Medicine and Health Sciences Commons^™

Facility-Based Audit System With Integrated Community Engagement To Improve Maternal And Perinatal Health Outcomes In Rural Pakistan: Protocol For A Mixed Methods Implementation Study, Zahid Memon, Wardah Ahmed, Shah Muhammad, Sajid Bashir Soofi, Shanti Chohan, Arjumand Rizvi, Paul Barach, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: Maternal and newborn mortality in Pakistan remains as a major public health challenge. Pakistan faces significant infrastructure challenges and inadequate access to quality health care, exacerbated by sociocultural factors. Facility-based audit systems coupled with community engagement are key elements in achieving improved health system performance. We describe an implementation approach adapted from the World Health Organization audit cycle in real-world settings, with a plan to scale-up through mixed methods evaluation plan.
Objective: This study aims to implement a locally acceptable and relevant audit system and evaluate its feasibility within the rural health system of Pakistan for scale-up.
Methods: The …

Educating Labor And Delivery Nurses On Evidence-Based Birthing Positions To Promote Fetal Descent During First And Second Stage Labor, Sophia Nguyen

Master's Projects and Capstones

The goal of this project was to increase confidence of labor and delivery nurses in utilizing evidence-supported birth positions during the first and second stages of labor in order to aid in fetal descent and labor progression. Current statistics demonstrate climbing trends in cesarean deliveries, which have been associated with increased maternal morbidity and mortality. One nurse intervention that can reduce failure to progress, a main contributor to cesarean sections, is the use of various evidence-supported maternal birth positions such as ambulation, assisted squat, sitting, backwards sitting, lunging, throne, side-lying with peanut ball, hands-and-knees, and throne position. This evidence-based practice …

Views And Opinions Of Mass Media Key Informants On Coverage Of Issues Related To Maternal, Newborn And Child Health In Lake Zone, Tanzania, Violeth A. Mbuni, Nyagwegwe Wango, Elias C. Nyanza

Institute for Educational Development, East Africa

In Tanzania, the mass media is a primary means of communicating health information to urban and rural populations. While unsafe abortion is the leading cause of maternal deaths and complications in Tanzania, this has increased the high unintended pregnancy rate. Journalists, editors, program managers and producers play a significant role in determining the health-related issues reported. In the present study, the views, and opinions of mass media key informants on coverage of issues related to maternal, newborn and child health in Lake Zone were investigated. This qualitative study was conducted with key informants from 24 mass media outlets that covered …

What Impact Does The Ability To Access Healthcare Have On Maternal Outcomes In Africa?, Helena Harris

Nursing | Senior Theses

Background: Maternal mortality rates reflect health inequities in access to obstetric care in some parts of the world including many African countries. Geographical barriers and limited number of skilled human resources have put women in rural areas at a significantly higher risk of maternal mortality.

Research Question: What impact does the ability to access healthcare have on maternal outcomes in African rural areas compared to urban cities?

Methods: A literature review was performed of credible databases. Six articles were reviewed extensively highlighting the purpose, strengths, and limitations of each study. Refer to Appendix A for the literature review table.

Findings: …

Access To Prenatal Care And Mental Health In Pregnant Women During Covid-19: A Systematic Review, Chloe Feezel, Marin Kahoun, Kaija Kunttu

Williams Honors College, Honors Research Projects

COVID-19 affected the world in many ways. Pregnant women were greatly impacted by a change in their access to prenatal care, from in-person care to telehealth methods, and social support being limited by social isolation. Compared with prevalence of anxiety and depression in pregnant women pre-COVID-19, pregnant women during COVID-19 reported higher levels of anxiety and depression symptoms due to the stress of circumstantial changes. The purpose of this systematic review is to review and critically appraise the evidence about access to prenatal care and mental health in pregnant women during the COVID-19 pandemic. The following PICOT formatted question will …

Implicit Bias Training For Perinatal Nursing, Racheal Lakine-Harden

Dissertations

Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias …

Preventing Maternal Falls, Blair Burkhart

Master's Projects and Capstones

Patient falls are unfortunate events in healthcare that are an essential quality improvement focus during patients’ hospital stays. At Hospital X, a private institution located in the suburbs of a large city, there had been 23 maternal falls within the last three years. This increase in maternal fall rate puts this hospital’s maternity unit above the average of other hospital’s fall rates according to the National Database of Nursing Quality Indicators. This quality improvement project aimed to reduce the rate of maternal falls on postpartum units through various forms of staff education. Education included Morse Fall Scale scoring, Sara Stedy …

