Healthcare for Newborn Babies - Case Study Example

HEALTHCARE FOR NEW BORN BABIES: A CRITICAL REVIEW OF HEALTH VISITS AND THE PROTECTION OF NEW BORN BABIES Contents Introduction 3 Policy Framework forHealthcare and Social Care for Babies 3 Technical and Practical Requirement for Baby Care 5 Post-Partum Care 5 Routine Processes 6 General Framework for Examining and Analysing Children’s Development 6 Observation at Birth 7 Health Visits 8 Head-To-Toe Examination of the Baby in Health Visits 9 Case Study: Visiting a Baby Born to a Family of Three 10 Prior to Setting Off for the Visit 11 During the Visit 12 Final Activities During the Visit 12 Future Issues and Matters 13 Conclusion 13 Bibliography 15 Introduction Nursing is an interdisciplinary profession that seeks to promote the health and wellness of members of the society through the utilisation of various techniques of dealing with members of the society (King & Hinds, 2013; Miller, 2012; Kinghorn & Gaines, 2011). Thus, from birth to the rest of life amongst people in society, there is the duty and obligation for nurses to provide improved lives for such persons in the society. This requirement provides the impetus for the study and analysis of information about how children are protected and give the best in life. The aim of this research is to assess the healthcare requirements and needs babies and in the context of providing a high quality of life for babies through nursing. In order to attain this end, the following ends will be explored: 1. A critical review and analysis of the policy framework that guides the provision of healthcare and social care for babies; 2. An analysis of the technical and practical requirements for the provision of care for babies in nursing; 3. A case study and analysis of how care can be provided for a family of three involving a new-born baby; 4. An analysis of emergent issues and matters relating to healthcare and social care for babies. Policy Framework for Healthcare and Social Care for Babies There are numerous debates about when policy covers babies. The right to the abortion of foetuses implies that the scope of the laws protecting children is somewhat restrained and limited by the rights of parents to decide whether to have babies or not (Ballatt & Campling, 2009). However, rights are granted to babies form the womb through the fact that healthcare facilities are required to take reasonable care to ensure that babies are separated from contagious diseases that could spread from mothers and behaviours like smoking that could adversely affect babies. The actual work and obligation towards giving these children care lies with healthcare providers and this include specialist care practice health nurses (SCPHN) who might have the obligation to provide care at the facility and follow up with visits afterwards (Dolan & Holt, 2012). These health visits and other activities by SCPHN will involve observing various rules and regulations and ensuring that care is taken in order to analyse the babies and provide their needs (Luker, Orr, & McHugh, 2012; Bridgemann, Keating, & Lind, 2013). The SCPHN is bound by the codes of the NMC which include providing care in good faith by respecting the needs of all people including the babies and their mothers in order to safeguard their health and safety. There are NICE practices which include maintaining certain specific standards in promoting the proper care of babies from birth through to the first five years through high quality, cost effective patient care as well as the use of treatment and prevention (National Institue for Health and Care Excellence, 2013). Also, the Healthy Child Programme of the UK government provides a range of guidance that prompts care amongst healthcare professionals including SCPHN who provide various levels of service to babies from pregnancy to the first five years and this include standards relating to a combined practice code which covers universal preventive service, family programmes for care to babies by way of screening, immunisation, health and development reviews, advice in health as well as wellbeing and parenting. This informs the practice of the SCPHN and this plays a role in the formulation of practice standards for such practitioners. Technical and Practical Requirement for Baby Care Prenatal involves the rights and obligations placed on mothers to ensure that the child’s care is taken into consideration before she commits any acts during pregnancy (Dolan & Holt, 2012). In the perinatal section of healthcare, there is the need for proper care to be taken by the mother, healthcare professionals like nurses and other members of the society in order to ensure that proper care is taken to ensure that appropriate care is taken. At birth, there are rules and regulations on what to do including data recording and immunisation and this is standard policy that an SCPHN must observe as part of her practice (Newton, 2008). However, there are some features of “normal babies” that must be observed and put in practice in order to ensure that a baby is given the right care from birth (Edmonds, 2012). Post-Partum Care Postpartum care is particularly important because most of the elements and aspects of the umbilical cord and other faeces from the baby need to be handled with extreme care and this has been the traditional duty of SCPHNs (Mcintosh, 2013). The medical team will need to take the details of the baby at birth. This includes the weight, the width of the foot, arm, and other parts of the body that relates to the baby in question. This will be documented and recorded in the name of the baby’s parents. From there, the baby ought to be identified and put in a way