Module 06 Discussion – If I Ruled the World – What Is Meant by Mother Friendly and Baby Friendly?

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As nurses, we want to provide the best care possible, but what does that look like? How do we know that what we are doing is the best practice for our patients? Is the care we provide focused on hospital regulations, the routines of the nurses, the conveniences of the doctors, or the needs of the patient and his or her family?

In the 1950’s and 1960’s, patient care was so hospital centric that fathers were not allowed in the delivery room, patients were routinely subjected to unnecessary painful and often dangerous procedures, and mothers and babies were routinely separated after birth. We need to re-think the way we provide care, based on evidence, focused on the patient and driven by patient outcomes. There are some forward thinking individuals who have begun to lead the way.

Do some research on the practice of patient-centered care. Think about how you would want to be cared for if you were the patient, or if your loved one were the patient. What is meant by the terms mother friendly and baby friendly? How can nurses facilitate patient and family focused care?

 
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For Essays Guru – Course Project-Paper Submission

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Your paper for the course project should be a 2-3 page APA paper (not including title page and the reference page) that describes the clinical problem and the following: Reason for choosing this topic The PICOT question Possible integration of the evidenced that you found in clinical practice Methods to evaluate the effectiveness of implementation

 
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db 2 replies 2 apa references current

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Reply to Hollie

Question 1—Postpartum Depression

Postpartum depression (PPD) is a major depressive disorder that occurs up to one year after birth (Hackley & Kriebs, 2017). Common symptoms of postpartum depression include: anhedonia; sleep disturbance; feelings of loneliness, isolation, or guilt; poor concentration; anxiety; and somatic complaints (Hackley & Kriebs, 2017). Mothers with postpartum depression are also less responsive to their infants and often need help caring for their infant (Hackley & Kriebs, 2017). Studies have shown that postpartum depression can impact child development, behaviors in childhood, and children’s cognitive function (Hackley & Kriebs, 2017).

The Edinburgh Postnatal Depression Scale (EPDS) is the screening tool used at my preceptor’s clinic to assess for postpartum depression. Hackley and Kriebs (2017) state that because postpartum depression has bimodal peaks at 2 and 6 months, the optimal time to screen for postpartum depression is between 2 weeks and 6 months postpartum. The American College of Obstetricians and Gynecologists (ACOG) recommends screening at the patient’s 6-week comprehensive postpartum visit (ACOG, 2018). However, because postpartum depression can occur at any time, studies and the American Academy of Pediatrics (AAP) are now supporting the use of EPDS screenings for mothers at the 2 month, 4 month, and 6 month well child visits (Emerson, Mathews, & Struwe, 2018).

The cutoff score for depression on the EPDS ranges from 9 to 13. The AAP (n.d.) recommends women with a score of 9 or more be further evaluated for depression. A score of more than 12 is considered likely for postpartum depression (Hackley and Kriebs, 2017). Women with these scores should be clinically evaluated, started on treatment, or referred to a a mental health clinician (Hackley and Kriebs, 2017). A score of less than 9 should not rule out depression if clinical suspicion of PPD is present. Any woman indicating suicidal thoughts on the EPDS or during the comprehensive clinical exam should be immediately assessed to determine if hospitalization is needed (Hackely & Kriebs, 2017). For those at high risk, the patient should be taken to the emergency room (Hackley & Kriebs, 2017).

References

AAP. (n.d.). Edinburgh postnatal depression scale. Retrieved from https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/practicing-safety/Documents/Postnatal%20Depression%20Scale.pdf

ACOG. (2018). Screening for perinatal depression. American College of Obstetricians and Gynecologists, 132(5), 208-212. Retrieved from https://www.acog.org/-/media/Committee-Opinions/Committee-on-Obstetric-Practice/co757.pdf?dmc=1&ts=20190310T2001493232

Emerson, M., Mathews, T., & Struwe, L. (2018). Postpartum depression screening for new mothers at well child visits. American Journal of Maternal/Child Nursing, 43(3), 139-145. doi: 10.1097/NMC.0000000000000426

Hackley, B. K., & Kriebs, J. M. (2017). Primary care of women(2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Reply Angela

uestion 2: 6-Week Postpartum Visit

At the 6-week postpartum visit a full physical assessment is done including gynecological exam. Assessment for postpartum depression continues as well as infant bonding and parenthood and transitioning to regular gynecological care (ACOG. Org, 2018). If there were issues with preeclampsia and eclampsia or gestational diabetes these areas are addressed as well. Providing the patient’s primary care provider with the prenatal and post-natal history is recommended as well to help the patient receive care that is complete and collaborative. ACOG (2018) recommends an initial postpartum visit in three weeks which may just include a phone conversation but is not a complete physical exam and then a six week to twelve weeks visit that will include a comprehensive exam. It is recommended that the postpartum visit be no later than 12 weeks postpartum.

ICD-10 codes that are used for these visits are Z39.0 encounter for care and examination of mother immediately after delivery, Z39.1 encounter for care and examination of lactating mother, Z39.2 encounter for routine postpartum follow-up. There are other codes for postpartum encounters but are more disease related. The code that is used most generally is the Z9.2 code (ICD.codes, 2019). CPT codes can be used in the numerical range of 99211 through 99215 to reflect that a postpartum patient is an established patient and is in clinic for a routine exam. The higher the number use the more intensive the visit, or the more information and procedures were provided (supercoder.com, 2018).

References

ACOG. Com. (2018). Optimizing postpartum care. Retrieved from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Postpartum-Care (Links to an external site.)Links to an external site.

ICD10.codes. (2019). Code. Retrieved from https://icd.codes/icd10cm/Z712 (Links to an external site.)Links to an external site.

Supercoder.com. (2018). CPT code. Retrieved from https://www.supercoder.com/cpt-codes/99215 (Links to an external site.)Links to an external site. 

 
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nursing leadership/wk5

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 wk5/dulce

Nursing informatics improves patient centered care, promote health and communication. “Nursing informatics is a field of nursing that incorporates nursing, computer, and information sciences to maintain and develop medical data and systems to support the practice of nursing, and to improve patient care outcomes” (Registerednursing.org, 2018).

What technology does your facility use?

My facility uses Cerner medical software “Cerner’s powerful, intelligent Electronic Medical Record (EMR) delivers the most comprehensive set of capabilities in the industry” (Cerner.com, 2018). Cerner is user friendly, allows us to scan patients armband prior to scanning medications, reducing medication administration errors. It also has built –in alerts for sepsis, fall risk, wound care and protocols in place for chest-pain, hypo/hyperglycemia, electrolyte imbalance etc.

How has it improved patient care or outcomes?

This technology allows easy access to vital signs, medical records, laboratory results, imaging, medication list, allergies, and progress notes. By integrating this information health care providers can improve patient care outcomes by reducing medical errors. The system is accessible to physicians from the privacy of their homes; which helps optimize patient safety and improve quality of care.

What can be done to make it more useful or to further improve patient care or outcomes?

To further improve patient care it would be helpful if Cerner had the capability to roll over information from previous admissions. Medical history, medication list, allergy, PCP, pharmacy etc, not having to input this information on re-admissions would save time and allow nurses more time for patient care .

 
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