NSG 6002 Week 1 Assignment: Project Pregnancy and Childbirth

Pregnancy and Childbirth

Healthy People 2030 Initiative provides a national strategic framework aimed at enhancing overall health and wellbeing of persons in the United States of America over a 10-year period, 2020-2030 (Jamesetta, 2021). A key objective of the Healthy People 2030 is preventing pregnancy complications, reducing infant and maternal deaths and assisting women to retain good health and wellbeing prior, during and after undergoing the pregnancy period. The discussion covers a description of Healthy People 2030 objective of preventing pregnancy and childbirth complications. It also covers the state of maternal health in the state of Georgia, maternal policy improvement policy, its clinical importance and influence, the role of APN in supporting the policy and inter-professional collaboration.

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Description of Pregnancy and Childbirth Objective

Statistics by the Centres for Disease Control and Prevention indicate that about 700 women die annually in the United States due to preventable pregnancy or delivery complications (Centres for Disease Control and Prevention, 2020). Ideally, the pregnancy and childbirth objective is focussed on a number of specific aims namely: reducing the rate of foetal deaths at 20 weeks or more of gestation, reducing pre-term births, expanding access and use of early and sufficient pre-natal care, foster healthy lifestyles among pregnant women (avoidance of drug, tobacco, and alcohol use), fostering family planning and curbing sexually transmitted infections such as HIV, congenital syphilis) (Jamesetta, 2021; Georgia Department of Public Health, 2020). Other key goals under the selected Healthy People 2030 objective including expanding the number of pregnant women who are receiving the HPV and Tdap vaccines, reducing maternal deaths, diminishing caesarean births among low-risk women, and enhancing the quality of care for women and mothers throughout the pregnancy stages and beyond (Scroggy et al., n.d).

Maternal Health in Georgia State

In a 2020 report on maternal mortality in Georgia, it was reported that the State of Georgia had one of the highest maternal deaths in the country (Georgia Department of Public Health, 2020). Latest Statistics by the CDC indicated that pregnancy-associated death rates in Georgia approached 66.4 deaths per 100,000 live births from the year 2013 to 2017in contradiction to the national maternal death rate of 29.6 per 100,000 live births during the same period (Centres for Disease Control and Prevention, 2020). Reported number of pregnancy-related deaths were 26 deaths per 100,000 live births, with about 70% of them being preventable in 2017 (Centres for Disease Control and Prevention, 2020). In terms of prevalence, pregnant women and girls in the state of Georgia faces increased risk of pregnancy and childbirth complications that heightening their likelihood of dying from pregnancy associated causes and pregnancy-related risk factors (HMHBGA, 2019). Some of the causes of direct maternal deaths in Georgia State include infection, pulmonary embolism haemorrhage, pre-eclampsia and eclampsia, cardiovascular conditions, cardiomyopathy, and pregnancy-induced hypertension, among others (Office of Disease Prevention and Health Promotion, 2020). Georgia’s gradual progress on Healthy People 2030 for pre-natal care is strategically focussed on ensuring increased access of women to prenatal education, proved access to prenatal care, and increased overage of women under the Georgia Medicaid and Children’s Health Insurance Plan amidst serious concerns over access to care and support disparities by demographics, with the most affected being blacks and Hispanic women (Georgia Department of Public Health, 2020).

Georgia State Maternal Health Improvement Policy

The Georgia State Maternal Health Improvement Policy is primarily intended to foster and promote better birth outcomes, reduce maternal and infant deaths and to shrink the significant radical demographic disparities in maternal health outcomes across the State (Jamesetta, 2021). The Right from the Start Medicaid (RSM) program is primarily intended to cover the medical care expenses of pregnant women, including labour and delivery, for at least 60 days after the date of child birth; the eligible pregnant women for coverage under this program include those with monthly income below the 200% of the established federal poverty level limit (Scroggy et al., n.d.).

Specific legislators involved in the policy development

Georgia lawmakers in the Georgia General Assembly are actively involved in the development of the policy aimed at preventing maternal deaths, and adoption of better interventions. Some of the key legislators include speaker of the House of Representatives, and the President of the Senate, who assume key positions as top officers of the State General Assembly (HMHBGA, 2019).

Role of the APRN in Assisting with the Policy

As important health care leaders, advanced practice nurse may play an instrumental role in advocating the development and adoption of relevant policy-interventions to boost public health, improved maternal care and foster health equity ((Jamesetta, 2021). Empirical studies in the United States have also shown that the APN may also promote the realisation of patient-centred care and evidence-based practice through nurse advocacy for the maternal Health improvement policy in order to ensure sustained betterment of the health and well-being of vulnerable persons including pregnant women and children (Williams et al., 2018).