and manner in which he will be differentiated from other babies in the healthcare facilities. At this point, the baby can be presented to the other relatives. There must be careful hand wash by relatives and friends who are likely to hold the baby. This should prevent the transmission of the baby who is in a highly vulnerable phase and could contract an infection (World Health Organisation, 2013). There is also the need to take care to prevent the vagina of the mother from catching infection. Hence, this comes with numerous forms of care and the changing of pads and the application of proper and appropriate medication to help in healing the wounds. The standard practice of the NHS is to allow the family to practice the cultural trends that they are familiar with and this varies from Anglo-Saxons, Arabs, Hindus, Jewish, African and other persons in the society (Chapman & Durham, 2009). Hence, there is the need for the facility in question to ensure that the culture of the people is identified and applied in the process. However, most of the processes carried out by the healthcare professionals is usually based on standard practices. Routine Processes There is a general need for the fundamental data of a baby to be recorded. This includes time of birth, circumstances at birth and other items to provide a database on which information can be deduced and utilised to help the baby to attain the best healthcare possible (Sheridian, 2008). The documentation gives way for immunisation and other forms of healthcare which will be classified as postnatal in nature to be done on the child. General Framework for Examining and Analysing Children’s Development As a precursor, any care that will be given to children in their early stages include the observation of facts and information about the child and this must be recorded by an SCPHN. This includes various observations from events and other information that might be made available to an SCPHN. This information must be gathered and put together to define the affairs of a child and from there, a plan for action can be formulated in order to deal with the child’s needs and provide the best services. This is presented in Figure 1 below: Figure 1: Assessing Babies’ Development Observation at Birth Mary Sheridan identifies that there are important pointers that an experienced nursing practitioner must observe in the baby between birth and the first few days after birth. At birth, the baby has long periods of birth with a few periods where they are awake and whilst they are awaked, there are periods of fretfulness, crying and calmness (Sheridian, 2008). Examinations must be carried out where the baby is awake and alert this includes the following: 1. Posture and Large Movement 2. Primary Reflexes 3. Hearing and Vision 4. Social interaction and the formation of attachments These basic pointers form the basis and impetus for the analysis of the baby and this continues throughout the life of the baby because the requirements and expectations of every age of the baby changes since there are different expectations for babies at each age or stage of their development (Sheridian, 2008). At birth the arms and legs are stiff (hypertonia) and the trunk and neck are floppy (hypotonia) (Sheridian, 2008). The features of babies born normally and those born through other means like breech birth and caesarean section have significantly different characteristics. Most babies react to light and sound differently. Some show little or no sensitivity whilst others show some kind of responsiveness to these things when they are close by. An SCPHN must conduct these observations in the first few days after birth. Health Visits After discharge from the hospital and medical facility, the SCPHN follow up with health visits to the home of new mothers and this will involve various examinations (Fisher, 2005). This is part of observing the needs of the child and providing the best services possible. The healthcare visit will involve examination of the kind of resources available to the mother and the observation of how the mother carries out her childcare. This is done by the nurses and midwives as a form of social care which is rendered to the new mother. The health visits also involves changes that the mother goes through during puerperium which is how the mother recovers after childbirth (Bolton, 2010). Nutritional factors and lactation will be checked during such visits and this provides guidelines on how the mother is faring and how she is dealing with circumstances and situations relating to her health and its implication to the baby. The ultimate end also includes assessing the situation involving the mother and drawing a routine on how the mother can improve her ways of giving the baby the best kind of upbringing and care (Bannon & Carter, 2012). In this process, the health visitor ought to be on the alert for red flags in the family or the mother’s attitudes and circumstances. If any real dangers are identified, there must be some action to be taken to ensure that the child’s interests are safeguarded. Head-To-Toe Examination of the Baby in Health Visits There is the need for critical examinations for obvious signs of situations and matters that could be signs of medical issues and problems that might demand prompt attention (Liebmann-Smith & Morgan, 2012). Prior to these visits and examinations, the healthcare visitor must take time to gain an intimate familiarity with the baby’s health history and medical conditions (Rosdahl & Kowalski, 2008). This will act as the basis to guide the health care visitor to formulate a more critical perspective that will guide the examination of the child. This is because