Asunto(s)
Mala Praxis/legislación & jurisprudencia , Enfermería Neonatal/legislación & jurisprudencia , Obstetricia/legislación & jurisprudencia , Atención Perinatal , Femenino , Humanos , Seguro de Responsabilidad Civil , Responsabilidad Legal , Mala Praxis/economía , Atención Perinatal/legislación & jurisprudencia , Atención Perinatal/normas , Embarazo , Estados UnidosRESUMEN
OBJECTIVE: To describe perinatal nurses' experiences of caring for incarcerated women during pregnancy and the postpartum period; to assess their knowledge of the 2011 position statement Shackling Incarcerated Pregnant Women published by the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN); and to assess their knowledge of their states' laws regulating nonmedical restraint use, or shackling, of incarcerated women. DESIGN: Cross-sectional survey. SETTING: Online across the United States. PARTICIPANTS: AWHONN members who self-identified as antepartum, intrapartum, postpartum, or mother-baby nurses (N = 923, 8.2% response rate). METHODS: A link to an investigator-developed survey was e-mailed to eligible AWHONN members (N = 11,274) between July and September 2017. RESULTS: A total of 74% (n = 690) of participants reported that they cared for incarcerated women during pregnancy or the postpartum period in hospital perinatal units. Of these, most (82.9%, n = 566) reported that their incarcerated patients were shackled sometimes to all of the time; only 9.7% reported ever feeling unsafe with incarcerated women who were pregnant. "Rule or protocol" was the most commonly endorsed reason for shackling. Only 17.0% (n = 157) of all participants knew about the AWHONN position statement, and 3% (n = 28) correctly identified the conditions under which shackling may ethically take place (risk of flight, harm to self, or harm to others). Only 7.4% (n = 68) of participants correctly identified whether their states had shackling laws. CONCLUSION: Our results suggest critical gaps in nurses' knowledge of professional standards and protective laws regarding the care of incarcerated women during pregnancy. Our findings underscore an urgent need for primary and continuing nursing education in this area.
Asunto(s)
Enfermería Neonatal , Rol de la Enfermera , Enfermería Obstétrica , Periodo Posparto/psicología , Mujeres Embarazadas/psicología , Prisioneros/psicología , Adulto , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Evaluación de Necesidades , Enfermería Neonatal/ética , Enfermería Neonatal/legislación & jurisprudencia , Proceso de Enfermería/ética , Proceso de Enfermería/legislación & jurisprudencia , Enfermería Obstétrica/ética , Enfermería Obstétrica/legislación & jurisprudencia , Embarazo , Estados UnidosAsunto(s)
Delegación Profesional/legislación & jurisprudencia , Enfermería Neonatal/legislación & jurisprudencia , Admisión y Programación de Personal/legislación & jurisprudencia , Competencia Clínica/legislación & jurisprudencia , Toma de Decisiones/ética , Delegación Profesional/normas , Humanos , Enfermería Neonatal/normas , Rol de la Enfermera , Supervisión de Enfermería/legislación & jurisprudencia , Admisión y Programación de Personal/normasRESUMEN
Litigation in perinatal nursing represents a disproportionate share of indemnity payouts and results in excessive psychological stress. Testimony at deposition or trial can be challenging for clinicians; little is taught in training or postgraduate education regarding litigation. Nurses, midwives, and physicians can effectively navigate the deposition process and prepare for trial testimony by understanding the plaintiff's goals, recognizing the role of documentation, and becoming familiar with various plaintiff's strategies including reptile theory. Knowledge of psychological concepts such as confirmation bias and cognitive dissonance may assist clinicians in responding to plaintiff's lines of questioning. Deposition preparation is crucial to the defense and requires active participation on the part of clinicians; it may include mock deposition or use of simulation laboratories. Common mistakes in deposition may be avoided with foresight and anticipatory planning by clinicians working closely with risk managers and defense attorneys. This article provides an overview of the deposition process, including the plaintiff's goals and common approaches, as well as the role of documentation and common errors of deponents.
Asunto(s)
Testimonio de Experto/métodos , Enfermería Neonatal/legislación & jurisprudencia , Atención Perinatal/legislación & jurisprudencia , Humanos , Mala Conducta Profesional/legislación & jurisprudencia , PsicologíaRESUMEN
Chlorhexidine is a skin antiseptic agent frequently used for off-label indications in NICUs. Changes to the safety labeling of chlorhexidine products for use in preterm infants were recently made because of the risk of severe chemical burns. We provide tips for a safer use of chlorhexidine to prevent injury in newborns and to help health care professionals protect themselves against burn injury claims.
Asunto(s)
Quemaduras Químicas , Clorhexidina/efectos adversos , Cuidado del Lactante , Recien Nacido Prematuro/fisiología , Mala Praxis/legislación & jurisprudencia , Enfermería Neonatal/legislación & jurisprudencia , Cuidados de la Piel , Antiinfecciosos Locales/efectos adversos , Quemaduras Químicas/etiología , Quemaduras Químicas/prevención & control , Humanos , Cuidado del Lactante/métodos , Cuidado del Lactante/normas , Recién Nacido , Cuidados de la Piel/métodos , Cuidados de la Piel/normasAsunto(s)
Daño Encefálico Crónico/enfermería , Enfermedades del Prematuro/enfermería , Enfermería Neonatal/legislación & jurisprudencia , Registros de Enfermería/legislación & jurisprudencia , Daño Encefálico Crónico/diagnóstico , Femenino , Alemania , Humanos , Recién Nacido , Comunicación Interdisciplinaria , Colaboración Intersectorial , Mala Praxis/legislación & jurisprudencia , Enfermería Neonatal/normas , Registros de Enfermería/normas , Grupo de Atención al Paciente/legislación & jurisprudenciaRESUMEN
Neonatal nurses regularly face complex legal and ethical dilemmas. This article discusses the hypothetical case of Jack, a two-day-old infant diagnosed with trisomy 13 (syndrome), a life-limiting condition. Jack's prognosis is poor, and he is not expected to live past two weeks of age. The legal and ethical perspectives of withholding life-sustaining treatment in infants and children will be explored through the application of ethical frameworks, as well as statute and case law relevant to children and adolescent nursing. The article also discusses the neonatal nurse's role, with reference to local and national guidelines.