Medicine and Health Sciences Commons^™

Implementation Of A Community Health Worker (Chw) Training Program To Improve Birth Outcomes, Emiko Maruri, Trinette Radasa, Jo Loomis

DNP Qualifying Manuscripts

Background

Those who have ever been affected by an adverse childhood experience (ACE) have a greater likelihood of having poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.

Problem

Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. The direct relationship is that Latinas therefore have poor birth outcomes.

Context

For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice students and Community Health Workers (CHWs) of the Central Valley of California …

Factors Influencing The Utilization Of Antenatal Care, Institutional Delivery, And Postnatal Care Services Among Women In Bangladesh, Akibul Islam Chowdhury, Mohammad Asadul Habib, Tanjina Rahman

Makara Journal of Health Research

Background: In Bangladesh, the utilization of maternal health services is low, which triggers pregnancy-related complications and maternal deaths. The current community-based cross-sectional study aims to evaluate the factors associated with antenatal care (ANC), institutional delivery, and postnatal care (PNC) service utilization among women in selected areas of Southwest Dhaka, Bangladesh.

Methods: The study was carried out among 391 mothers from rural and urban areas. Data were collected using a standard questionnaire. Univariate and multivariate analyses were performed to identify the significant determinants associated with maternity care service utilization.

Results: Result shows that approximately 65%, 71%, and 72% …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

A Process Evaluation On The Health Care Transition Process For Youth With Osteogenesis Imperfecta With Special Health Care Needs, Janet Amirkhanian

Doctor of Nursing Practice (DNP) Manuscripts

With medical, surgical, and technological advances, children with childhood diseases with special health care needs (SHCNs) are surviving and living into adulthood (Cohen et al., 2014). Health care transition (HCT) should be a process through which youth are expected to achieve the skills necessary to manage their health as adults (Sawicki et al., 2017). HCT should be a purposeful, organized, and coordinated process involving the youth, family, and health care team (Stringer et al., 2015; Gabriel et al., 2017; White et al., 2018). Evidence supports that adolescents and young adults with SHCNs are often unprepared for transition (Jensen et al., …

Implementation Of Staff Education To Standardize The Use Of Positions During The First Stage Of Labor, Minh Chau T. Phan

Master's Projects and Capstones

This project aims to educate labor and delivery (L&D) nurses on effective laboring positions that can aid fetal descent during the first stage of labor. In an L&D unit of a south Bay Area County hospital, there is a lack of standardization of knowledge and practices on laboring positions among the nursing staff. Evidence shows that upright positions and frequent mobility are effective in shortening the duration of labor and minimizing unnecessary cesarean deliveries. Based on the evidence, a project was implemented using verbal education of evidence-based laboring positions. An educational handout was also provided along with a recorded video …

Implementation Of Staff Education To Standardize Use Of Positions During The First Stage Of Labor, Kelsey Jo Koch

Master's Projects and Capstones

The aim of this project was to assess whether supplemental education on labor positioning for Labor and Delivery nurses would increase the nurses’ confidence in utilizing patient positioning to promote fetal descent and progress labor. Previous research suggests that upright, mobile positions during the first stage of labor have various benefits, including reduced cesarean rates, shorter lengths of labor, and less epidural usage. However, a major barrier to maximizing these benefits is a gap in knowledge among Labor and Delivery nurses, resulting in inconsistent use of various positions. This improvement project addresses this problem at a large community hospital in …

Ways To Decrease Risk Of Postpartum Hemorrhage, Madison Holcomb

Honors Theses

Postpartum hemorrhage (PPH) is the leading preventable cause of maternal mortality (Jena et al., 2022). In fact, it accounts for 25% of maternal deaths globally (Cooper et al., 2022). There is a tremendous need for education to the pregnant population There are methods to decrease the risk that needs to be taught to patients. The education on risk factors should be provided in the in the preconception period and throughout pregnancy. There are several components of educational practice that may improve the knowledge of pregnant individuals. The educational components can be divided into implementations during the antenatal period and the …

Innovating Cultural Competence Education For Nurses, Darian A. Frieson, Jennifer Patrick, Walker Ray Corless, Abigail Taylor Coulthard, Rebecca R. Fogerty

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

Objective

To improve cultural competency levels of registered nurses on the Mother/Baby unit by educating nurses.

Background

Demographics are shifting in the U.S. with an increase in minority populations. Research has revealed insufficient education or a complete absence of education, resulting in nurses that are not equipped to adequately care for culturally diverse patients.

