Child Health Evolution



Child Health Evolution



Objectives



1. Define the vocabulary terms listed


2. List government programs that have affected the care of children


3. Contrast present-day causes of morbidity and mortality with those of the past


4. Discuss current health care trends in pediatrics and the effect they have on nursing care


5. Identify the role of the pediatric nurse


6. Discuss critical thinking as it relates to the nursing process


7. Describe the philosophy of evidence-based practice


8. Discuss legal implications for the pediatric nurse



Key Terms
















image http://evolve.elsevier.com/Price/pediatric/



Evolution of Child Health


Pediatrics is the branch of medicine that deals specifically with children, their development, childhood diseases, and the treatment of such diseases. The word pediatrics is derived from the Greek pais/paisos, meaning “child,” and iatreia, meaning “cure.” The study of pediatrics began under the influence of Abraham Jacobi (1830-1919), a Prussian-born physician. Known today as the Father of Pediatrics, Jacobi paved the way for the promotion of children’s health through the establishment of “milk stations,” where mothers could bring sick children for treatment and learn the importance of pure milk and its proper preparation. The emergence of pediatric nursing as a specialty paralleled the establishment of pediatric departments in medical schools, the founding of children’s hospitals, and the development of separate units for children in general hospitals.


The nursing care of children has evolved dramatically over the past 100 years. From its initial connection with the specialty of pediatric medicine, it has evolved into a holistic approach for providing health care to children and families. Pediatric nursing views children as having a physical, intellectual, emotional, and spiritual nature and as having needs that differ according to developmental level. In the early part of the twentieth century, the nursing of children was primarily focused on illness. Children frequently became ill and died during epidemics of communicable diseases such as measles and polio. With improved sanitation, the advent of antimicrobials, and the institution of preventive measures such as immunizations and improved prenatal care, children no longer encounter the obstacles that prevented them from reaching adulthood. As the organic causes of death and disability have declined, pediatric nursing has become focused on improving the quality of care by providing an environment for optimal growth and development, as well as health promotion, health maintenance, and health restoration. Over the years, many advances have been made in medical and surgical techniques, giving rise to medical and nursing subspecialties within the area of pediatrics. For example, children with heart problems are treated by a pediatric cardiologist and cared for by pediatric cardiology nurse specialists. The complex surgery necessary for the newborn infant with a congenital defect is provided by the pediatric surgeon. Equipment to diagnose and treat illness in infants and children has become more sophisticated and specialized. Chromosomal studies and biochemical screening have made identification and family counseling more significant than ever. Acutely ill children are being cared for in special diagnostic and treatment facilities, where they receive expert attention. Many conditions that were once treated in inpatient settings are now treated in clinics, same-day surgery units, and other ambulatory settings.



Government Programs


In the past 40 or more years, several federal programs have positively affected child health care. In 1965, Medicaid and the Children and Youth Project were formed to provide care for children in low-income and inaccessible areas. The Child Nutrition Act (1966) provides meals, either free or at a reduced rate, for low-income children. The Special Supplemental Food Program for Women, Infants, and Children (WIC) was established in 1972. This program serves to safeguard the health of low-income women, infants, and children up to age 5 who are at nutritional risk by providing nutritious foods to supplement diets, information on healthy eating, and referral to health care. In 1982, the Missing Children’s Act was passed, which established a clearinghouse for missing children.


There are more than 8 million uninsured children in the United States, and millions more are underinsured. Uninsured children are more likely than insured children to have unmet medical needs. Regular health screenings are crucial to a child’s healthy development. Uninsured children are also more likely to perform poorly in school. The Children’s Defense Fund advocates for children’s health care reform. In addition, the Balanced Budget Act of 1997 established the State Children’s Health Insurance Program (SCHIP) as Title XXI of the Social Security Act to expand insurance coverage to a large portion of uninsured children who are ineligible for Medicaid. Many children are eligible for SCHIP and Medicaid. The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 are new government programs designed to address the issue of inadequate health care coverage for children and will also make immunizations for children easier to access. Education is also needed to break down barriers. The nurse is often in a position to provide this education.


Health promotion and disease prevention have become priorities. In 1990, the United States Department of Health and Human Services released a document entitled Healthy People 2000: National Health Promotion and Disease Prevention Objectives. This document builds on previously developed objectives to present an opportunity for Americans to take responsibility for their own health. It emphasizes equal access to health care for all segments of the population, particularly the most vulnerable. Many of these objectives apply to infants and children and are being researched and updated on an ongoing basis.


Healthy People 2010 is a follow-up to Healthy People 2000. Its objectives are promotion of healthy behaviors, promotion of healthy and safe communities, improvement of systems for personal and public health, and prevention and reduction of diseases and disorders. Healthy People 2020 will continue work on many of the same issues as it strives to build a healthier nation.


Table 1-1 summarizes federal programs that affect maternal-child health, and Table 1-2 compares the leading health indicators for Healthy People 2010 with selected proposed objectives of Healthy People 2020.



Table 1-1


Summary of Federal Programs That Affect Maternal-Child Health
















































































NAME YEAR COMMENT
White House Conference on Children and Youth 1909 Issued 15 recommendations, one of which was for the formation of a Children’s Bureau for child welfare
Social Security 1935 Provides matching state/federal funds for maternal/child care and for children with disabilities, supports preventive health programs (immunizations, screenings)
Fair Labor Standards Act 1938 Establishes minimum working age of 16 years
Maternal-Child Health Infant Care Project 1963 Effort to decrease infant and child mortality
Children and Youth Project 1965 Targets low-income children and children in less accessible areas who need health care
Medicaid EPSDT 1965 Early and periodic screening, diagnosis, and treatment (EPSDT) for low-income children
Crippled Children’s Service 1965 Services disabled children under 21 years
Head Start 1965 Assists disadvantaged preschool children, increases educational skills
National School Lunch Act and Child Nutrition Act 1966 Provides reduced or free meals to low-income families
WIC 1972 Supplemental food program for low-income women, infants, and children (WIC)
Education for All Handicapped Children 1975 P.L. 94-142, free public education for all disabled children ages 3-21 years; provides necessary supportive services
CMHCs (Community Mental Health Centers) 1982 Effort to increase availability of mental health centers to low-income families
Missing Children’s Act 1982 Nationwide clearinghouse for missing children (National Crime Information Computer)
Comprehensive Child Immunization Act 1993 Ensures that all children in the United States are protected against vaccine-preventable infectious diseases at the earliest appropriate age
Family and Medical Leave Act (FMLA) 1993 Enables eligible employees to take up to 12 weeks of unpaid leave from their jobs every year to care for newborn or newly adopted children; to care for children, parents, or spouses who have serious health conditions; or to recover from their own serious health conditions; after the leave, the law entitles employees to return to their previous jobs or the equivalent jobs with the same pay, benefits, and other conditions
Health Insurance Portability and Accountability Act (HIPAA) 1996 Developed by the Department of Health and Human Services to protect patient’s medical records and other health information provided to health plans, doctors, hospitals, and other health care providers
State Children’s Health Insurance Program (SCHIP) 1997 Provides health care coverage for children in families that earn too much money to qualify for Medicaid but cannot afford private health insurance
Children’s Online Privacy Protection Act 2000 Regulates the collection of personally identifiable information online from children under 13 years

Related posts:

  1. The School-Age Child: Study Guide
  2. Communicable Diseases: Study Guide
  3. Neurologic and Sensory Disorders
  4. The Newborn Infant

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Dec 22, 2016 | Posted by in NURSING | Comments Off on Child Health Evolution

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