Nursing Considerations - Clinical Tree

Caring for pregnant women with heart disease is a complex undertaking for several reasons. First, neither nurses nor physicians have typically trained, or practiced, in both the obstetric and adult critical care settings. Second, the care of pregnant women always involves two patients, a seldom-experienced situation for nonobstetric nurses and physicians. Third, management of the critically ill obstetric patient requires care directed not only at the patient’s pathophysiology but also care and attention paid to the family and psychosocial issues that invariably occur.

This chapter provides an overview of nursing standards in general and then discusses the multidisciplinary care and nursing education that are critical components of our maternal cardiac care program.

Overview of Nursing Standards

Standards of nursing practice apply to both the obstetric and critical care nurses’ practice ( Table 26.1 ).

Table 26.1

Standards of nursing practice ^a

Step	Standard	Description
1	Assessment	The nurse collects comprehensive data about the patient’s health.
2	Diagnosis	The nurse analyzes assessment data to determine nursing diagnoses and conditions.
3	Outcome identification	The nurse identifies expected patient outcomes.
4	Planning	The nurse develops a plan of care that includes strategies and alternatives to achieve outcomes.
5	Implementation	The nurse implements the interventions identified in the plan.
6	Evaluation	The nurse evaluates the process and progress toward attainment of outcomes.

a Standards of professional performance include attainment of knowledge and competence, evidence-based practice, effective communication, collaboration, ethical practice, and participation in quality evaluation and improvement (American Association of Critical-Care Nurses, 2015; American Nurses Association, 2010).

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