Maternal, Child Health and Neonatal Nursing Commons^™

Food Insecurity Screening Of Families In A Level Iii Neonatal Intensive Care Unit, Katelyn P. Vawter Rn, Bsn, Rnc-Nic, Megan Ortiz Rn, Bsn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Full Study Title: Food Insecurity Screening of Families in a Level III Neonatal Intensive Care Unit

Background: Early infancy food insecurity (FI) is linked to poor health later in life, and Neonatal Intensive Care Units (NICUs) are often overlooked. Routine FI screening can help identify and assist the families suffering from FI seen in the NICU before being discharged home.

Purpose: The aim was to identify if families were assessed for FI by social workers or if they were more likely to report FI in a brief survey.

Method: A randomized chart review of social work notes for 30 NICU …

Implementation And Evaluation Of Iron Deficiency Anemia Content In Prenatal Education Classes, Jasmine N. Walker Bsn, Erin M. Morris Bsn, Carrie Harvey Phd, Aprn, Acnp-Bc, Chfn, Mary K. Fouquier Phd, Aprn, Cnm, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this quality improvement project is to provide and increase educational awareness and knowledge regarding iron deficiency anemia (IDA) in pregnant patients at an urban primary care clinic in Memphis, TN. This project is intended to decrease the number of individuals with IDA in pregnancy while decreasing the occurrence of IDA-related complications in pregnancy. The study aimed to introduce a cost-effective approach to help decrease or eradicate complications related to IDA during pregnancy.

The World Health Organization (WHO) estimates the prevalence of anemia-complicating pregnancies to be more than 40 percent. Pregnant women with IDA residing in low …

Post-Discharge Malaria Chemoprevention In Children Admitted With Severe Anaemia In Malaria-Endemic Settings In Africa: A Systematic Review And Individual Patient Data Meta-Analysis Of Randomised Controlled Trials, Kamija Phiri, Carole Khairallah, Titus Kwambai, Kalifa Bojang, Aggrey Dhabangi, Robert Opoka, Richard Idro, Kasia Stepniewska, Michael Boele Van Hensbroek, Chandy C John

Paediatrics and Child Health, East Africa

Background: Severe anaemia is associated with high in-hospital mortality among young children. In malaria-endemic areas, surviving children also have an increased risk of mortality or readmission after hospital discharge. We conducted a systematic review and individual patient data meta-analysis to determine the efficacy of monthly post-discharge malaria chemoprevention in children recovering from severe anaemia.

Methods: This analysis was conducted according to PRISMA-IPD guidelines. We searched multiple databases on Aug 28, 2023, without date or language restrictions, for randomised controlled trials comparing monthly post-discharge malaria chemoprevention with placebo or standard of care among children (agedyears) admitted with severe anaemia in malaria-endemic …

Oral Sucrose And The Relation To Neonatal Pain Perception, Meagan L. Burns

MSN Capstone Projects

Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (Treede, 2018). The phenomenon of pain is a personal and unique experience that many of the world’s population has experienced in some form or fashion throughout their lifetime. Neonates are exposed to many painful procedures and/or situations due to various medical ailments that may require a neonatal intensive care unit (NICU) admission. Infants have a special place in the hearts of adults all over the world, and any interventions that would increase the likelihood of diminishing or removing perceived pain in this population are likely …

Child Abuse From A Nursing Perspective: Assessment And Implications, Ashtyn Spring

Senior Honors Theses

Nurses experience the relationship dynamics between pediatric patients and their families firsthand. Being informed by the goals of holistic care, nurses should be assessing for unhealthy dynamics among pediatric patients and their caregivers so they can respond appropriately when a potential for abuse is present. Healthcare workers have the duty to provide safety and healing to their patients. Through the unique contact nurses have with patients, their training for accurate assessment skills, and their responsibility as healthcare workers, nurses are placed with the opportunity to help children out of abusive situations. Prompt identification of the potential for abuse can prevent …

Exclusive Breastfeeding Versus Formula Feeding: Evaluating The Development Of Childhood Allergies, Jasmine Olshin, Anna Kousky, Lily Williams, Michael Mark

