Medicine and Health Sciences Commons^™

Implementing Emergency Bedside Backpacks In The Nicu To Improve Patient Outcomes, Melissa M. Garcia

Master's Projects and Capstones

Abstract

Planning for a disaster, by implementing a unit specific disaster plan, has become an essential recommendation for Neonatal Intensive Care Units. Emergent situations have resulted from past natural disasters proving the need for additional planning when it comes to units with fragile populations. Research has shown instituting a specialized disaster plan, increases patient safety resulting in improved patient outcomes. This prospectus aims to implement emergency bedside backpacks as the first step in the development of a NICU specific disaster plan. These backpacks are meant to be an addition to the current hospital emergency plan, with the goal being to …

Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn

Master's Projects and Capstones

A three-month time period was used to develop a postpartum education program change by designing a discharge nurse role on the postpartum unit at University of North Carolina Women’s Hospital. The goal of the education change is to increase patient satisfaction scores of discharged post-natal mothers on the postpartum unit by having HCAPS and Press Ganey to improve up to10% over the next 6 months.

An observational assessment revealed a fragmented and antiquated discharge process. This process was paper based and difficult to complete in light of the short stay and high volume patient population. Informal nurse feedback as well …

Risk Assessment Strategy For Late Preterm Infants, Nisha Nair, Constance Hill

DNP Forum

Late preterm infants (LPIs), born between 34 and 36 6/7 weeks gestation, face many challenges. These infants comprise 71% of preterm births and 8.7% of all births in the United States (Hamilton, Martin, & Ventura, 2010). They have a higher incidence of medical complications than their full-term counterparts leading to longer hospital stays or readmissions (Consortium on Safe Labor, 2010; Khashu, Narayanan, Bhargava, & Osiovich, 2009; Pulver et al., 2010). The nurse’s role in educating parents of LPIs is pertinent as these babies are at heightened risk for a number of significant complications. The purpose of this project is to …

Reducing Perineal Tears: The Effect Of Pushing Methods And Length Of 2nd Stage Of Labor, Kristen A. Mohre, Jessica A. Wall, Chien-Yueh Lee

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Objective: To evaluate the current literature evidence for the effects of either instructed or spontaneous pushing on perineal laceration incidence during delivery and the duration of second stage of labor.

Background: Lacerations (tears) of the perineum are common among women during delivery, increasing pain, infection risk, and other problems for women. Furthermore, prolonged second stage of labor has been shown a risk factor for lacerations. Pushing methods could have an effect on the incidence of lacerations and duration of second stage of labor.

Methods: Thorough search of online databases for the highest levels of evidence relating to the topic within …

Educated Birth: Beliefs Vs. Outcomes, Lauren Presley

Human Nutrition and Hospitality Management Undergraduate Honors Theses

“Our infant mortality rate is a national embarrassment.”¹ The words seem shocking and harsh across the headline of a 2014 Washington Post article. The thought of America not only not being the best at something, but falling upsettingly behind, is a foreign concept to many who view America as a nation inferior to none. However, the statistics on infant mortality rate tell the stark truth that of 26 “wealthy” countries, the U.S. ranks last, with a sobering 6.1 deaths per 1,000 live infant births.²

Part of the Healthy People 2020 Objectives is to reduce the rate of infant …

Bed Rest And Its Continued Use In Women With High-Risk Pregnancy: A Review Of Literature, Irene De Los Reyes

Senior Theses

Bed rest is defined as confinement to bed and restriction of activity. In the clinical setting bed rest includes strict bed rest, strict bed rest in Trendelenburg position, bed rest with bathroom privileges, and up ad lib (Irion, Irion, Lewis & Giglio, 2012). Bed rest has been the standard treatment for over the past 30 years in preventing preterm birth and complications arising from high-risk pregnancy despite the lack of evidence to support its safety and effectiveness for the mother and fetus (Maloni, 2010). The purpose of this literature review and critique is to provide information about the adverse physiologic …