Methods

The Evidence-Based Practice Improvement (EBPI) Model guided the development and implementation of the project. A cultural competence education module was developed utilizing resources from the U.S. Department of Health and Human Services. Outcomes were measured using a pretest/posttest design tool, the Inventory for Assessing the …

Births In The Mountain West, 2016-2020, Corryn Richardson, Hira Ahmed, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines state-level data on births and health indicators from the National Center for Health Statistics (NCHS), a government health statistics unit of the Center for Disease Control and Prevention (CDC). This fact sheet presents data related to births in the Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah.

Protocols For Postpartum Hemorrhage, Jackleen Chambers

Symposium of Student Scholars

The occurrence of postpartum hemorrhages (PH) within the healthcare system are on the rise. The detrimental effects that can occur are extremely serious and require an intervention of education and proper training. Labor and delivery units experience traumatic PHs due to lack of proper training regarding early warning signs and correct technical interventions needed for a quick turnaround. This project will use research from scholarly articles to take a closer look at statistical evidence based on the outcomes of being prepared versus underprepared. The project will discuss various methods on how to better prepare nurses to care for hemorrhagic situations. …

Postpartum Depression For Mothers With Early Fetal Death Or Stillbirths, Callie Goldman

Symposium of Student Scholars

Background: Many times, prevention of early fetus death and stillbirths is possible; however, some mortality events are spontaneous or unavoidable. While existing research reveals the likelihood of postpartum depression for mothers following birth, few studies address the potential for postpartum depression of mothers of stillbirth or demised fetuses. The purpose of this study is to determine how mothers can be better prepared for the hardship of losing a baby during childbirth, while going through common difficulties, such as postpartum depression, following birth. Methods: A mixed method approach will be conducted to gather qualitative (interview) and quantitative (Edinburgh Postnatal Depression Scale …

Improving Discharge Planning In The Nicu, Jessica Fleming

Symposium of Student Scholars

The birth of a child is an exciting time for parents. They spend months preparing for the arrival of their baby, but parents aren’t prepared for complications that can occur at birth. Events such as early arrival or respiratory issues can result in a newborn being admitted to the NICU. This can create stress and anxiety for parents. Once a child is admitted to the NICU, it is important that discharge planning and education begin promptly, to alleviate parental distress, prepare them to care for their child upon discharge, and improve patient outcome, but some NICUs struggle to provide and …

Effectiveness Of Non-Pharmacological Interventions When Treating Postpartum Depression In First-Time Mothers, Rudy Trujillo, Tamantha Minton-Damm, Ashley Muntean, Natalia Lack

Symposium of Student Scholars

Abstract

Non-pharmacological intervention alone or paired with pharmacological interventions is somewhat effective in treating and lowering rates of postpartum depression (PPD) in women. Undergraduate students reviewed studies of the use of pharmacological and non-pharmacological treatments for postpartum depression. To narrow down results, the students based the review on studies completed within the last 10 years, focusing specifically on primiparas (first births) women. Responses ranged from no notable efficacy in reducing PPD measured against the Edinburgh Scale to marginal improvements when non-pharmacological and pharmacological approaches were combined, and testing extended to other scales of motherhood and postpartum. The students discuss the …

Nurses Assisting With Breastfeeding, Sofia Robles-Gonzalez

Symposium of Student Scholars

Abstract

Background: It is a World Health Organization (WHO) global goal to increase the rate of breastfeeding infants exclusively up to 6 months from the current 37% to 50%. It’s a journey for mothers to have a successful breastfeeding experience and nurses can be a part of it. Nurses are trained to assist mothers in breastfeeding but there are difficulties to breastfeeding that could lead to unintended cessation. The difficulties can lead to a decrease in documenting newborn feedings. The purpose of this research is to see how nurses are trained to assist mothers in breastfeeding and what impacts the …

Intermittent Auscultation Versus Continuous Fetal Monitoring In Low-Risk Pregnancies And Deliveries, Heather Wood

Symposium of Student Scholars

Intermittent auscultation (IA) became the standard of practice during labor through the monitoring developments of Von Winkel. He defined fetal distress parameters that were constant until the development of electronic fetal monitoring (EFM). EFM has since eclipsed the use of IA. However, not to the benefit of the low-risk mother and child. Currently, the global caesarean rate is 21% and the US rate is 31.8%. Research indicates that the use of IA decreases the rate of caesarean section, decreases ICU admissions, and increases fetal well-being outcomes such as higher Apgar scores, lower neonatal seizures, and lower perinatal mortality. With continuous …

