Safe Care Improvement

The use of heroin, cocaine, and other illicit drugs has become a public health concern especially during pregnancy. Maternal substance abuse has become an issue during the crack epidemic in the 1980’s; however, there is an alarm rate of infants born addicted to heroin. More than 3.7% women have indicated the uses some form of illicit drugs during their pregnancy, as well as 1.9 % reports binge drinking (Bhuvaneswar el at., 2008; Grant el at., 2009). With this in mind, more than 375,000 infants are born to maternal substance abusers each year costing over $100,000 in medical expenses covered by the state (Reitman, 2002).

In the 80s Boston, as well as other cities, experienced a drug epidemic. The drug was called crack and it affect the city of Boston badly. A nurse named Fulani Haynes at Boston Medical Center was working during the crack epidemic. She explains how to care for babies who were born addicted to drugs that passed from a mother’s bloodstream through the placenta and into a tiny body. “The babies couldn’t tolerate being held or rocked, she recalled. They wailed at the sound of soft lullabies. Only complete darkness, silence, tight swaddling, and medication could soothe them.” This drug has nothing to do with heroin but it shows the people of Boston that if the heroin addiction continues to spread, more and more children will be born addicts and

The problems at hand that the SIMARRA Act bill is proposing to address, involves child welfare issues, women’s health concerns, and a lack of protection and healthcare needs for these women and their unborn children within the criminal justice system. According to the bill, it has been propositioned to enhance the welfare and public health for incarcerated pregnant women and mothers by improving the effectiveness and efficiency of the Federal prison system, by establishing a pilot program of critical-stage, developmental nurseries in Federal prisons for children born to inmates, with risk needs assessments, and risk and recidivism reduction (H.R.5130, 2016). The bill is intended to focus and alleviate the lack thereof adequate care, stress, and hazardous health practices that incarcerated mothers are experiencing with their infant babies, while also monitoring the health of these women. Both the mothers and infants are affected in these situations because the health of the mother has substantial

In 2014, after seeing a significant increase in babies born with neonatal abstinence syndrome (NAS), Tennessee began criminally charging pregnant women who use drugs (Sakuma, 2014). Supporters of the new legislation refer to it as a “velvet hammer” used to convince the pregnant drug users into going into treatment, or doing jail time. However, critics are concerned that this legislation will be just another barrier for a group of women who are already at risk, (Sakuma, 2014).

The main objective of healthcare professionals is to provide the best quality of patient care and the highest level of patient safety. To achieve that objective, there are many organizations that help improve the quality of care. One of the best examples is the Joint Commission. Unfortunately, the healthcare system is not free from total risks. In healthcare activities, there are possible errors, mistakes, near miss and adverse events. All of those negative events are preventable. But, it is clear that errors caused in healthcare result in thousands of deaths in the United States.

Los Angeles, Doctor and founder John McLaughlin, came up with the idea to reduce health care costs and improve patient safety

While legislators believe that this policy will effectively sort out the “worst of the worst” (Gonzales & DuBois, 2014), this reporter doubts the efficiency and utility of the policy. If the aim is to force mothers into treatment, then perhaps sending them to jail is not the most effective method. Those defending the law have sent mixed messages around how it should be carried out, some describing the law as a “velvet hammer” while others employ it as a strong-arm tactic used to bust women who use narcotics (Beyerstein, 2014; Goldensohn & Levy, 2014). This, in addition to the previous legislation protecting mothers, makes it uncertain how a woman will be received when she reveals her substance use. Likewise, the chances of getting arrested

According to Lowe (2017), “…across the United States, a woman presents every 3 minutes to an emergency department for opioid misuse or abuse” (p.657). With the significant increase in the misuse of opioids over the last thirty years in the US, it has become a serious public health concern. With the most dramatic rise in opioid use being of childbearing age women, it is a very important issue in maternal health care (Keough & Fantasia, 2017). It is imperative that nurses are informed and have efficient knowledge of the potential risks, effects, treatment, and prevention of opioid dependence during pregnancy.

It is this writer’s belief that these babies should be cared for by another family member or child welfare agency until the mother can prove that she is responsible. This would be measured by the mother attending counseling sessions where she learns about the dangers of drug abuse and she would also undergo random drug testing to assure the child will be safe in her care.

710 in the 216th Legislature, which proposes to expand the definition of “abused child” or “abused and neglected child” to include pre-natal exposure of the child to controlled substances. Substance use during pregnancy is not only a local and state issue, but also a global one. Drug use during pregnancy has been getting progressively worse during the last decade, contributing to the increase in maternal and neonatal complications, neonatal abstinence syndrome (NAS) and rising health care costs (Patrick et al, 2012). In 2008, $5.4 billion alone was spent on the treatment and caring of newborns with NAS (ACOG, 2008). The only real way to address this issue is on a massive scale, and this is why I chose to advocate from a macro-level and policy perspective. I sent my policy brief to Senator Dawn Marie Addiego, because she has a prior history of caring about women’s social and health issues. This brief provides thoughts, concerns and recommendations to further develop and advance policies regarding pregnant women under the influence of dangerous controlled substances and the harmful and even fatal impact it can have on the

The Opioid Epidemic and the Newborn Patient article was written by Dr. Jean Rex and in this article, she talks about the effects that opioids have on families. The article is specific to pregnant mothers and infants. According to Rex (2017), “recent studies have found that 14-28 percent of pregnant women filled a prescription for an opioid medication during their pregnancy.” The use of opioids while pregnant can lead to numerous birth effects for the baby. She also talks about the effects of Neonatal abstinence syndrome (NAS) on an infant. The syndrome is caused when an infant is exposed to opioids while in the utero. Dr. Rex continues the article with discussions for a healthcare professional to be able to know the signs

In the early 1980s, with the rising abuse of “crack-cocaine” and major concerns about it’s effect on children exposed in utero, there was a big push to put legislation in place regarding reporting of illegal drug use during pregnancy, considering it as a form of child abuse (Behnke et al., 2013). The Keeping Children and Families Safe Act was passed in 2003, requiring health care providers to notify Child Protective Services of any infant experiencing drug withdrawal or recognized to be affected by illegal drugs at birth. The effects of maternal alcohol and tobacco use on

Quality is providing the best care for a patient possible. Safety is providing care that will keep the patient from enduring harm. Providing good safe quality care is vital to the successful care of the patients. I have committed my nursing career to always do what is best for my patient by not cutting corners and always keep their thoughts and feelings as a main

Nice summary. It is sad to hear about so many complications during and after a women's birth as a result of substance and alcohol use. Mothers who continue substance use put their baby at high risk for developmental issues after birth. All mothers should ensure their safety of their child by living in a safe environment. As a result of poor lifestyles, children may live the same fate as their parents. As studies have shown, those living in unstable environments may develop mental illnesses. More education needs to be given on the affects of substance and alcohol on children. Even using mothers who are aware of the risks try to stop using substances but they do not have enough strength to completely stop. More services should be offered for

Children can be subjected to the negative effects of parental substance use in a variety of different ways. For example, substance use during pregancy can cause detrimental outcomes for newborn infants by placing them at a higher risk of Sudden Infant Death Syndrome (SIDS), being born with birth defects, developing behavioral and developmental delays, being born premature, etc. Children with addicted parents, are placed at a higher risk of: lacking appropriate supervision; lacking basic needs such as: food, clothing, housing, and medical care; exposure to violence; developing substance abuse issues themselves.