Common Factors In Unplanned Cesarean Section, Lauren C. Compton

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Obstetrical delivery by cesarean section is a prevalent form of delivery. Whether clinically indicated or by maternal request, cesarean delivery rates in the United States have risen to account for over a third of all deliveries. Cesarean section procedures are often clinically indicated and occur because of fetal factors, but they can also be elected by maternal request. The aims of this study are to analyze the frequency of the factors in the study questions that are associated with unplanned cesarean section procedures and to compare the frequency of these factors per cesarean section with the time of day the …

The Impact Of Breastfeeding Education: A Retrospective Look At Breastfeeding Education And Breastfeeding Rates, Hannah Newell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breastfeeding is associated with improved health outcomes for both mother and child. Not only does it provide optimal nutrition for the infant, it also encourages an intimate maternal-infant bonding experience that establishes the basis for parenting and interaction. Major medical organizations including the Surgeon General’s Healthy People 2020 have an aim of increasing the number of women who initiate breastfeeding, and a recommendation of exclusive breastfeeding for the first six months and continued breastfeeding for at least one year. While most women are aware that breastfeeding is the best source of nutrition for infants, they often lack knowledge regarding the …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

The Rates Of Mothers Who Continually Breastfeed After Implemented Breastfeeding Teaching, Katherine L. Moore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Many mothers are unaware of the benefits of breastfeeding. This lack of knowledge leads to an inability to weigh the advantages and disadvantages of the potential source of nutrition their infant will receive during his or her first months of life. Many mothers never even attempt to breastfeed their infant. Even among the mothers who do initially choose to breastfeed, the majority deviate to other forms of feeding early in the postpartum period. Despite the fact that most major medical organizations encourage exclusive breastfeeding through the first six months of an infant’s life, the CDC report for 2013 claims the …

Impact Of Specialized Nursery Care For Late Preterm Infants On Nicu Admission Rate And Length Of Stay, Laura Hunt, Gene Hallford, Candace Robledo, Edgardo Szyld, Clara Song

School of Medicine Publications and Presentations

Objective To compare neonatal intensive care unit (NICU) admission rates and length of stay (LOS) of late preterm infants (LPIs) born before and after opening a specialized care nursery (SCN) at our academic, pediatric tertiary care center with 4,500 total deliveries annually

Study Design Retrospective chart review of inborn LPIs (350/7–366/7 weeks) who were asymptomatic or minimally symptomatic at birth and delivered 7 months before the opening of the SCN (pre-SCN) or 7 months subsequently (post-SCN). Infants were excluded for major congenital anomalies or other conditions requiring immediate NICU admission. The pre-SCN options for care were standard couplet care or …

What Can Pakistan Do To Address Maternal And Child Health Over The Next Decade?, Zulfiqar Ahmed Bhutta, Assad Hafeez

Department of Paediatrics and Child Health

Pakistan faces huge challenges in meeting its international obligations and agreed Millennium Development Goal targets for reducing maternal and child mortality. While there have been reductions in maternal and under-5 child mortality, overall rates are barely above secular trends and neonatal mortality has not reduced much. Progress in addressing basic determinants, such as poverty, undernutrition, safe water, and sound sanitary conditions as well as female education, is unsatisfactory and, not surprisingly, population growth hampers economic growth and development across the country. The devolution of health to the provinces has created challenges as well as opportunities for action. This paper presents …

Women’S Perceptions Of Antenatal, Delivery, And Postpartum Services In Rural Tanzania, Gladys Reuben Mahit, Dickson Ally Mkoka, Angwara Dennis Kiwara, Columba Mbekenga, Anna-Karin Hurtig, Isabel Goicolea

School of Nursing & Midwifery, East Africa

Background: Maternal health care provision remains a major challenge in developing countries. There is agreement that the provision of quality clinical services is essential if high rates of maternal death are to be reduced. However, despite efforts to improve access to these services, a high number of women in Tanzania do not access them. The aim of this study is to explore women’s views about the maternal health services (pregnancy, delivery, and postpartum period) that they received at health facilities in order to identify gaps in service provision that may lead to low-quality maternal care and increased risks associated with …

Caregivers Of Underserved Minority Populations: Views And Opinions Of The Role Of Schools In Bmi Screening, Education And Communication, Lori Keough Phd, M.Ed, Fnp-Bc

Journal of Health Disparities Research and Practice

A pilot study exploring caregiver views of the role of schools in students’ health.

