Medicine and Health Sciences Commons^™

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 …

Evaluation Of An Updated Maternal Severe Hypertension Recognition And Response Protocol, Diana Marshall

Dissertations

Problem: Hypertensive disorders of pregnancy are a leading cause of morbidity and mortality. An area of concern is the lack of women and infant departments that have a standardized approach for treatment of severe hypertension congruent with the American College of Obstetricians and Gynecologists (ACOG) recommendations.

Methods: A department with approximately 4,000 deliveries per year was the site for this quality improvement project. A descriptive observational design was used to evaluate the effect of an updated protocol on treating hypertensive events within 30-60 minutes. The protocol was updated by a maternal fetal medicine physician and a certified nurse midwife. Data …

Implementation Of Postpartum Oral Glucose Testing Follow-Up In Women With Gestational Diabetes, Amanda Rose Metz

Dissertations

Implementation of Postpartum Oral Glucose Testing Follow-up in Women with Gestational Diabetes

Problem One of the most common medical complications of pregnancy is Gestational Diabetes (GDM). After delivery, guidelines recommend follow-up glucose tolerance testing (OGTT) 4-to 12-weeks postpartum. Despite these recommendations, only 16% to 22% of women complete an OGTT postpartum.

Methods The purpose of this quality improvement (QI) project is to pilot a postpartum outreach follow-up via telephone to reach women diagnosed with GDM; the communication will be sent using the institution’s electronic messaging system. Quantitative data were collected prospectively. Data collected included if the patient was contacted and …

Implementation Of Quantitative Blood Loss Tool To Detect Postpartum Hemorrhage After Vaginal Delivery, Rachael Williams

Dissertations

Problem Maternal deaths and comorbidities related to postpartum hemorrhage (PPH) continue to be high despite being quite preventable. The delay in recognition and treatment of PPH due to the use of imprecise estimated blood loss (EBL) instead of precise measurement using quantitative blood loss (QBL) attributes to this issue.

Methods For this quality improvement (QI) project, a descriptive, observational design was used to gather quantitative data regarding QBL implementation instead of EBL as well as the number of PPH’s identified. A pilot cohort of staff nurses participated by documenting QBL two hours after each delivery. The nurses were given an …

Remifentanil Patient Controlled Analgesia Use In Laboring Women: A Feasibility And Acceptability Study, Joshua Carr

Dissertations

Background/Purpose: Interest in remifentanil patient controlled analgesia (RPCA) as a treatment for labor pain has increased due to its unique pharmacodynamics and effectiveness on pain control among parturients. Despite its promise, RPCA remains infrequently used in the US. The purpose of this study was to 1) examine the implementation and acceptability of a new RPCA protocol in the labor and delivery ward of a mid-sized hospital, and 2) identify the attitudes and beliefs of healthcare workers in a real-world clinical setting.

Theoretical/Conceptual Framework: The holistic nature of Comfort Theory can account for the proposed mechanisms contributing to the …

Perceptions Of Perinatal Nurses Caring For Perceived Stigmatized Patients During The Covid-19 Pandemic In Perinatal Settings: A Qualitative Study, Deborah Tucker

Dissertations

Perinatal nursing consists of caring for women before, during, and shortly after the birth experience, providing a unique opportunity for nurses to care for women and families in a fundamental moment of life (Simpson et al., 2020). This qualitative descriptive study design allows for straight descriptions of phenomena to evaluate perceptions of nurses caring for perceived stigmatized patients in the perinatal setting during the SARS-CoV-2 (COVID-19) pandemic. As research gaps were identified, the following research questions were developed and used to guide this study:

1. What are the perceptions of caring in perinatal nurses who deliver care to perceived stigmatized …

Improving Postpartum Hypertension Discharge Education: A Pilot Project, Kathryn Barth

Dissertations

Problem: Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal morbidity, mortality, and postpartum readmission. Several evidence-based algorithms and protocols have been implemented in the inpatient setting to treat severe blood pressure and prevent complications. However, there remains an opportunity to improve the postpartum care transition and discharge education for patients with these conditions in an attempt to decrease 30-day postpartum hypertension readmissions.

Methods: This pilot project utilized a descriptive design and took place on a postpartum unit at a Midwest metropolitan high-risk obstetrical teaching hospital. Interventions included patient-specific discharge education, distribution of a home blood pressure …

Rural Pregnant Women’S Experiences With Substance Use Disorder: A Qualitative Study, Cami Weber

Dissertations

Rural pregnant women with substance use disorder (SUD) are an understudied vulnerable population that often experiences poor pregnancy outcomes (Higgins et al., 2019; Jumah, 2016; Kramlich et al., 2018; Shaw et al., 2015). Despite the high prevalence and high burden associated with SUD, rural women are less likely than non-pregnant women to seek addiction treatment and complete an outpatient treatment program during pregnancy (Shaw et al., 2015). This study aimed to give voice to rural Missouri women with SUD. The research questions explored the life experiences and motivations for seeking treatment using a qualitative, descriptive research design with grounded theory …