Phases of Maternal & Neonatal Nursing Care

Since the early 1970s, nurses have organized and practiced their profession around a sequence of five phases of patient care. Maternal and neonatal nurses apply these phases, as well. For maternal and neonatal nurses, these phases must be applied to the care of both the mother and her baby at the same time.

Assessment

• Initial assessment is the first phase of maternal and neonatal nursing care. The purpose of the initial assessment in maternal and neonatal nursing is to identify any problems the mother and baby have or are likely to encounter. In this phase, the nurse will construct a nursing history for the patients.

Diagnosis

• With diagnosis, the maternal/neonatal nurse interprets the assessment data to identify both the strengths and problems of the mother and baby. The nursing diagnosis is legally, ethically, and conceptually distinct from a medical diagnosis, which is concerned with disease processes and arriving at a diagnostic code. Some consider Maslow's hierarchical classification scheme for human needs a useful framework for the nursing diagnosis.

Planning

• In the planning phase, the maternal and neonatal nurse works with the mother to articulate and prioritize nursing care interventions and goals. Frequently, this process brings in other family members. The result of this phase is a written care plan. Even if a standardized care plan is used, it should be adapted to the mother's and baby's individual situation.

Implementation

• Implementation is simply the carrying out of the nursing care plan. Frequently, the nurse will need to refer back to the original written plan and modify it in concert with the mother during this phase. This is a dialogical process that is ongoing.

Evaluation

• With evaluation, the maternal and neonatal nurse judges the progress of the mother and baby towards the nursing care goals. At this point, nursing care may be terminated if the goals are achieved, or continued if they are not. The nurse and mother may also discuss changing the goals, if that becomes necessary or desirable to the mother.

Data Types and Sources

• Ideally, through the five phases of care, nurses work with a combination of subjective and objective data. Subjective data are those which the patient alone can describe, such as pain. Objective data, such as maternal and fetal heart rates or blood test results, are physically verifiable to observers. However, in maternal and neonatal nursing, only one patient, the mother, can actually describe her subjective experiences.