Reducing Diaper Dermatitis In The Nicu, Yesenia Alvira

Symposium of Student Scholars

Abstract

Purpose: This evidence-based project aims to support the acquisition of diaper dermatitis protocols that include nursing interventions, assessment tools, and educational opportunities for NICU nurses. Neonatal diaper dermatitis cases are common in the NICU due to the skin of neonates often being underdeveloped and sensitive to the environment. Diapers, especially, can irritate the perineal skin of neonates. Nurses who do not comply with standard perineal skin care can compromise the neonate's skin integrity. This can cause diaper dermatitis, which, if left untreated, can pose a risk of infection and cause pain to the neonate. Literature review: The review of …

In Full-Term Pregnant Women With Gestational Diabetes, Does Induction Of Labor Increase The Risk Of The Patient Requiring An Emergency C-Section When Compared To Spontaneous Labor?, Melissa Hernandez

Symposium of Student Scholars

Abstract

Background: Gestational diabetes (GDM) during pregnancy can have serious complications where an induction might be recommended instead of waiting for spontaneous labor (SL) to occur. With all labor, there is a risk of an emergency cesarean section (c-section). Women with GDM might require induction for their safety and the safety of their babies. According to the Mayo Clinic, problems that arise with GDM include the infant with excessive birth weight, congenital defects, and hypoglycemia. Women might develop preeclampsia, birth trauma, or delayed wound healing. The purpose of this project is to compare induction versus SL in full-term mothers with …

Educating Parents On Infant Safe Sleep To Reduce Sleep-Related Deaths, Marleni Cervantes

Symposium of Student Scholars

During my pediatric clinical rotation, I saw parents practicing unsafe sleeping practices with their infants. Infants would sleep with their pillows, blankets and in non-supine positions. There are around 3000 sleep related infant deaths annually in the United States (Patrick et al., 2021). To combat this issue a safe sleep education program should be implemented in labor and delivery and NICU units to ensure parents are getting the proper training before discharge. Parents will attend an education program before discharging from the hospital. The program will be completed in 2 days to ensure the parents are able to ask questions …

Prenatal Care: Access For All?, Jasmin Stewart

Symposium of Student Scholars

Prenatal care is an essential part of a woman’s pregnancy journey. It ensures that both mother and child are doing well, and helps to locate and diagnose any issues before they become complications. Without regular check ups, mothers will not be aware of life-threatening complications such as preeclampsia or placenta previa. Women in low socioeconomic brackets often do not have good access to prenatal care. Research studies have interviewed women and have stated many times there are no providers in the area where they live and they have to make long trips to see a doctor, which they cannot afford. …

Point-Of-Care Devices To Reduce Iatrogenic Anemia Among Preterm Infants, Jenna Craven

Symposium of Student Scholars

Abstract

In neonatal intensive care units (NICUs), the prevalence of anemia and required blood transfusions continues to rise. Blood testing is necessary in this population in order to accurately develop diagnoses and treatment options. However, blood loss in the NICU is the main cause of preterm neonatal anemia. Preterm infants tend to experience larger amounts of blood loss compared to other infants in the NICU. They are born with fewer red blood cells and are not able to rapidly reproduce these blood cells when needed, and multiple blood draws further deplete the infant’s hemoglobin and hematocrit levels. In current practice, …

Effects And Outcomes Of Different Laboring Positions And The Influence From Societal Norms, Amberlyn Heskett

Nursing | Senior Theses

Background

Within labor and delivery, every birth is different. Alarmingly, the U.S. has the highest maternal mortality rate, including death during labor, among developed countries (World Health Organization, 2022). Many maternal deaths may be preventable.

In the U.S., the use of forceps, vacuum-assisted birth, episiotomies, and emergency C-sections are common for women during childbirth. Even though some laboring positions may assist birthing more than others, there often is resistance to allowing various positions due to outside influences, including societal norms, hospital management, and healthcare professional training. Women in labor are vulnerable and look to their nurses for support during the …

Preventing Postpartum Complications Using A Home Visitation Model Of Care, Jenna Ingram

Nursing | Senior Theses

Background

The United States is currently facing a health crisis among the maternal postpartum population. As stated by The Commonwealth Fund in a study released in 2020, “In 2018, there were 17 maternal deaths for every 100,000 live births in the U.S. – a ratio more than double of most other high-income countries” (Roosa, 2020). Most often, mothers with uncomplicated pregnancies and births are discharged soon after the delivery of their new baby. In most outpatient settings, providers do not expect a follow up appointment for the mother until roughly three to six weeks after discharge. During this transition period …

The Components Of Vaccine Hesitancy And The Role Of Patient Education In Promotion Of Vaccinations In Newborns, Camille Joy Rayo

Nursing | Senior Theses

Background

Due to an array of reasons relating to vaccine hesitancy, many newborns are without their standardized and recommended vaccinations as a result of their parent’s beliefs. Parents hold the power to vaccinate their children. Nurses must provide reliable information, debunk myths, and pursue pro-vaccination ideas when educating a parent about newborn vaccinations. By doing so, vaccine hesitancy should decrease and vaccination rates should increase. Unvaccinated newborns are put at a greater risk of contracting serious illnesses that may spread to others or even lead to one’s own death.