Non-Thesis Student Work

Allergies such as dietary, allergic rhinitis, allergy-related asthma, and atopic dermatitis have become increasingly prevalent in childhood and pose a public health concern – especially as severe allergic reactions, such as anaphylaxis, are rising among children. Exclusive breastfeeding and formula feeding are two common infant feeding practices, but their role in influencing the development of childhood allergies are not entirely understood. Thus, the question is raised as to whether infants who are exclusively breastfed are at a decreased risk for developing childhood allergies, compared to infants who are formula fed. A literature search was conducted utilizing relevant databases PubMed, BioMed …

The Effects Of Skin To Skin Contact On Newborns With Neonatal Abstinence Syndrome, Jenna Brasile, Molly Walker

Non-Thesis Student Work

A literature search was conducted on the effects of skin to skin contact on newborns with neonatal abstinence syndrome (NAS). In the United States, research has shown that typically the first intervention for NAS newborns is immediate pharmacological treatment, but new research poses that non-pharmacological interventions such as skin to skin contact, or kangaroo care, benefit the newborn greatly without exposing them to additional opiates or other addictive substances. The literature search implemented on CINAHL and Nursing Reference Center Plus was performed using the following search terms: neonat*, skin to skin*, babywear*, kangaroo car*, neonatal abstinence syndrome*, NAS*, and in …

Early Intervention Referral Process Improvement In Primary Care Pediatrics: An Evidence-Based Algorithm, Katherine G Mcmahon Thompson

DNP Scholarly Projects

Early Intervention programs provide evidence-based services to children with developmental delay from 0 to 3 years of age. Many children eligible for Early Intervention programs are not successfully referred to services provided by health care professionals for evaluations. The purpose of this doctoral project is to describe the evidence-based steps in a referral algorithm for early intervention evaluation to increase referrals by primary care health care providers and to increase evaluation rates of referred children. A draft algorithm was based on content analysis of empirical and theoretical literature. Experts in early intervention primary care services reviewed the draft algorithm, rank …

Newborn Weight Change And Predictors Of Underweight In The Neonatal Period In Guinea-Bissau, Nepal, Pakistan And Uganda, Valerie J. Flaherman, Amy S. Ginsburg, Muhammad Imran Nisar, Muddassir Altaf, Khushboo Liaquat, Benazir Baloch, Najeeb Rehman, Yasir Shafiq, Shabina Ariff, Fyezah Jehan

Department of Paediatrics and Child Health

In low- and middle-income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we assessed growth frequently over the first 30 days among infants born ≥2000 g in Guinea-Bissau, Nepal, Pakistan and Uganda. In this cohort of 741 infants, the mean birth weight was 3036 ± 424 g. For 721 (98%) infants, weight loss occurred for a median of 2 days (interquartile range, 1-4) following birth until weight nadir was reached 5.9 ± 4.3% below birth …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

The Measles-Mumps-Rubella Vaccine And Parental Hesitancy: The World’S Unspoken Pandemic, Kayla James

Senior Honors Theses

The Measles-Mumps-Rubella vaccine (MMR) is a proven necessity for the prevention of measles, mumps, and rubella, which possess severe and possibly life-threatening complications. However, the means in which these vaccines are produced, mandated, or scheduled raise certain concerns within the medical and pharmaceutical consumer community. In fact, there are various communities around the globe that willfully choose to refuse the MMR vaccine, along with many other pediatric vaccinations, resulting in diminished vaccination rates and risk of possible outbreak of any of these three diseases. With this impending threat on the rise, it is necessary to engage in research to best …

Compounding Inequalities: Adolescent Psychosocial Wellbeing And Resilience Among Refugee And Host Communities In Jordan During The Covid-19 Pandemic, Nicola Jones, Sarah Baird, Bassam Abu Hamad, Zulfiqar Ahmed Bhutta, Erin Oakley, Manisha Shah, Jude Sajdi, Kathryn M. Yount

