Teenage Childbearing, Reproductive Justice, and Infant Mental Health.

Reproductive justice advocates emphasize the rights of women to choose to have children, to decide the conditions under which they give birth, and to parent their children with support, safety, and dignity. This article examines what a reproductive justice perspective contributes to infant mental health work with teenage mothers and their families. It explores the historical framing of teenage pregnancy in which young mothers are the cause of a variety of social problems and in which the primary policy and practice approach is pregnancy prevention. The article offers alternative framings of teenage childbearing, based on reproductive justice principles, which focus on social conditions surrounding teenage parenthood and the meaning of motherhood in the lives of young women. These alternative frames shift the practice agenda to eradicating unjust social conditions and providing supports for young women in their roles as parents. The article then describes ways in which two infant mental health programs have incorporated reproductive justice principles into their work with young families: Chicago's community doula model and Florida's Young Parents Project for court-involved teenage parents. Finally, the article extracts a set of principles deriving from a reproductive justice perspective that are relevant to infant mental health work with young families.

Los defensores de la justicia reproductiva enfatizan los derechos de la mujer de escoger tener niños, decidir las condiciones bajo las cuales dan a luz, y criar sus niños con apoyo, seguridad y dignidad. Este ensayo examina lo que una perspectiva de justicia reproductiva contribuye al trabajo de salud mental infantil con madres adolescentes y sus familias. El ensayo explora el marco histórico del embarazo adolescente en el que las jóvenes mamás son la causa de una variedad de problemas sociales y para el que el principal acercamiento de la política y práctica es la prevención del embarazo. El estudio ofrece alternativas para enmarcar la maternidad adolescente, con base en los principios de la justicia reproductiva, la cual se enfoca en las condiciones sociales que rodean la maternidad adolescente y el significado de maternidad en la vida de las mujeres jóvenes. Estos marcos alternativos cambian la agenda práctica a erradicar las condiciones sociales injustas y proveer apoyo a las mujeres jóvenes en su papel de madres. El estudio describe a continuación maneras por medio de las cuales dos programas de salud mental infantil han incorporado principios de justicia reproductiva en su trabajo con familias jóvenes: el modelo comunitario de Chicago de mujeres que acompañan y ayudan durante el embarazo (Doulas) y el Proyecto de Madres Jóvenes de Florida para progenitores adolescentes involucrados en asuntos legales. Finalmente, el ensayo extrae una serie de principios que se derivan de una perspectiva de justicia reproductiva que son relevantes para el trabajo de salud mental infantil con familias jóvenes.

Les avocats de la justice reproductive mettent l'accent sur les droits des femmes à choisir d'avoir des enfants, à décider des conditions dans lesquelles elles vont donner naissance, et à parenter leurs enfants avec soutien, sécurité et dignité. Cet article examine qu'une perspective de justice reproductive contribue au travail de santé mentale du nourrisson avec des mères adolescentes et leurs familles. Nous explorons le contexte historique de la grossesse adolescente qui veut que les jeunes mères soient la cause d'une variété de problèmes sociaux et au sein duquel la politique primaire et la pratique d'approche consistent en prévention de grossesse. Cet article offre des contextes ou des encadrements alternatifs de la grossesse adolescente, basée sur les principes de justice reproductive, mettant l'accent sur les conditions sociales qui entourent le parentage adolescent et la signification de la maternité dans les vies des jeunes femmes. Ces perspectives alternatives déplacent le but de la pratique vers l'éradication de conditions sociales injustes et l'offre de soutien à ces jeunes femmes dans leurs rôles de parents. Nous décrivons ensuite des manières dont deux programmes de santé mentale du nourrisson ont incorporé des principes de justice reproductive dans leur travail avec des jeunes familles: le modèle de doula communautaire de la ville de Chicago aux Etats-Unis et le Projet de Jeunes Parents pour les parents se trouvant dans un tribunal, programme de l'état de Floride aux Etats-Unis. Enfin, nous présentons un ensemble de principles dérivés d'une perspective de justice reproductive qui sont pertinent pour le travail de santé mentale du nourrisson avec les jeunes familles.

Effects of technological interventions on the safety of a medication-use system.

PURPOSE: A study was conducted to assess the effects and outcomes of implementing new technology into the medication-use process. METHODS: A pharmacy computer system, automated dispensing cabinets, and point-of-care products were implemented. The hypotheses of the study were that system errors in each phase of the medication-use process would decrease with the implementation of each technological application and that workload measures, such as staffing and inventory levels, would increase. Using a scripted questionnaire, interviews of participating staff (registered nurses, licensed practical nurses, nursing-unit clerks, pharmacists, pharmacy technicians, physicians, and physician assistants) were conducted to determine their impressions of the safety of the medication-use system before and after the implementation of technology. All hospitalwide errors were reported monthly between November 2002 and July 2005 by the number of errors per 1000 patient days and were categorized by error type. The accuracy of the medication administration record was examined; the pharmacy dispensing process was evaluated for accuracy, timeliness, and system changes; the accuracy of medication administration was observed; and staffing changes were also evaluated. RESULTS: Because of the technology implementation, the accuracy of patient identification was introduced, process changes and technological design identified potential failure modes in the medication administration process, inventory increased, turn-around time to process medication doses in the pharmacy decreased, accuracy of medication administration increased, and the staffing of nurses and pharmacists increased. CONCLUSION: Implementation of new technology into the medication management system standardized the medication administration processes, decreased turnaround time for processing medication orders, and increased accuracy of medication administration to patients.