American Nurses Association 'Code of Ethics for Nurses'
American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) 'Guidelines for Perinatal Care'.
American Medical Association 'Code of Medical Ethics'
Is often directly linked to clinical practice issues
Rarely involves clinical practice issues
Should be handled separately from clinical practice issues
National professional standards
Trends in practice
A root-cause analysis should be conducted
It must be reported to TJC within 60 days
Those involved should be placed on administrative leave pending an investigation
Any unexplained adverse occurrence
Birth of a baby with previously undiagnosed congenital abnormalities
Unanticipated death of a full-term infant
Determine fault of the healthcare provider or hospital
Examine institutional liability
Review potentially contributing systems
Adequate medical record documentation
Annual competency validation
Current unit policies and procedures
Include "near misses" with potential for adverse outcomes
Identify and discipline those at fault
Increase institutional and nursing liability
Considered unprofessional behavior
Discussed with the patient's family
Focused on the issue in question
Consults with another physician in the unit.
Institutes the chain of command/ chain of consultation.
Provides the intervention indicated.
How care is delivered
Policies and procedures
Rates of maternal morbidity and mortality
The number of elective inductions of labor prior to 39 weeks' gestation
The rates of third and fourth degree lacerations
How tachysystole is identified and treated
Number of nurses who are certified in fetal monitoring
Rates of cesarean birth for indeterminate fetal status
Number of sentinel events per year
Policies and procedures consistent with national standards and guidelines
Dopplering FHTs every 30 minutes during early labor
Electronic fetal monitoring
Fetal scalp electrode
Requesting elective induction at 39 weeks
All husbands should be present during labor and birth
The husband may fear his response to his wife giving birth
The woman's request should be honored
Her lack of knowledge of appropriate health-care for the baby
The baby's early care being provided largely by a maternal grandmother
The first month after birth being considered a time for confinement and rest
Keeping the placenta in a leak proof container
Requiring disposal of the placenta by internment (burial)
Keeping the placenta frozen until burial
Advises Maria that the pills are only vitamins and not considered medication
Assess the significance of Maria's mother's advice
Reminds her that the vitamins were ordered by the nurse-midwife
Here's an interesting quiz for you.