Medicine and Health Sciences Commons^™

Establishing Routine Multiple Micronutrient Supplementation During Pregnancy In An Impoverished Guatemalan Community, Marissa Schuette, Erin Brueggemann

Doctor of Nursing Practice Projects

Pregnant and breastfeeding women in impoverished settings face heightened nutritional demands, placing them and their children at increased risk of inadequate nutrition's detrimental effects. Existing literature suggests that supplementing with multiple micronutrients (MMS) may offer superior protection against morbidity and mortality compared to traditional iron and folic acid (IFA) formulations. This research is set in the Land of Hope (LOH) clinic, located in Escuintla, Guatemala, a community served by the non-profit organization ER Abroad. The study aims to assess the feasibility of standardizing MMS provision to pregnant women at LOH, coupled with supplementary education on pregnancy and nutrition. The team …

Recommendations For Sugammadex Administration In Standard And Special Populations, Kristen E. Mattson, Alexa Brummund

Doctor of Nursing Practice Projects

The purpose of this project was to collect evidence-based information regarding sugammadex administration in both standard and selected special populations. Special populations included renal failure, breastfeeding, pregnancy, and pediatrics. The objectives of the project were to collect and present current research to the host facility, define barriers to the use of sugammadex, and assess the participants’ knowledge of sugammadex use in special populations. A guideline for sugammdex administration was created and presented to the host facility through a poster presentation and quick reference guide. A voluntary post-implementation survey was implemented, and the results were recorded, analyzed, and displayed in the …

Pregnancy In United States Immigration Detention: Listening To Migrant Women's Stories, Amanda Heffernan

Nursing ETDs

Over the last five years, dramatic shifts in immigration policy across three presidential administrations have impacted migrants arriving at the U.S.’ southern border, with unique impacts on pregnant migrants. The purpose of this study was to document, analyze and contextualize the experience of pregnancy in United States immigration detention. Specifically, the study aimed to: 1) understand the situation of pregnant migrants detained in United States immigration detention facilities between 2017-2022; 2) situate the experience of detained pregnant migrants within multiple contexts, including their own individual and family migration stories and the larger context of United States immigration policy; and 3) …

The Relationship Between Self-Efficacy And Informed Decision-Making On Primiparous Women During The Birthing Process, Morgan R. Fillipo

Nursing | Senior Theses

Childbirth is a very intense and vulnerable experience, especially for first-time mothers. Across the globe, the prevalence of traumatic and unsatisfying births has become an increasingly troublesome issue for women. There is extensive evidence of maltreatment, and a large portion of the problem has to do with the client’s medical team. To combat this dilemma, the best course of action would be to prepare women for this possibility by increasing the client’s self-efficacy and decision-making abilities. Self-efficacy, also known as confidence in one’s skills, is an important trait to have when it comes to patients being able to advocate for …

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 …

Impact Of The Maternity Care Changes Of The Covid-19 Pandemic On Pregnant Women And Their Birth Partners: An Integrative Literature Review, Rebekah Kemp

Master of Science in Nursing Final Projects

Introduction: In March 2020, the novel coronavirus originating out of Wuhan in China and spreading rapidly worldwide, became known as the COVID-19 pandemic. Patients with pre-existing conditions, such as the elderly and pregnant women, are among those most vulnerable to severe infection due to COVID-19. Increased pulmonary expansion in the respiratory tract make pregnant women more susceptible to viral respiratory infections and exacerbation of illnesses like COVID-19. Another major concern correlated with the pandemic and pregnancy is its effect on pregnant women’s mental health. Unique physiological and psychological changes place pregnant women at an increased risk for experiencing mental health …

The Eat Sleep Console Approach: An Evaluation Of Impact, Outcomes And Continuation Of Care, Stefanie Disilvio

Doctor of Nursing Practice (DNP) Manuscripts

Neonatal Opioid Withdrawal Syndrome (NOWS), a subgroup of Neonatal Abstinence Syndrome (NAS), is a constellation of postnatal symptoms that occurs due to the abrupt cessation of intrauterine opioid exposure. Historically, these infants have been evaluated and treated by the Finnegan Neonatal Abstinence Scoring Tool (FNAST) (Appendix A). Recent evidence supports the use of the Eat Sleep Console Approach (ESC) (Appendix B) as an alternative to the FNAST. The ESC model focuses on the comfort and care of these infants by maximizing nonpharmacologic methods and increasing family involvement in the treatment of their infant. The purpose of this project was to …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Development Of A Project To Improve Prenatal Education At A Rural Medically Assisted Treatment Center Focused On Neonatal Abstinence Syndrome And Parenting Skills., Tracey Brink