How the policy influences clinical practice

The Georgia State Maternal Health Improvement Policy is essentially focussed on offering leveraged quality of maternal care, enhancing patient safety, and reducing efforts that have often contributed to preventable pregnancy and childbirth complications (Georgia Department of Public Health, 2020). Improved access to primary care and increased partnership between the various parties and inter-professional teams in the delivery of maternal care and support is viewed integral in the realisation of best maternal health outcomes in Georgia and elsewhere (U.S. Institute of Medicine, 2017).

How the policy can be used by the inter-professional team to ensure coordination

When used by the inter-professional team, the policy reinforces the need for a strong partnership perspective and stakeholder coordination focussed on strengthening internal (such hospital departments) and external (such as authorities, research facilities, non-governmental entities, private sectors) partners in the identification of social needs and demands and in the investment in communities for improved health outcomes (U.S. Institute of Medicine, 2017). Williams et al (2018) insisted that inter-professional collaboration in the maternal healthcare setting may bring together different individuals and institutions with distinct competencies, organisational resources and capabilities for ensuring improvements in maternal health outcomes. Inter-professional collaboration is often mainly for purposes of improving population health through the development and adoption of comprehensive evidence-based approaches geared at responding to the distinct needs, demands and expectations of the targeted individuals and communities (Office of Disease Prevention and Health Promotion, 2020).

Conclusion

The objective of preventing maternal and infant deaths through improving quality of care and support for pregnant women and their children must be given top priority in the state of Georgia. The high rates of pregnancy-related and pregnancy-associated causes of maternal and infant mortality in the Georgia can be addressed through the adoption of a comprehensive state-wide Maternal Health Improvement policy. Through increased inter-professional collaboration and focus on improving quality of maternal care, the implementation of the policy may also require the involvement of advanced practice nurses and other key healthcare professionals in the delivery of holistic, patient-centred care and support.

References

Centres for Disease Control and Prevention, (2020).Healthy People 2030: Maternal, Infant, and Child Health. Workgroup. https://www.cdc.gov/oralhealth/about/healthy-people.html

Georgia Department of Public Health, (2020).Maternal Mortality. https://dph.georgia.gov/maternal-mortality

HMHBGA, (2019).Georgia: state of the state report. http://hmhbga.org/wp-content/uploads/2019-HMHBGA-State-of-the-State-Report-FINAL.pdf

Jamesetta, N. (2021).A different approach with Healthy People 2030.” The Nurse Practitioner, 46(2): 9.

Office of Disease Prevention and Health Promotion, (2020).Healthy People 2030 Framework. https://www.healthypeople.gov/2020/About-Healthy-People/Development-Healthy-People-2030/Framework

Scroggy, R., Herren, K. & Kelly, D. (n.d.).RIGHT FROM THE START MEDICAID (RSM). https://dhs.georgia.gov/sites/dhs.georgia.gov/files/related_files/document/DFCS.RSM%20Medicaid%205.12.pdf

U.S. Institute of Medicine, (2017).The Future of Nursing: Leading Change, Advancing Health. Washington (DC): National Academies Press (US); Transforming Practice. https://www.ncbi.nlm.nih.gov/books/NBK209871/

Williams, S.D., Phillips, J.M., & Koyama K.(2018) .Nurse Advocacy: Adopting a Health in All Policies Approach. OJIN:The Online Journal of Issues in Nursing, 23 (3), Manuscript 1. https://doi.org/10.3912/OJIN.Vol23No03Man01

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NSG6002 Week 1 Project

(My chosen topic from Healthy People 2030 list of objectives is “Pregnancy and Childbirth”) 3-4 Pages (not including title and reference pages)

Rubric/Criteria:

1. Describe a single health promotion/disease prevention problem/objective from the Healthy People 2030 Objectives (Pregnancy and Childbirth)

2. Describe the incidence, prevalence, epidemiology, cost burden etc. (Georgia)

3. Discuss how the policy is intended for a specific population, program or organization.

4. Identify and discuss specific legislators who are involved in the policy development. (Georgia)

5. Identify the role of the APRN in assisting with the policy or refuting the policy – this requires the evidence to support opinion, ideas and/or concepts.

6. Discuss how the policy influences clinical practice and is used to promote the best outcomes.

7. Examine how the policy can be used by the inter-professional team to ensure coordination.

8. Perform and demonstrate a comprehensive review of the current evidence.

9. Use primary sources and evidence that is not older than 5 years.

10. Use scholarly grammar, using APA 7th edition.

11. Use 3 credible resources for the assignment, including at least 1 scholarly peer-reviewed resource.