Objective

To identify common factors regarding vaccine-hesitant parents of the newborn …

Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong

Nursing | Senior Theses

Background

The prevalence of childhood and adolescent obesity in the United States has steadily risen over the years and has become a public health concern. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obese children and adolescents are at risk for poor health and poor quality of life. Furthermore, there are numerous comorbidities associated with childhood and adolescent obesity. While some of the associated diseases are acute, others can become chronic and result in lifelong conditions.

Objective

The purpose of the present thesis is to explore …

Tiny Tusks Internship: The Relationship Between Socioeconomic Status And Breastfeeding Barriers, Blair Finlinson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks is a breastfeeding and infant support program developed by the nursing program at University of Arkansas. From 2021-2022, I have had the opportunity to complete my honors internship with this organization. Tiny Tusks was started with the goal of creating safe spaces for mothers to breastfeed and/or pump during school sporting events, along with providing up to date information on breastfeeding and infant safety practices. Tiny Tusks also provides changing tables, spaces for young children to decompress in a low-stimulation environment.

Association Between Breastfeeding, Oxytocin, And Risk Of Postpartum Hemorrhage, Jordan Davis, Sophia Nelson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Rates of maternal morbidity and mortality are far too high in the United States compared to other developed countries. Additionally, breastfeeding is often poorly prioritized, leading to a negative community connotation and low rates of exclusive breastfeeding. The purpose of this study was to compile the available research on breastfeeding initiation and its association with risk for postpartum hemorrhage. Fifteen peer-reviewed articles were collected from databases and other scholarly articles and screened for correlation between breastfeeding and maternal health risk. Overall, many articles suggest that skin-to-skin contact and early initiation of breastfeeding may be the most effective way to reduce …

Tiny Tusks Breastfeeding And Infant Support: Breastfeeding's Effects On Maternal Mental Health, Anna Jacobs

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breastfeeding has proven to be beneficial for infant health and maternal physical health, but there are variable outcomes for maternal mental health. This literature review explores the relationship between breastfeeding and maternal mental health, a topic that is often disregarded when discussing breastfeeding with mothers. After an internship with Tiny Tusks Breastfeeding and Infant Support, a program to make breastfeeding more accessible at Razorback Athletics events, maternal mental health related to breastfeeding was shown to be a topic in need of more current research. This objective of this literature review was to determine how breastfeeding can impact maternal mental health …

Addressing Interprofessional Competence In Interpretation Of Electronic Fetal Monitor Tracings, Susan H. Hébert

Doctoral Dissertations

Interpretation of electronic fetal monitor (EFM) tracings is a critical clinical practice skill nurses and physicians perform during the intrapartum stage of pregnancy. However, if performed inaccurately can potentially jeopardize the well-being of the neonate. This risk is present because if concerning EFM tracings are not interpreted accurately, preventative care interventions to promote the well-being of the unborn child do not occur. The project was initiated by completing a scoping literature review on the methods for training and evaluating EFM interpretation competence, which revealed current EFM interpretation training and evaluation methods are lacking. A concept analysis defined nurse competence in …

The Effects Of Prenatal Patient Education Regarding Epidural Anesthesia, Auburn Merritt

Symposium of Student Scholars

This project is important because there is a lack of education for prenatal women regarding epidural anesthesia which causes misunderstanding, confusion, a deficit of knowledge, and a lack of support. The purpose of this project is to analyze and suggest the importance of proper education regarding epidural anesthesia. Proper prenatal education causes resolution of misconceptions as well as causes patients to be more satisfied with their pain management during labor. Evidence that I found suggested that after proper education more pregnant women planned to receive epidural anesthesia (Cutajar, 2018). Women preferred detailed education to increase knowledge of the risks and …

Increasing Translation Services In Labor And Delivery, Victoria Morales

Symposium of Student Scholars

Abstract

Communication is one of the most basic and fundamental concepts in healthcare. Whether between nurse, doctor, patient, or environmental services, effective communication is vital to ensuring patient safety, achieving positive patient outcomes, promoting healthcare, and ensuring that patients make informed decisions. Data was gathered from non-English speaking patient surveys from a Labor and Delivery unit at a metro Atlanta hospital, to determine that not enough translation services were readily available for non-English speaking patients, and as a result, patient outcomes and satisfaction were negatively impacted. According to The International Journal of Translation and Interpreting Research, systemic reviews from multiple …