Department of Paediatrics and Child Health

Purpose: The COVID-19 pandemic and associated risk-mitigation strategies have altered the social contexts in which adolescents in low- and middle-income countries live. Little is known, however, about the impacts of the pandemic on displaced populations, and how those impacts differ by gender and life stage. We investigate the extent to which the pandemic has compounded pre-existing social inequalities among adolescents in Jordan, and the role support structures play in promoting resilience.
Methods: Our analysis leverages longitudinal quantitative survey data and in-depth qualitative interviews, collected before and after the onset of COVID-19, with over 3,000 Syrian refugees, stateless Palestinians and vulnerable …

Still Birth Classification: Application Of Relevant Condition At Death (Recode) Classification System In A Tertiary Care Hospital Of Pakistan, Urooj Kashif, Shelina Bhamani, Asma Patel, Zaheena Shamsul Islam

Department of Obstetrics & Gynaecology

Objectives: To determine the cause of stillbirth after application of relevant condition at death (ReCoDe) classification system.
Methods: This was a retrospective cross sectional study of 207 women diagnosed with stillbirth after 24 completed weeks of pregnancy at the Aga Khan University Hospital (AKUH), Karachi between 1st January 2015 and 31st December 2019. The primary objective was to find the cause of stillbirth according to the new classification of relevant condition at death (ReCoDe).
Results: There were a total of 32413 live births and 207 stillbirths during the study period thus stillbirth rate of 6 per 1000 live births. In …

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

Educating School Nurses: Returning To School During The Covid-19 Pandemic, Kelle Flynn-Gulley

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

As schools began reopening, following government mandated school closure early on during the COVID-19 pandemic, new safety measures and protocols were put in place to keep students and staff safe. School nurses have become essential to ensuring schools reopen safely. However, as school nurses were forced to adapt to their increasing roles and responsibilities, a method for providing continuing education to school nurses within an East Tennessee school district did not exist. The goal of this evidence-based practice project was to provide continuing education to school nurses on COVID-19 return to school guidelines via an e-learning modality. Larrabee’s Model for …

Effect Of Infant Breastfeeding Versus Formula Feeding For A Minimum Of One Month On Cognitive Outcomes In Early Childhood, Mary K. Bosson, Sarah Michelle Hodges, Madison Victoria Cavalli, Kaitlyn Grace Carmichael

EURēCA: Exhibition of Undergraduate Research and Creative Achievement

Cognitive development is an important part of infant growth since intellectual predilections in infancy set enduring patterns. Evidence supports that exclusive or mixed breastfeeding for at least one month may improve general child cognition scores. Breast milk contains nutrients such as docosahexaenoic acid (DHA), arachidonic acid (AA), zinc, choline, and vitamin B12 that enhance myelination in the brain to improve cognition. Even if formula is able to be fortified with these vitamins and minerals, formula-fed infants tend to experience slower digestion with less nutrient absorption. Despite the potential nutritional gains of breastfeeding, there is a knowledge gap regarding how long …

Provider Perceptions On The Outcome Of Postpartum Depression Screening During Well- Child Visits, Natasha Patterson

The Eleanor Mann School of Nursing Student Works

The US Preventative Task Force and Centers for Medicare and Medicaid Services recommend screening for perinatal and postpartum depression (PPD) during well-child visits that occur during the first year of the baby’s life. Postpartum means the time after childbirth, and postpartum depression is defined as a variant of major depressive disorder that occur during pregnancy or within 4 weeks of delivery. Current pediatric guidelines recommend that PPD screening occur at three to five days after birth and at one, two, four, six, nine and twelve month well-child evaluations during the first year of life. This DNP clinical inquiry project brought …

Exploring Parent Perception Of Adverse Childhood Experiences Screening In Pediatric Primary Care: A Clinical Inquiry Project, Kathryn Stevens