Doctor of Nursing Practice Papers

Abstract

Background: Many women who suffer from substance use disorder syndrome (SUDS) have low self-esteem and can be labeled as “unfit parents” which can impede infant bonding and maternal sobriety. Parent and self-efficacy are associated with improved maternal-infant attachment and sobriety (Adams, et.al. 2021). The earlier prenatal education is implemented, the more empowered the mothers will feel to be able to help their infants and themselves.

Setting: A medically assisted treatment center (MAT) for pregnant women who presents with SUDS. The six-bed inpatient facility is in a rural county in central Kentucky.

Purpose: To create an educational program about parent …

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 …

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 …

Community Health Worker Program - Substance Use Disorder In Pregnancy, Alicia Claire Kletter Dnp

Doctor of Nursing Practice (DNP) Projects

Background Substance use disorder (SUD) in pregnancy is a concern for mother, baby and community. Healthcare policies are increasingly calling for diversification of the workforce to meet healthcare needs. Community health workers (CHWs) are understood from the literature to be effective at bridging the gap between patient and healthcare provider, especially for vulnerable populations. Local Problem California’s Central Valley is majority Latinx and faces challenges from poverty, lack of medical resources, unemployment and SUD at rates which are higher than other communities. Combine SUD with pregnancy and the need for robust social connections, psychological support, and physical healthcare become even …

Pregnancy Education In Rural Areas, Kayla Tinsley

Doctor of Nursing Practice Scholarly Project

Educating of the pregnancy population before, during and after pregnancy can help to ensure a healthy pregnancy and in turn reduce maternal mortality. The purpose of this research project was to understand education provided in the clinic and hospital setting in a rural area by those who take care of and talk to pregnant women and their support persons. A descriptive research design was utilized to discover the important education topics that are discussed, and the routine tests that are done throughout the pregnancy, during labor and at delivery, and even ask how prepared they feel they are equipped to …

Utilizing Community Health Workers To Support Latinx Women With Substance Use Disorder During Pregnancy, Alicia Claire Kletter

DNP Qualifying Manuscripts

Community health workers in the Latinx community, sometimes called promotores de salud, are employed in a variety of medical settings to help increase access to health promoting services such as awareness, education, and screening. Given their deep understanding of the culture and community in which they work, community health workers in Latinx communities are increasingly included in the healthcare team for their cultural sensitivity and versatility with hard- to-reach populations, including the support of pregnant women and children. An integrative review of the literature seeks to understand if community health workers can improve outcomes for pregnant women who also suffer …

Benefits Of Exercise In Pregnant Women, Jenna Renee Barretto

Nursing | Senior Theses

Exercise is an important lifestyle habit to include in one's daily routine. Remaining physical activity during pregnancy is important. According to the CDC, pregnant women should, “Get at least 150 minutes of moderate-intensity aerobic activity during pregnancy and the postpartum period.” (Centers for Disease Control and Prevention, 2021). This paper will encompass a range of topics that highlight the benefits of exercise from a physiological as well as a mental health standpoint. Although more research needs to be conducted to solidify the benefits of exercise, the articles that were collected demonstrate how it can help mothers have a healthy pregnancy. …

Comparing An Evidence-Based Screening Tool To Standard Substance Abuse Screening Questions In Identifying Pregnant Women At Risk For Substance Abuse, Nicole Y. Romero

Doctor of Nursing Practice Scholarly Projects

The purpose of the study project was to compare a nonspecific substance screening questionnaire with a well validated, evidence-based substance screening tool designed specifically for the pregnant population Evidence has shown use of an evidence-based screening tool improves maternal and fetal outcomes and reduces the risk of missed cases, stereotyping, and stigma. This study project utilized the social learning theory model, which defines human behavior as a reciprocal, continuous interaction among cognitive, behavioral, and environmental determinants. A pilot observational study project was conducted within a focal organization in a specified women’s health clinic over a 12-week period comparing their currently …

