The EXCELCARE (tm) Family Maternity Plan/Documentation is a standard
form in use in many hospitals.  It generally consist of a 5 page
series of pages, complete with checklists to aid the nursing staff.
It also includes areas for comments.
The version from which this file is derived is the one in use in the
Williamsburg Community Hospital, Williamsburg, Virginia.  It includes
the following four categories of care:
5008  DAILY CARE - VAGINAL DELIVERY POSTPARTUM
5524  EPISIOTOMY / LACERATION
5521  ALTERATION IN PARENTING
5202  DISCHARGE OF A POSTPARTUM PT.
Caps are provided exactly as provided in the printed version.
Excerpts from:
              EXCELCARE (tm) Nursing Care Plan/Documentation
5008  DAILY CARE - VAGINAL DELIVERY POSTPARTUM
[5008 1 through 6 include physical indicators, i.e. documenting pain,
skin and oral conditions, pulse, GI, GYN, etc.]
[5008 7 through 8 include providing supplies, changing linens, call
bell, etc.]
5008
9.  Encourage early bonding w/ infant.  Allow pt/family to hold
    & bond w/ infant ASAP.
    ASSESS infant bonding & mother's interaction w/ baby.
[Line for written comments, i.e., "assessment."]
_________________________________________________________
10. ASSESS pt's receptiveness to teaching.  Review Teaching Sheet &
    offer videos PRN.  Give pt teaching booklets & pamphlets.
    Pamphlets given:_______________________________
    [ ]Pt and family verbalize / demonstrate understanding & ask
       appropriate questions.
11.  Consider pt/family need for Social Service &/ HHC consultations.
[5008 12 covers handling of needles, fluids, wearing gloves, etc.]
[Section 5524, 1 - 5 cover physical needs, i.e., sitz bath, etc.]
5521  ALTERATION IN PARENTING   [In its entirety]
1.  A.  ASSESS verbal & non-verbal expressions of attachment when
    awake.
      1.  Verbal statements about infant/child.
      2.  Visual, tactile, & auditory stimulation of infant/child.
      3.  Beginning recognition of needs & ability to provide care.
    B.  Provide a relaxed, supportive opportunity to assess feelings &
        concerns regarding parenting role when awake.
    C.  Explore w/ mother infant/child's characteristics, strengths,
        and response to care.
    D.  Tell mother/family that parenting is a learned behavior.
        Establish realistic expectations & strategies:
      1.  Collaborate w/ mother to determine amt of assistance
          required to provide infant care q change of shift.
      2.  Encourage participation of father, support person in
          infant/child's care.
      3.  Encourage mother to plan time for personal needs & rest,
          during hospital stay & @ home.
      4.  Identify w/ mother/family/friends who will assist w/ care of
          infant/child after D/C.
      5.  Assist w/ identification of appropriate coping behaviors in
          response to frustration.
2.    A. ASSESS risk factors:
         1. Impaired thought process      2. Unwanted pregnancy
         3. Prolonged hospitalization     4. "Problem" pregnancy
         5. Knowledge deficits            6. Relationship problems
         7. Lack of support systems       8. Unrealistic expectations
         9. Single   10. Adolescent      11. Older parent
        12. Abusive/Hx of abuse          13. Drug, alcohol dependency
        14. Maternal illness             15. Financial stress
        16. Congenital defects           17. Undesired sex
      B. Refer to Social Services, consider consult to CHHC if
         attachment behaviors are diminished, multiple risk factors
         exist, or support system is inadequate.
[5202 covers discharge procedures.]
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