The Eleanor Mann School of Nursing Student Works

This manuscript explores the incidence and implications of Adverse Childhood Experiences (ACEs) and outlines a project assessing parental perception of their own ACEs screening during their child’s wellness visit. ACEs are adversarial events occurring during childhood, which may be chronic or singular. Abuse, neglect, and household dysfunction result in negative outcomes, including compromised neurological development and cognitive behaviors, developmental delays, poor lifestyle choices, and reduced mental and physical health. Additionally, a growing body of literature supports the impaired parenting skills in those with a history of ACEs. This can perpetuate intergenerational trauma, deprived opportunities, and poor familial health. Despite the …

Decreasing Hospitalization In Infants, William Hang

MSN Capstone Projects

Infants are the most vulnerable population at risk for serious diseases. Respiratory syncytial virus (RSV) is a disease that can be detrimental in infants because of their immature lungs and immune system. Palivizumab, a humanized monoclonal antibody medication, given every 28-30 days has been shown to reduces RSV symptoms and decrease rates of hospitalization by 15%. By reducing the rate of hospital stay, it will also reduce cost.

Breastfeeding Issues Leading To Early Cessation, Brandy Kirstein

DNP Research Projects

Breastfeeding has come to the forefront in modern research as a necessary and important phenomenon to understand and address due to the vast amount of evidence revealing its health benefits for both Mom and baby. Disparities exist related to socioeconomic status, education level, poverty, young age, obesity, alcohol use, smoking, and living in rural areas. This project aims to discover the areas that need the most awareness and change specific to the state of Tennessee to increase the prevalence of exclusive breastfeeding for six months (EBF6) creating healthier future generations and society. This project was a non-experimental, retrospective, correlational design, …

Improving Patient Flow By Increasing Early Discharges On A Mother & Baby Unit, Faye Weir, Joy Moody, Kathleen Cyr, Cathy Palleschi, Stephen Tyzik, Joseph East, Heidi Morin, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Transformation

Discharging patients early in the day has many advantages amongst which is increased bed availability. However, the experience in a large academic tertiary medical center demonstrated that most discharges occurred early to mid afternoon. A care team on a mother /baby unit established a quality improvement project to increase the number of discharges by 11AM and streamline key discharge planning activities.

A root cause analysis identified multiple barriers to attaining he established goals. To address these barriers, a multi prong approach was instituted to include a discharge education KPI for all unit staff.

Data collection post countermeasure implementation demonstrated some …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Nursing Interventions That Address Barriers In The United States That Impact Neonatal Mortality, Victoria D. Sullivan, Ashton J. White

Nursing Undergraduate Work

In 2016, four out of every 1000 babies born in the US died within one month of age. This systematic research review explored nursing interventions that addressed barriers that impact neonatal mortality. The most significant barriers nurses faced in reducing and preventing NM were maternal access to healthcare and education during pregnancy, which can be influenced by maternal age, low socioeconomic status, lack of familial support, poor health literacy, and geographic location. The articles examined included nursing interventions that were evidence-based and addressed barriers relating to NM. Interventions promoting the reduction of NM included education of women’s health and prenatal …

La Adherencia A Las Recomendaciones De Sueño Seguro Por Parte De Las Enfermeras En Unidades De Cuidado Intensiva Neonatal (Ucin) De Hospitales Públicos Y Privados En El Gran Buenos Aires / The Adherence To Safe Sleep Recommendations By Nurses In Neonatal Intensive Care Units (Nicus) Of Public And Private Hospitals In Grand Buenos Aires, Joelle M. Schauer

Independent Study Project (ISP) Collection

El Síndrome de Muerte Súbita de Lactante (SMSL) es “la muerte de un niño menor de 1 año que ocurre, aparentemente, durante el sueño y no puede ser explicada luego de una investigación exhaustiva, que incluye una autopsia completa, la investigación de las circunstancias de la muerte y la revisión de la historia clínica" (Jenik et al., 2015, p. 2). La Academia Americana de Pediatría (AAP) tiene recomendaciones sobre las prácticas del sueño seguro que pueden disminuir el riesgo de SMSL y otras Muertes Súbitas Inesperadas Infantiles (MSII).