Maternal-Fetal Attachment And Its Relationship To Quality Of Life In Pregnant Women With Diabetes, Cheryl Ann Angel

Dissertations

Background: Maternal-fetal attachment (MFA) is the bond between a mother and her unborn child during pregnancy. Pregnant women with diabetes are considered high-risk and their numbers are expected to increase as levels of obesity rise and women wait longer to have children. This researcher has observed health care providers instructing pregnant women with diabetes about diabetes self-management (DSM) activities such as “dietary management” and encouraging the women to make those changes for their baby. However, some women remained unable to successfully engage in DSM behaviors despite having exhibited signs of MFA, e.g., expressing “thoughts of the fetus” to health care …

Online Support For Families Affected By Opioid Use Disorder, Sharonda Hill

Doctor of Nursing Practice Projects

Families who care for children with neonatal abstinence syndrome (NAS) face many challenges and may be lacking support. The purpose of this project was to provide evidence-based information to families caring for NAS children through an established online support group, To the Moon and Back. Nola Pender’s Health Promotion Model was the theoretical model used to guide this project. An intervention to deliver support and information was implemented through three sessions. During these sessions participants were educated on evidenced-based tools to help their children with behavioral self- regulation and communication with providers. Data was collected through pre and post assessments …

Evaluating Providers’ Knowledge, Attitudes And Intentions Toward Assessing Pregnancy Desires In Women Of Childbearing Age, Sydney Hahn

DNP Projects

Abstract

Background: Unintended pregnancies account for over half of all pregnancies in the United States. Unintended pregnancies can lead to abortion, socioeconomic difficulties, medical complications, psychological issues, and political issues. Unintended pregnancies are potentially harmful to both the mother and the baby. Healthy People 2030 listed reducing the number of unintended pregnancies as one of their family planning objectives.

Purpose: The purpose of this DNP project was to evaluate providers’ knowledge, attitudes, and intentions toward assessing pregnancy desires in women of childbearing age. Methods: The study was a one-group pre/post intervention design. The data was gathered via a convivence sample …

Formalizing A High-Risk Obstetrical Initiative: Focus—Hypertensive Disorders, Elena Vulgamott Rodrigue

Doctor of Nursing Practice

Background: Hypertensive disorders during pregnancy have a detrimental effect on maternal and fetal outcomes, causing low birth weights, preterm births, and stillbirths. During pregnancy, hypertensive disorders affect up to 13% of all pregnancies and make up 10% of all maternal mortality in the United States (Centers for Disease Control and Prevention [CDC], 2019). Purpose: The purpose of this DNP project was to implement and standardize a high-risk obstetrical initiative for hypertensive mothers. Summary of Evidence: Data suggest that increased education and increased surveillance for high-risk obstetric patients decreases the need for obstetric services and decreases the evolution of hypertensive …

Assessing The Impact Of Covid-19 Restrictions On The Perinatal Experience In Mississippi, Baylee Grimsley

Honors Theses

The purpose of this study is to assess how COVID-19 restrictions affected the perinatal experience of women in Mississippi. A flyer detailing the purpose and inclusion criteria of the study was sent via social media platforms. Five postpartum women from the Hattiesburg, Mississippi area participated in this study. Eight open-ended questions were asked in an interview format, and a seven-question demographic survey was given to each participant at the conclusion of the interview. Five restrictions related to COVID-19 were identified: visitor restrictions in the hospital, mask requirements in healthcare facilities, screening of patients upon admission to the Labor and Delivery …

Processes Used By Mothers In Opioid Recovery To Manage The Needs Of The Maternal-Infant Dyad: A Grounded Theory Study, Nicole M. Mattson

Dissertations (1934 -)

Maternal opioid use during pregnancy and the postpartum period has significant impact on the mother and infant. Maternal well-being and early maternal-infant contact can impact the early attachment and bonding of the dyad. Additionally, the stigma surrounding opioid use in pregnancy can have detrimental effects on the dyad during pregnancy and in the postpartum period. Theory driven nursing interventions to promote mother-infant dyadic care for pairs impacted by maternal opioid use disorder (OUD) are needed. First, it was necessary to understand the current processes used by mothers with OUD to manage the unique needs of their dyad. The purpose of …