Abstract

To date, 20 states in theUnited Statesrequire school-based body mass index (BMI) screening for school-aged populations and for some the requirements include caregiver notification of the findings. Few studies have provided empirical data indicating whether or not caregivers accept or act on BMI communication from schools. Therefore, an exploratory pilot study was conducted in a culturally diverse urban school district to determine how a required (BMI) screening and notification were viewed by caregivers. Most caregivers reported that they felt schools did not have a role …

Pain Management In The Neonatal Intensive Care Unit, Holly N. Hagy

Montview Journal of Research & Scholarship

While pain management in the Neonatal Intensive Care Unit (NICU) was thought to be useless due to the infants’ inabilities to experience pain, research has confirmed that infants can and do experience pain at the same, if not greater, level of intensity as adults experience pain. Painful stimuli cause a system-wide sympathetic nervous system response that can cause damage when prolonged or unmanaged. There are multitudes of ways to treat an infant’s pain, but there seems to be a discrepancy between the knowledge that health care workers have regarding pain management in the NICU and the actual implementation of that …

We Can Do Better: An Argument For Improved Care Of The Opioid Addicted Mother-Infant Dyad, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

As the number of addicted maternal-infant dyads increases, so does the need for nursing to expand its understanding of the addiction process and the evidencebased interventions that best serve mothers and infants. Nursing attitudes toward the opioid-addicted mother and infant dyad are influenced by knowledge deficits and communication difficulties. Care required encompasses medical, legal, social, and economic perspectives. Professionals and society at large have disagreements regarding whether to approach the phenomenon from a punitive or supportive strategy. Facilities to care for the mother-infant dyad with addiction are limited. Increasing knowledge has great potential for active understanding and ability to impact …

Quantify Blood Loss To Prevent Escalation Of Blood Loss, Manprit Virk

Master's Projects and Capstones

Abstract

The CNL project’s aim is to implement quantifying blood loss (QBL) after each delivery to prevent the escalation of postpartum hemorrhage (PPH), and decrease maternal mortality and morbidity related to PPH in Maternal Child Health (MCH). This project is initiated in a Northern California acute-care facility’s MCH department, which consists of: childbearing women pregnant at gestation age of more than thirty-four weeks, and women post delivery. According to CMQCC (2014), 1-3% of pregnancies are affected by postpartum hemorrhage, and the acute-care facility has a current postpartum hemorrhage rate of 2.7%. There is lack of standardized method of measuring blood …

Implementation Of A Debrief “Takeaway” Board, Carly A. Skeath

Master's Projects and Capstones

Abstract

My original focus of my project was to implement Team STEPPS, to help improve the communication and teamwork within our entire perinatal service department. However, as I started I ran into barriers with time and with other projects put out by our management that needed to take president. It is then that I decided to narrow my focus on one aspect of Team STEPPS which we are already implementing, and that is debriefs. As a member of the Perinatal Patient Safety Program (PPSP), I was able to learn about all the takeaway’s we received from debriefs that had occurred, …

Breastfeeding With The Bronson Mothers’ Milk Bank, Marykate Bodnar

Masters Theses

Bronson Methodist Hospital in Kalamazoo is home to one of only 15 certified breast milk banks in the United States. Women have shared breast milk for centuries through wet nurses, but this institutionalized and regulated version of sharing is distinct from previous forms. Breastfeeding has become a symbol of successful motherhood; donor milk adds a new dimension to this aspect of idealized motherhood. This study explores how the milk bank works: its organizational structure within a hospital, how donors are selected, and how recipients qualify for donor milk. It is grounded in Feminist and Medical Anthropology literature. Using semi-structured interviews …

Discovering Self: Childbearing Adolescents' Maternal Identity, Janelle L. B. Macintosh, Lynn Clark Callister

Faculty Publications

Purpose: Adolescent pregnancy and motherhood have long been a topic of interest for many healthcare professionals. However, there are limited data on how childbearing adolescents incorporate motherhood identity into their sense of self. The purpose of this study was to explore how childbearing adolescents perceive motherhood as becoming part of their personal identity.