El objetivo de esta investigación es analizar la adherencia a estas recomendaciones …

Impact Of Donor Milk On Short- And Long-Term Growth Of Very Low Birth Weight Infants, Rebecca Hoban, Michael E. Schoeny, Anita Esquerra-Zwiers, Tanyaporn K. Kaenkumchorn, Gina Casini, Grace Tobin, Alan H. Siegel, Kousiki Patra, Matthew Hamilton, Jennifer Wicks, Paula Meier, Aloka L. Patel

Faculty Publications

Mother’s own milk (MOM) reduces the risk of morbidities in very low birth weight (VLBW) infants. When MOM is unavailable, donor breastmilk (DM) is used, with unclear impact on short- and long-term growth. This retrospective analysis compared anthropometric data at six time points from birth to 20–24 months corrected age in VLBW infants who received MOM supplements of preterm formula (n = 160) versus fortified DM (n = 161) during neonatal intensive care unit (NICU) hospitalization. The cohort was 46% female; mean birth weight and gestational age (GA) were 998 g and 27.3 weeks. Multilevel linear growth models assessed changes …

Pediatric Primary Care Concussion Evaluation And Management, Kaitlyn Layman

Doctoral Dissertations and Scholarly Projects

Concussions are an important and timely subject, especially within the pediatric population, as they are the most involved in extracurricular contact sports and are susceptible to concussions and their sequelae. The researcher performed a quasi-experimental pilot study in a pediatric primary care office where the researcher educated 15 providers on the HEADS UP concussion screening tool and management approach. The researcher gave providers pre- and post-intervention surveys to determine if providers’ comfort and knowledge regarding assessing and managing concussions within the pediatric primary care setting changed. Four providers participated in the study. The researcher conducted a chart review two months …

Maternal Obesity And Fetal Macrosomia: An Integrative Review Of The Literature Regarding Interventions, Charity Stalcup

Senior Honors Theses

Research suggests pre-pregnancy obesity is associated with an increased risk of macrosomia in the newborn. Since women are expected to gain weight during pregnancy, the standard recommendation of weight loss for obesity is not ideal for this population. In this systematic review of the literature regarding interventions for maternal obesity to reduce fetal macrosomia, 149 articles were screened using three different databases to identify recent randomized controlled trials related to this topic. A total of 11 full text articles were analyzed and included in the review. The articles addressed nutritional, lifestyle, and pharmacological interventions. The results indicated there is currently …

Impacting Women's And Children's Health Care Globally- A United State-Haiti Nursing Partnership., Melissa Motz, Mary Aungst, Karen Groves

Patient Care Services / Nursing

No abstract provided.

Breastfeeding: The Illusion Of Choice, Yeon Bai, Lauren Dinour

Department of Nutrition and Food Studies Scholarship and Creative Works

Background

Breastfeeding is frequently described as a woman's decision, yet this choice is often illusionary owing to suboptimal social and structural supports. Despite the passage of the Patient Protection and Affordable Care Act (2010) that requires all qualifying employers to provide mothers “reasonable” break time and a private, non-bathroom space to express breast milk, the majority of women in the United States still do not have access to both accommodations.

The Problem

At least three issues may be influencing this suboptimal implementation at workplaces: 1) federal law does not address lactation space functionality and accessibility, 2) federal law only …

Policy Brief: Lifespan Respite Care Reauthorization Act, The 2015-2016 Cohort Of New Hampshire Leadership Education In Neurodevelopmental And Related Disabilities (Nh Lend) Program Trainees.

Policy Analysis

The Lifespan Respite Care Act (PL 109-442) provides critical support for families caring for loved ones at home. Family caregivers in the United States provide an estimated $470 billion worth of uncompensated care—a figure that exceeds the total Medicaid budget for 2013 (NAC Task Force, 2016). According to the National Respite Coalition, access to respite care helps protect caregiver health, strengthens families, keeps marriages intact, and prevents the need for expensive institutional long-term care. Reauthorization of the Lifespan Respite Care Act is essential to the well-being of individuals in need of long-term care and their families affected by long-term health …