Processes Used By Mothers In Opioid Recovery To Manage The Needs Of The Maternal-Infant Dyad: A Grounded Theory Study, Nicole M. Mattson

Dissertations (1934 -)

Maternal opioid use during pregnancy and the postpartum period has significant impact on the mother and infant. Maternal well-being and early maternal-infant contact can impact the early attachment and bonding of the dyad. Additionally, the stigma surrounding opioid use in pregnancy can have detrimental effects on the dyad during pregnancy and in the postpartum period. Theory driven nursing interventions to promote mother-infant dyadic care for pairs impacted by maternal opioid use disorder (OUD) are needed. First, it was necessary to understand the current processes used by mothers with OUD to manage the unique needs of their dyad. The purpose of …

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

Pregnant Women's Experiences With Gastrointestinal Discomforts And Strategies They Use To Cope, Heidi Jo Paquette

Dissertations (1934 -)

Problem The experience of gastrointestinal (GI) discomforts of pregnancy is almost universal. Heartburn, constipation, nausea and/or vomiting are the most common, with variation in frequency and intensity by trimester. GI discomforts of pregnancy are understudied. Most research on GI discomforts of pregnancy has employed quantitative instruments, before and after specific therapeutic approaches. Little research has focused on women’s experiences of GI discomforts of pregnancy and self-management strategies. Women are experts in their experience of their own pregnancies and their voices are rich sources of data, but have been largely ignored in the study of GI discomforts of pregnancy. Methodology The …

Substance Use Screening, Brief Intervention, And Referral To Treatment (Sbirt) In Pregnant Women Living With Hiv, Whitney Markowitz

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Substance Use Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Pregnant Women Living with Human Immunodeficiency Virus (HIV)

BACKGROUND: According to the 2018 National Survey on Drug Use and Health, 5.4%, 9.9%, and 11.1% of pregnant women reported use of illicit drugs, alcohol, and tobacco, respectively, in the past month. In the same year, Centers for Disease Control reported 19% of new HIV diagnoses were among women. Substance use in pregnant women living with HIV increases risk of adverse outcomes for both mother and child including neonatal viral transmission and obstetrical complications. Universal screening for substance use …

Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee

Evidence-Based Practice Project Reports

Given the global tragedy that this most recent pandemic has caused, more attention has been given to the devastating outcomes that the spread of infectious disease outbreaks can have. Similar to those with comorbid conditions, pregnant women are also extremely vulnerable to infectious diseases, as disease manifestation does not only affect the mother, but the fetus as well. Thus, the prevention of both the influenza virus and pertussis are two major goals when providing care for this population. Preventing both of these disease processes during the intrapartum period helps to ensure optimal wellness for both mother and baby and overall …

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 …

Contraceptive Accessibility And Reproductive Outcomes In Adolescents Seeking Care At School-Based Health Centers: A Systematic Review, Jamie Jenkins

All Graduate Theses, Dissertations, and Other Capstone Projects

Context: Adolescent pregnancy continues to be a public health concern in the United States. School-based health centers are an ideal setting for providing affordable, accessible, and confidential reproductive services for adolescents that can help prevent unintended pregnancies. However, there are great variations in the reproductive services offered at school-based health centers across the United States. Objective: This study aims to explore the question: Do school-based health centers that provide on-site contraception access have lower adolescent pregnancy rates and higher reported contraception use when compared to school-based health centers that do not provide on-site contraception? Methods: A literature …

Telehealth Use During The Prenatal Period: Strengths And Limitations, Adrian M. Goblisch, Tessa L. Hand

All Electronic Theses and Dissertations

Background/Purpose: The purpose of this paper is to examine the risks and benefits of telehealth use during the prenatal period. With the increasing use of technology to provide healthcare, especially during the COVID-19 pandemic, it is critical to examine the implications this care modality has on individuals and the community. Theoretical Framework: Katharine Kolcaba’s Comfort Theory was applied to the topic of telehealth use in the prenatal period. This theory explains that there is an immediate experience of strengthening when relief, ease, and transcendence are met and that an individual is more likely to exhibit health-seeking behaviors when comfort in …