familiarity with the health history of the child will enable the healthcare visitor to know which things and matters are important and vital to help them to check up the child. The physical assessment should be done to deduce physical, mental and social signs on the baby that prompts some kind of responses and changes (Rosdahl & Kowalski, 2008). With the benefit of the history of the patient, there is the need for some kind of careful head to toe analysis and reviews (Sinha, Miall, & Gardine, 2010). A head-to-toe examination involves the examination of the gums, teeth, thyroid glands, heart, lungs, breasts and body system of the baby (Rosdahl & Kowalski, 2008; Lomax, 2010). The change of the weight should be examined by checking the baby’s weight and comparing it to the weight at birth. The head circumference of the baby must also be taken. The healthcare visitor must also examine the maturity, muscle tone, reflexes and the way the baby seem to be carrying out his or her normal activities (Sinha, Miall, & Gardine, 2010; Marsden, 2012). The head should be examined through the identification of the skull shape and size (Sinha, Miall, & Gardine, 2010). Swellings on the skull must be examined to see if they are birthmarks or actually injuries or signs of other medical complications and issues. The eyes of a baby must be checked and examined to see if they are normal or not. Red reflexes in eyes must prompt checks for cataracts (Norsigian, 2012). Also, yellowish eyes and scalera must give signs of jaundice or other similar complications. The mouth ought to be checked for central cyanosis and/or signs of neonatal teeth. These are important pointers that might give indications of something unusual with the baby. The respiratory rate of the chest must be checked to see if it is normal or not and the symmetry of chest movements must balance otherwise, there might be the need for further checks (Cook & Langton, 2013). The abdomen of a baby could also show signs of liver conditions and other internal conditions within the baby and this must be observed closely in a health visit (Cook & Langton, 2013). The structure of the back and spine of a baby must also be checked. Hip alignments and positioning must be observed critically by a health visitor. The anus of the baby must be checked for obvious signs whilst the limbs must also be examined for extra digits and/or clubbed foot amongst others. These signs provide a basis for an opinion to be passed about the wellbeing of the baby and the risks inherent in the baby as well as the extent of these risks in the baby. Case Study: Visiting a Baby Born to a Family of Three This section of the research will focus on a blend of practical as well as other academic theories relating to how to deal with a health visit to the home of a new mother who has a child. The baby in question is 10-14 years old alongside an older sibling of about 22 months old. The new mother has a mother-in-law who lives nearby and visits from time to time to check on her and the children. The visit is to be part of the Healthy Child Programme which includes visiting to check the baby for important and vital signs. These signs include important pointers that might be necessary to prompt some kind of changes and some kind of treatment plan or process in order to deal with the needs and expectations of the child and mother. Prior to Setting Off for the Visit In order to conduct a meaningful study, there is the need for the health visitor and the team to get a familiarity of the family they are visiting. This includes examining pregnancy history of the mother and the delivery process. Also, vital records relating to the baby and the baby’s data taken at birth must be taken. The data of the baby must be examined to identify risks and other factors that could prove vital in analysing and evaluating the child’s conditions. Risks and other issues that are of importance and significance must be documented and this must prompt an action plan that would be employed in order to check the progress of the child. Afterwards, the family history of the mother and father including some important information like blood type and others must be made known to the health visitor. This will guide in creating a broad framework for the examination process. In order to retain trust, there is the need for the visit to be either planned or based on an event that reasonably prompts the visit. This includes the prior information of the mother about the visit. This is to enable the mother to prepare to meet the health visitor. In cases where something extraordinary occurs, an unplanned visit could take place. Either ways, there is the need for trust to be viewed as an important aspect of the entire process. Hence, respect is key and the mother’s fundamental rights must be respected throughout the process and the activities. During the Visit During the visit, the health visitor needs to build some kind of rapport with the mother. This must be done through communication with the patient and a follow up of what has happened in the past. Some kind of camaraderie or discussion can help to build some degree of connection with the mother. After that, the mother must be examined and reviewed critically to check her recovery and her position after the birth and delivery. Also her health and capability of lactating and her temperamental attitudes towards the baby must be taken into account through the asking of some diplomatic questions and the observation of the mother’s attitudes. After the mother’s examination and observation is done, the health visitor will have to conduct a head-to-to examination of the baby. This is done by measuring the baby’s head