nurse systematically evaluates the quality and effectiveness of
nursing practice.
 Standard II: Performance Appraisal
The nurse evaluates his or her own nursing practice in relation to
professional practice standards and relevant statutes and
regulations.
 Standard III: Education
The nurse acquires and maintains current knowledge and
competency
in nursing practice.
Standard IV: Collegiality
The nurse interacts with and contributes to the professional
development of peers, colleagues, and other health care
providers.

Standard V: Ethics
The nurse’s assessment, actions, and recommendations on
behalf of children and their families are determined in an
ethical manner.

Standard VI: Collaboration

The nurse collaborates with the child, family, and other
health
care providers in providing client care.
 Standard VIII: Resource Utilization
The nurse considers factors related to safety, effectiveness, and
cost in planning and delivering patient care

Standard IX: Practice Environment -The nurse contributes to the

environment of care delivery within the practice settings.

Standard X: Accountability -The nurse is professionally and legally

accountable for his/her practice. The professional registered
nurse may delegate to and supervise qualified personnel who
provide patient care.
Maternal Child and Health Nurse Do
1. Monitor children's health.
2. Support maternal health and wellbeing.
3. Identify health and development concerns early.
4. Provide intervention and referral when necessary.
5. Deliver health promotion and education programs.
6. Provide parenting support.
Roles of Maternal and Child Health Nurse
1. Care Provider
2. Teacher
3. Collaborator
4. Researcher
5. Advocate
6. Manager of Care
 Key Responsibilities and Duties
1. Provide evidenced based assessments
2. Provide information, support, advice and appropriate referrals
relating to children and parents wellbeing, including health,
immunization, breast feeding, antenatal and post-natal care.
3. Provide an innovative approach to flexible service delivery that will
encourage access and participation for all families in the
community.
4. Provide a focus on prevention, early detection and intervention of
the health and well being concerns of vulnerable infants, children
and their families through an interdisciplinary and integrated
service response.
 Key Responsibilities and Duties
5. Recognize and facilitate the access to families of cultural and linguistic
diverse backgrounds.
6. Promote and provide information and advice about vaccinating against
preventable.
7. Act as an advocate for children, parents, the community and the Maternal

and Child Health Service as appropriate.

8. Proactively participate in the Maternal Child Health service team in the

development and implementation of continuous improvements to the

service.
9. Participate in relevant networks and outreach programs concerning
young children and families as requested.
Perinatal Nursing Theories and
Models
 Mercer's Maternal Role Attainment Theory
 Roy's Adaptation Model of Nursing
 Casey's Model of Nursing
 Parse's Human Becoming Theory
 Nightingale's Environment Theory
 Neuman's Systems Model
 Rogers' Theory of Unitary Human Beings
 Erickson's Modeling and Role Modeling Theory
 Orlando's Nursing Process Discipline Theory
 Kolcaba's Theory of Comfort
 Orem's Self-Care Deficit Nursing Theory
 King's Theory of Goal Attainment
 Watson's Philosophy and Science of Caring
Advanced Preparation for Maternity and Pediatric Nurses
1. Certified Nurse-Midwives
2. Nurse Practitioners
3. Clinical Nurse Specialists
4. Clinical Nurse Leaders
KEY RESPONSIBILITIES AND DUTIES
1. Provide evidenced based assessments
2. Provide information, support, advice and appropriate referrals relating to children and
parents wellbeing, including health, immunization, breast feeding, antenatal and post-natal
care.
3. Provide an innovative approach to flexible service delivery that will encourage access and
participation for all families in the community.
4. Provide a focus on prevention, early detection and intervention of the health and well being
concerns of vulnerable infants, children and their families through an interdisciplinary and
integrated service response.
5. Recognize and facilitate the access to families of cultural and linguistic diverse
backgrounds.
6. Promote and provide information and advice about vaccinating against preventable.
7. Act as an advocate for children, parents, the community and the Maternal
and Child Health Service as appropriate.

8. Proactively participate in the Maternal Child Health service team in the

development and implementation of continuous improvements to the service.

9. Participate in relevant networks and outreach programs concerning young

children and families as requested.
The 17 sustainable development goals
(SDGs) to transform our world:

 GOAL 1: No Poverty  GOAL 10: Reduced Inequality

 GOAL 2: Zero Hunger  GOAL 11: Sustainable Cities and
Communities
 GOAL 3: Good Health and Well-b
eing  GOAL 12: Responsible Consump
tion and Production
 GOAL 4: Quality Education
 GOAL 13: Climate Action
 GOAL 5: Gender Equality
 GOAL 14: Life Below Water
 GOAL 6: Clean Water and Sanita
tion  GOAL 15: Life on Land
 GOAL 7: Affordable and Clean E  GOAL 16: Peace and Justice Stro
nergy ng Institutions
 GOAL 8: Decent Work and Econo  GOAL 17: Partnerships to achiev
mic Growth e the Goal
 GOAL 3: Good Health and Well-being
Targets
 By 2030, reduce the global maternal mortality ratio to less
than 70 per 100,000 live births
 By 2030, end preventable deaths of newborns and children
under 5 years of age, with all countries aiming to reduce
neonatal mortality to at least as low as 12 per 1,000 live
births and under-5 mortality to at least as low as 25 per 1,000
live births
 By 2030, end the epidemics of AIDS, tuberculosis, malaria
and neglected tropical diseases and combat hepatitis, water-
borne diseases and other communicable diseases
 By 2030, reduce by one third premature mortality from non-communicable diseases through
prevention and treatment and promote mental health and well-being
 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and
harmful use of alcohol
 By 2020, halve the number of global deaths and injuries from road traffic accidents 3.7
 By 2030, ensure universal access to sexual and reproductive health-care services, including

for family planning, information and education, and the integration of reproductive health into

national strategies and programmes

 Achieve universal health coverage, including financial risk protection, access to quality

essential health-care services and access to safe, effective, quality and affordable essential

medicines and vaccines for all

 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals
and air, water and soil pollution and contamination
 Strengthen the implementation of the World Health Organization Framework Convention on
Tobacco Control in all countries, as appropriate

 Support the research and development of vaccines and medicines for the communicable
and noncommunicable diseases that primarily affect developing countries, provide access to
affordable essential medicines and vaccines, in accordance with the Doha Declaration on
the TRIPS Agreement and Public Health, which affirms the right of developing countries to
use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual
Property Rights regarding flexibilities to protect public health, and, in particular, provide
access to medicines for all
 Substantially increase health financing and the recruitment,
development, training and retention of the health workforce in
developing countries, especially in least developed countries and
small island developing States
 Strengthen the capacity of all countries, in particular developing
countries, for early warning, risk reduction and management of
national and global health risks
Millennium Development Goals 4 and 5
Goal 4: Reduce child mortality
Target 4 A: Reduce by two-thirds, between 1990 and 2015, the under-five
mortality rate
•Indicator 4.1 Under-five mortality rate
•Indicator 4.2 Infant mortality rate
•Indicator 4.3 Proportion of 1year-old children immunized against
measles
Goal 5: Improve maternal health by 2015
Target 5 A: Reduce by three-quarters, between 1990 and 2015, the maternal
mortality ratio
•Indicator 5.1 Maternal mortality ratio
•Indicator 5.2 Proportion of births attended by skilled health
personnel
•Indicator 5.3 Contraceptive prevalence rate
•Indicator 5.4 Adolescent birth rate
• Indicator 5.5 Antenatal care coverage (at least one visit and at
least four visits)
• Indicator 5.6 Unmet need for family planning