Chapter 1 – 21st Century Maternity Nursing
Efforts to reduce health disparities
o HRSA Health Disparities Collaboratives- goal of eliminating disparities and improving
delivery systems of healthcare for everyone in the US who is cared for in the HRSA-
supported health centers.
o Institute for Healthcare Improvement (IHI)
o The National Institutes of Health- committed to improve the health of minorities and
provides funding for research and training minority researchers
o National Institute of Nursing Research-support of research that promotes health equity
and eliminates health disparities
o Centers for Disease Control and Prevention (CDC)-provides data against which to
measure progress in eliminating disparities
o U.S. Department of Health and Human Services
Progress report on eliminating health disparities released in 2015
Contemporary issues and Trends
-Healthy People 2020- provides science-based 10-year national objectives for improving the
health of all Americans- it has 4 overarching goals.
- 33 of these goals are directly related to maternal, infant and child health
- EX: reduce the rate of fetal and infant deaths, maternal mortality, preterm births, and
Ceserean births among low risk women
- risk for c-section- fetal HR drops, moms BP, bleeding, placenta previa/abruption
-Millennium development goals- 8 goals to be achieved by 2015 that respond to the main
development challenges in the world
1. Eradicate extreme poverty and hunger.
2. Achieve universal primary education.
3. Promote gender equality and empower women.
4. Reduce child mortality.
5. Improve maternal health.
6. Combat HIV/AIDS, malaria, and other diseases.
7. Ensure environmental sustainability.
8. Develop a global partnership for development.
-Integrative health care
-Interpersonal education- foster a collaborative learning environment between faculty and
students- client care will improve when health professionals work together (SBAR,Team STEPPS)-
include values/ethics for interprofessional practice, roles/responsibilities, interprofessional
communication and teamwork.
-Problems with the US health care system
• Structure of the health care delivery system- is often fragmented and expensive and
inaccessible to many
• Reducing medical errors-leading cause of death in the US
• High cost of health care
• Limited access to care- the most significant barrier to access is the inability to pay
• Health Care Reform: ACA adopted into law, 2010-make insurance affordable, contain
costs, and reform the insurance market
• Accountable care organizations (ACOs)- coordinate high quality care, eliminate
duplication of services, and prevent medical errors, which results of savings of health
care dollars
• Health Literacy- understanding and being able to use health care information