in order to check if there are signs of hydrocephalus or microcephalus. Also, the baby’s gross and motor reflexes must be checked closely. The colour of the baby’s eyes must be examined and evaluated. The health visitor must also check if blood spot was done on the 5th day after birth or not. When the observation from head to toe is done, the baby must be weighed and specific issues and problems that relates to the baby’s health history must be examined closely with emphasis on high risk problems and situations. This must provide an insight into issues and matters that ought to lead to some kind of changes and modifications. Final Activities During the Visit After all the specific examinations are done, there is the need for the health visitor to examine the relationship between mother and baby and sibling and baby. This must be done through the observation of how the baby’s sibling treats the baby to identify if there are any health risks or not. Also, the mother’s breastfeeding must be observed by the health visitor. This will help to document and identify the kind of household being kept by the mother and how well they are bonding. Finally, the health visitor must provide advice and counselling to the mother on areas and issues like feeding, resting and hygiene. This will help the mother to make the right choices and right decisions on how to improve her role as a mother. Also, how long she keeps the baby in the cot and the kind of schedule she has towards the baby is important and must be reviewed and discussed with her so that a better process and a better approach can be formulated in order to create strong relationships and bonds between the mother and the baby. Future Issues and Matters The issue of marriage equality seem to be on top of the agenda of the social system and structures. It appears that very soon, same sex marriages will be treated as other marriages and such couples can adopt children freely or have children of their own. This will mean the attitudes of health visitors will have to be adjusted to a point where they will accommodate same-sex couples and/or transgender couples who might not be clear-cut members of one gender. Conclusion The study identifies that the process of best practices have changed and grown significantly to a point where there are professional codes, legal requirements and other government policies that guide the way babies are treated right from the late stages of pregnancy to their birth and early life. This creates a set of obligations placed upon healthcare service provides who are required to attain this. Most healthcare professionals are required to do things according to high standards to observe babies and safeguard their best interest. Health visits are important aspects of the observation and examination of these babies. During health visits, there is the need for the healthcare official to observe the mother and then conduct a head-to-toe examination of the baby to deduce any risks and provide timely intervention. Bibliography Ballatt, J., & Campling, P. (2009). Intelligent, Kindness: Reforming the Culture of Healthcare. London: RCPsych Press. Bannon, M. J., & Carter, Y. (2012). Practical Paediatric Problems in Primary Care. Oxford: Oxford University Press. Bolton, A. (2010). Community Health Nursing. New York: Jones and Bartlett. Bridgemann, J., Keating, H., & Lind, C. (2013). Regulation Family Responsibilities. Surrey: Ashgate Publishing. Chapman, L., & Durham, R. (2009). Maternal-Newborn Nursing: The Critical Components of Nursing Care. Philadelphia, PA: FA Davis. Cook, K., & Langton, H. (2013). Cardiothoracic Care for Children and Young People. London: Wiley Publishing. Dolan, B., & Holt, L. (2012). Accidents & Emergency, Theory in Practice. London: Elsevier Health. Edmonds, K. (2012). Dewhursts Textbook of Obstetrics and Gynaecology. London: Wiley. Fisher, A. (2005). Health and Social Care. London: Heinemann. King, C. R., & Hinds, P. S. (2013). Quality of Life: From Nursing and Patient Perspectives. New York: Jones and Bartlett. Kinghorn, S., & Gaines, S. (2011). Palliative Nursing: Improving End-of-Life Service. London: Elsevier. Liebmann-Smith, J., & Morgan, J. (2012). Baby Body Signs: The Head-to-Toe Guide to your Childs Health. New York: Random House. Lomax, A. (2010). Examination of the Newbork. London: Wiley. Luker, K., Orr, J., & McHugh, G. A. (2012). Health Visiting and Rediscovery. Hoboken, NJ: John Wiley and Sons. Marsden, K. (2012). Good Gut Bugs: How the Healing Powers of Probiotics Transform your Health. London: Hackette. Mcintosh, T. (2013). A Social History of Maternity and Childbirth. London: Routledge. Miller, C. A. (2012). Nursing for Wellness in Older Health. Amsterdam: Wolters Kluwer Health. National Health Service. (2003). Getting the Right Start: National Service Framework for Children which . London: TSo. National Health Service. (2010). Pregnancy and Complex Social Factors. London: NHS. National Institue for Health and Care Excellence. (2013, December 13). NICE Guidelines. Retrieved June 12, 2014, from National Institute for Health and Care Excellence: http://www.nice.org.uk/#panel3 Newton, V. E. (2008). Paediatric Audiological Medicine. London: Wiley Publishing. Norsigian, G. (2012). Our Bodies, Ourselves: Pregnancy and Birth. New York: Simon and Schuster. Rosdahl, B. C., & Kowalski, M. (2008). Textbook of Basic Nursing. Amsterdam: Wolters Kluwer. Sheridian, M. D. (2008). From Birth to Five Years: Childrens Development. London: Routledge. Sinha, S., Miall, L., & Gardine, L. (2010). Essential Neonatal Medicine. London: Wiley. World Health Organisation. (2013). Pregnancy, Childcare, Postpartum and New Born care. New York: WHO. Read More