Gaps in Postnatal Support for Intended Parents.

PURPOSE: To identify gaps in postnatal depression screening and support services for intended parents (parents who are intended to receive the baby from a gestational surrogacy pregnancy), also known as commissioned parents. STUDY DESIGN AND METHODS: This descriptive study used quantitative and free-text survey questions designed to assess postnatal depression screening and postnatal services available for all parents and, more specifically, for intended parents. SAMPLE: The survey was sent to 2,000 randomly selected postpartum nurses in the United States who are members of the Association of Women's Health, Obstetric and Neonatal Nurses. RESULTS: Completion of the survey was offered to the 125 nurses who responded that they provided care for intended parents. Thirty-seven percent of respondents indicated that postpartum support services are available for both parents. Free-text responses describe a gap in postnatal services for intended parents. Although 85% of survey respondents reported that postpartum depression screening occurs in their setting, nurses reported neither fathers nor intended parents are screened for postnatal depression. CLINICAL IMPLICATIONS: This study expands the known gap in postnatal support services for intended parents, including postnatal depression screening. Recommendations for nurses working in the perinatal setting include providing consistent support for all parents as they transition to parenthood. Creating standardized policies and practices reflecting the diverse needs and cultures of intended parents can help direct all clinicians toward providing more significant support. Adapting current postnatal screening and support systems could provide a continuum of support for all families.

Midwifery and nursing: Considerations on cord management at birth.

Mounting evidence overwhelmingly supports the practice of the return of an infant's placental blood volume at the time of birth. Waiting just a few minutes before clamping the umbilical cord can provide health benefits to infants of all gestational ages. Despite the robust evidence, uptake of delayed cord clamping (DCC) into mainstream obstetrical practice is moving slowly. The practice of DCC is influenced by various factors that include the setting in which the birth takes place, the use of evidence-informed guidelines and other influences that facilitate or hinder the practice of DCC. Through communication, collaboration, and unique disciplinary perspectives, midwives and nurses work with other members of their respective care team to develop strategies for best practice to improve an infant's well-being through optimal cord management. Midwifery has been practiced for centuries throughout the world and midwives have supported DCC since the beginning of recorded history. An important tenet of midwifery philosophy is watchful waiting and non-intervention in normal processes. Nurses are vital to care of birthing families in- and out-of-hospitals as well as in prenatal and postpartum ambulatory care. Nurses and midwives are positioned to be involved in the process of adapting to the mounting evidence for DCC. Strategies to increase better utilization of the practice of DCC have been proposed. For all, teamwork and collaboration among disciplines participating in maternity care are essential for adapting to the new evidence. Involving midwives and nurses as partners in an interdisciplinary approach to plan, implement and sustain DCC at birth increases success.

Trends in Baby-Friendly® Care in the United States: Historical Influences on Contemporary Care.

The protection that breast-feeding affords both mother and infant against acute and chronic illness is well documented. The grassroots, public health, and governmental supports for breast-feeding have influenced changes in maternal and newborn care. History indicates that the additional influence has come in the form of governmental workshops and initiatives, professional organizations, as well as The Joint Commission. This includes the influence that the Baby-Friendly® Hospital Initiative and the Ten Steps to Successful Breastfeeding have had on infant care throughout the years. The requirements that hospitals must follow to implement all, or some, of the Ten Steps lead to change in care that not only increases breast-feeding rates but also leads to health improvements. This article reviews how an upward trend in the adoption of Baby-Friendly practices to support breast-feeding impacts infant care.

Creating the Joint Commission "super user": an innovative plan to ensure survey readiness.

Preparing for The Joint Commission accreditation survey can be a daunting process. To ensure staff readiness, we created a plan to disseminate updated information to all hospital staff. Harnessing the momentum of increased staff involvement through shared governance and the past successes of the "super user" role, The Joint Commission Super User (TJCSU) role was created. This article discusses the role of the TJCSU and its positive impact on our hospital's readiness for and results of The Joint Commission accreditation survey.

The collegial clinical model for orientation of new graduate nurses: a strategy to improve the transition from student nurse to professional nurse.

The orientation process assists the graduate nurse (GN) to make the transition from nursing student to professional nurse. The collegial clinical model is an orientation strategy that was designed, developed, and implemented to assist GNs with this transition. GNs are familiar with the composition of a clinical group as this is the manner in which the hospital experiences are designed in nursing school. With the nurse educator effectively functioning as a clinical instructor during 3 days of the clinical orientation, the GNs ease into the transition to the unit on which they will be working. Four GNs hired to work on the postpartum unit during June 2006 participated in the pilot test of the collegial clinical model. Quotations from the reflective journal exercise that the GNs completed clearly show the benefit of this type of orientation. Preorientation and postorientation meetings with preceptors also highlight the benefits of this model as an orientation strategy.