PICOT Statement Paper
PICOT Statement Paper
Running head: REDUCING STILLBIRTHS Reducing stillbirths NRS 490 April 8, 2018 1 REDUCING STILLBIRTHS 2 The
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problem Even though infant mortality in the US is not as high as it is in developing countries, stillbirths still remain high, accounting for a high percentage of maternal deaths. In every 160 pregnancies in the US, at least one of the babies is usually still born, adding up to 26,000 deaths each year. This is a high rate compared to the rates of other developed countries (Robert M. Silver, 2007). Still birth is an emotional experience for both the mother and the health care provider. High stillbirth rates can be attributed to multiple factors including negligence of patient needs by healthcare providers, as well as a patient’s physical, mental, and emotional state due to factors such as being overweight, giving birth after a certain age, drug addiction and smoking, or having been diagnosed with diabetes (CACCIATORE, 2010). Description and setting in which the problem can be observed Compared to other highly industrialized countries such as Japan, Germany, and Australia, US has a high stillbirth rate, whose main cause could be the increasing gap between the rich and the poor. Most of these stillbirth statistics indicate racial and economic trends. As has been identified by research findings, multiple parties including health care providers, patients, and the community have a role to play in minimizing the rate of stillbirths (Gary L Darmstadt, 2009). According to research, factors such as a woman’s age contribute to the likelihood of a still birth, with women under the age of 15 being more likely to have still births compared to women within the age of 25 to 29. Women who are over 35 also have a higher risk of experiencing stillbirths (Fernando C Barros, 2010). Impact of the problem Stillbirth causes a high emotional and psychological pain to the family experiencing the loss. However, stillbirth is not simply an individual’s problem but is also a national issue which ought to be addressed at a community and at a national level (BMJ, 2015). Many REDUCING STILLBIRTHS 3 causes of stillbirth including economic and social factors, health complications, or drug abuse are known to recur in subsequent pregnancies, hence leading to an increase of the chances of experiencing stillbirth in the next pregnancy (ulfiqar A. Bhutta, 2003). Due to these difficulties in addressing the root causes, most professionals and the community have a difficult in identifying the level of care which one needs for subsequent pregnancies. Significance of the problem and its implications to nursing Nursing care has a significant impact on maternal care and impacts the possibility of a mother experiencing stillborn birth. This care also affects a patient’s reaction post the stillbirth, and especially how they deal with the loss. Patients with medical conditions such as High blood pressure have a high possibility of experiencing stillbirth, hence the need to pay keen attention to patients with specific needs to ensure that they are healthy and well cared for during the pregnancy. Factors such as religious beliefs, previous history of loss, and family structures also affect how a patient is likely to care for themselves during a pregnancy, and nurses would be expected to understand these social cultural factors in order to ensure that a patient is well cared for (RANZCOG, 2014). Proposed solution In order to minimize the cases of stillborn births, there are various behavioral and social mediated approaches which healthcare professionals and the community can take. These include ensuring that quality and universal healthcare is accessible to all, educating the community on the effects of maternal exposure to harmful practices and substances, and ensuring that maternal nutrition before and after pregnancy is ensured (Esme V Menezes, 2009). REDUCING STILLBIRTHS 4 References BMJ. (2015). Risk of recurrent stillbirth: systematic review and meta-analysis. BMJ , 350. Retrieved from https://www.bmj.com/content/350/bmj.h3080 CACCIATORE, J. (2010). Stillbirth:Patient-centered Psychosocial Care. CLINICAL OBSTETRICS AND GYNECOLOGY, 9. Retrieved from https://repository.asu.edu/attachments/145706/content/Stillbirth%20Patient%20center ed%20psychosocial%20care%20final%20Cacciatore%202010.pdf Esme V Menezes, M. Y. (2009). Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy. BMC Pregnancy Childbirth, 9. Fernando C Barros, Z. q. (2010). Global report on preterm birth and stillbirth. Barros, 36. Retrieved from https://link.springer.com/content/pdf/10.1186%2F1471-2393-10-S1S3.pdf Gary L Darmstadt, M. Y. (2009). Reducing stillbirths: interventions during labour. Retrieved from NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2679412/ RANZCOG. ( 2014). Caring for families. Retrieved from Evidence-based guidance for healthcare professionals: https://www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOGMEDIA/Women’s%20Health/Caring-for-families-experiencing-stillbirth-Part1.pdf?ext=.pdf Robert M. Silver, M. W. (2007). WORK-UP OF STILLBIRTH: A REVIEW OF THE EVIDENCE. Am J Obstet Gynecol, 433-444. ulfiqar A. Bhutta, G. L. (2003). Using Evidence to Save Newborn Lives. Policy Perspectives on Newborn Health, 6.
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