Study Design: This qualitative study using ethnographic data collection involved 7 months of observation, interaction, and interviews.

Methods: Data were collected from nine expectant adolescents during in-depth interviews. All participants were patients at a teen mother and child clinic staffed by certified nurse midwives and a pediatrician. …

Pregnancy Apps: A Closer Look At The Implications For Childbirth Educators, Christine Frazer, Leslie Hussey, Emily Bosch, Michelle Squire

Walden Faculty and Staff Publications

Most pregnant women download an average of three pregnancy apps during their gestational period. There are no set standards in place for what needs to be included in an app’s description leaving consumers to decide for themselves when it comes to selecting the right app to download. The childbirth educator must be knowledgeable about pregnancy apps, in-tune as to what apps their clientele download, and how to analyze them for credibility. This article presents characteristics associated with women of childbearing age (i.e. Millennial/Net generation); the reasons why pregnant women are turning to apps; the limitations of apps, and the childbirth …

Effects Of Nurse Caring Behaviors On Mothers' Anxiety And Attachment In Pregnancy Following Perinatal Loss, Joyce G. Oliverio Volsch

Loma Linda University Electronic Theses, Dissertations & Projects

Childbirth is usually a joyful experience for most families. However, women who have experienced the death of a baby during pregnancy often view subsequent pregnancies with fear and apprehension. It is estimated that 59% – 86% of women with previous perinatal loss will become pregnant again (O’Leary, 2004). There is limited research on what bereaved parents perceive as caring behaviors by nurses following the human experience of perinatal loss. The purpose of this research study was to determine if nurse caring behaviors (NCB) during the perinatal loss event affect pregnancy-specific anxiety (PSA) and maternal-fetal attachment (MFA) in women who are …

Prospectus Summary Brief: Nicu Communication Improvement, Joy E. Lawley

Master's Projects and Capstones

Joy Lawley RNC, NICU Communication Improvement: A prospectus summary brief. Effective communication in the neonatal intensive care unit (NICU) not only reduces errors and adverse patient outcomes but also create an environment that promotes staff satisfaction. The purpose of this prospectus is that of improving the process of communication between the perinatal departments. The specific aim was to improve communication to the NICU through standardize communication tools (SBAR) from patient delivery to discharge starting April 1, 2015. With 100% participation of all staff members within a three month period and a 95% staff satisfaction related to improved communication from staff …

Perinatal Patient Management, Natalie Whitten

Master's Projects and Capstones

The medical center has lacked the bed capacity and nursing staff to accommodate the needs of maternity patients. Patients are redirected to other network and non-network medical centers due to lack of bed availability, inadequate nurse staffing, and poorly managed patient movement. This project aims to improve patient management in the perinatal departments, including the discharge process. We will have 100% staff participation to facilitate bed management. The patient management project was conducted in a 200-bed hospital serving the residents of an urban area. The perinatal areas of labor & delivery (L&D), antepartum, and postpartum (OB) are highly productive units …

Perinatal Health Education Intervention For Adolescent And Young Adult Pregnant Homeless Women Living In Transitional Housing, And Best Practice Teaching Intervention Program For Staff Responsible For Care Of The Mother-Baby Dyad, Colleen Carrington