Reducing Postpartum Maternal Falls: A Quality Improvement Project, Sarah L. Iroz

Master's Projects and Capstones

Falls are an unfortunate, common occurrence in the healthcare system and are often not thought to be a problem in the obstetrics population. Key stakeholders in a Northern California hospital brought the issue of maternal falls to leaders of the quality improvement team on the maternity unit. In the last three years, there have been 23 falls on the maternity floor, making their fall rate above the national average. It is the purpose of this project to aid the quality improvement team in reducing postpartum maternal falls over the next three years. After conducting a unit assessment, performing a literature …

The Influence Of Gender Bias On Male Nurses And Nursing Students In The Obstetric, Maternal, And Pediatric Nursing Profession., Julian Alvarez

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This literature review analyzes if gender bias influences the disproportionate number of male nurses and male nursing students in the pediatric, maternal, and obstetric nursing fields as compared to nursing as a whole. PubMed and CINAHL databases were utilized to find 15 research articles focused on the experiences of male nurses and male nursing students. These articles were compared amongst each other to find common themes of the male experience in the nursing fields of pediatrics, maternity, and obstetrics. The three common themes found were 1) Men tend to encounter situations where their professionalism will be monitored more closely when …

Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton

Dissertations

Abstract

Problem: Hypertensive disorders of pregnancy continue to be on the rise in the United States, contributing to an increase in both maternal morbidity and mortality rates. These disorders not only have an effect on the pregnant women, but also the neonate. Early recognition and treatment of increased blood pressure findings can improve maternal and fetal outcomes.

Methods: This Quality Improvement (QI) project used a descriptive design and was comprised of a retrospective chart review, focused on the effectiveness of evaluating a hypertension bundle to improve maternal outcomes. The data collected for this project encompassed six months pre and post …

Barriers To Healthy Births At Nigerian Hospitals, Caroline Johnston

Senior Theses

Maternal mortality is a problem everywhere, but it is especially dangerous in Nigeria where the average woman experiences pregnancy six times during her lifetime (Population Reference Bureau, 2001). Many researchers focus on the medical complications associated with labor, such as hemorrhage, eclampsia, or infection. Although these birth complications are the direct sources of maternal death, it is also important to recognize how maternal mortality is a multifaceted issue influenced by local cultural groups, religions, politics, poverty level and the absence of basic infrastructures. Although maternal mortality is interconnected with social and geographical elements, my paper concentrates on Nigerian hospitals and …

Maternal And Newborn Care During The Covid-19 Pandemic In Kenya: Re-Contextualising The Community Midwifery Model, Rachel Kimani, Rose Maina, Constance Shumba, Sheila Shaibu

School of Nursing & Midwifery, East Africa

Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. SARS-CoV-2 is a novel coronavirus that requires a community-centred response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanised birth that prioritises the physical and emotional safety of the mother and the baby. There is an urgent need for innovative strategies to prevent the …

Risk For Maternal Infant Bonding Reduction In High Risk Deliveries And The Recovery Phases, Amanda M. Karimi, Corie Vanarsdale Msn

Nursing Undergraduate Work

Bonding is one of the first developmental tasks for infants and is imperative for successful growth. The bonding phase begins in the periods immediately following birth. Complications that inhibit bonding postpartum may delay this process. Breastfeeding barriers, maternal substance abuse, and poor maternal mental health are among the contributing factors to delayed bonding. The purpose of this research study was to answer the question, “What best practiced nursing interventions assist mothers to promote bonding with the newborn after high risk deliveries?” This research review included a sample size of 10 articles which provided a variety of interventions to promote bonding …

The Effects Of Recorded Maternal Sound On Preterm Neonates: A Systematic Literature Review, Angela Aloisantoni

Honors Undergraduate Theses

A fetus hears and responds to maternal sounds as early as 26 weeks' gestation. When born prematurely, a neonate may face health challenges due to overall organ immaturity and hospitalization in the Neonatal Intensive Care Unit, where developmentally important maternal sounds are replaced with routine hospital noise. A potential intervention that can provide meaningful auditory stimulation these neonates lack is implementation of maternal sound interventions. These interventions replicate the intrauterine auditory environment by playing recorded maternal speech and heart sounds in the incubator. A literature review was completed to identify effects on neurodevelopmental, nutritional, and physiological measurements this intervention may …