Seton Hall University DNP Final Projects

Purpose: A population at great risk is pregnant homeless adolescents and young adult women. Research shows that about 20% of homeless young women become pregnant (Bender, & Thompson, 2007). These pregnant young women are at an increased risk for low birth weight infants and a high infant mortality due to inadequate health care, poor dietary habits, and a knowledge deficit related to maintaining good health during pregnancy and to care of the infant and growing child. A transitional shelter may offer many psychosocial services to assist the women in becoming independent; however, a significant gap exists regarding the medical …

Exploring The Relationships Of Power, Attitudes Regarding Intermittent Fetal Monitoring, And Perceived Barriers To Research Utilization With A Labor And Delivery Nurse's Attitude Toward Patient Advocacy, Lisa Heelan

Seton Hall University Dissertations and Theses (ETDs)

A problem identified in nursing practice was the routine use of continuous fetal monitoring (CEFM) with low risk laboring women. CEFM is associated with worsened outcomes for the low risk laboring woman with no benefit to the newborn. In addition, this routine practice does not allow most laboring women the right to make an informed choice regarding treatment options. Nursing includes the role of patient advocacy. There was a need to better understand what is associated with a labor and delivery nurse’s attitude toward patient advocacy.

This descriptive correlational research design examined the relationships of power as knowing participation in …

The Relationships Among Perceived Stress, Birth Satisfaction, And Breastfeeding Self-Efficacy In Early Postpartum Women, Katherine Hinic

Seton Hall University Dissertations and Theses (ETDs)

This descriptive correlational study examined the relationships among perceived stress, birth satisfaction, and breastfeeding self-efficacy in women in the early postpartum period. The study, guided by self-efficacy and stress and coping theories, aimed to identify factors related to breastfeeding self-efficacy, an important psychological variable in sustained breastfeeding. The sample (N =107) was comprised of primarily well-educated, higher income, non-Hispanic White (69.8%) women recruited from a single New Jersey hospital in the first four days postpartum. The sample was comprised of nearly equal numbers of primiparous and multiparous women, all of whom expressed an intention to breastfeed, with an overall …

Family And Child Development Education For Harrisonburg Adolescents, Mollie M. Moran, Jennifer E. Corser, Julia M. Glauber

Senior Honors Projects, 2010-2019

The pregnancy rate among 15- to 17-year-old women in Harrisonburg is double Virginia's state rate (Townsend, 2008). While meeting administers and guidance counselors of Harrisonburg High School we learned that Harrisonburg High School views this issue as one that cannot be addressed by teaching abstinence in their public school. They have found that because of cultural beliefs, abstinence is not an effective tool for preventing teenage pregnancy. Instead, HHS teaches their students about safe sexual practices and how to have a healthy pregnancy in the event they were to become pregnant. The high school offers a class called “Child and …

Use Of The Peanut Ball To Decrease First And Second Stages Of Labor, Carol L. Payton

Graduate Theses, Dissertations, and Capstones

The purpose for this capstone project was to use a Peanut Ball, to mimic a sitting or squatting position, for decreasing length of first and second stages of labor. In addition, this project was designed to incorporate qualitative data on women’s perception of using the Peanut Ball during labor. The project question was “For laboring women, will use of a Peanut Ball for positioning, as compared to no use of a Peanut Ball, decrease length of first and/or second stages of labor?” The results included a significantly longer second stage of labor in the intervention group (75.63 minutes) when compared …

Effects Of Multimodal Fever Education On Parents Of Febrile Children, Teresa S. Parkhouse

Evidence-Based Practice Project Reports

Insufficient knowledge regarding the physiology and appropriate management of fever in children often contributes to an increased parental anxiety, inappropriate antipyretic use, and overutilization of medical resources (Chang, Liu, & Huang, 2013; Crocetti, Moghbeli, & Serwint, 2001; Schmitt, 1980). Parental concerns regarding childhood fever can lead to an overuse of health care resources as febrile illness in children accounts for approximately 20% of emergency department visits, 30% of office visits, and over 50% of after-hour phone calls to private physicians (Zomorrodi & Attia, 2008). Research shows that multidimensional educational interventions are most effective in improving parental management of fever (Young …