Medicine and Health Sciences Commons^™

Screening For Maternal Postpartum Depression In The Pediatric Primary Care Setting: An Educational Project, Mischelle M. Young, Dr. Robert Cornette, Dr. Lisa Padgett

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

Abstract

The birth of a baby can bring about an array of powerful emotions that range from joy and excitement to feelings of anxiety, worry, and depression. A majority of mothers experience postpartum baby blues which normally begins 2-3 days after delivery and can last for up to 2-3 weeks, but some mothers experience a more severe form known as postpartum depression (PPD). PPD can be mistaken for baby blues at first, but the signs and symptoms do not diminish and can continue to worsen. Postpartum depression signs and symptoms include withdrawing from friends and family, severe mood swings, excessive …

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 …

Pregnancy Back Pain: Its Prevalence, Pattern, And The Practice Of Ergonomic Behaviors Among Pregnant Women In Rural Sule Tankarkar Local Government Area Of Jigawa State Nigeria, Daha G. Muhammad, Sani Abdullahi, Yusuuf Tunde Gbonjubola, Mustafa Isyaku, Saadatu Abubakar Maiwada

Cooper Rowan Medical Journal

Background: Studies on Back pain in pregnancy have reported rates ranging from 25% and 90%, with most studies estimating that 50% of pregnant women will suffer from back pain during the course of their pregnancy. Low back is the most common region affected followed by posterior pelvic region and upper back region being the region least affected. In Nigeria, relative to the minimum wage, back pain consumes a significantly high amount of money in accessing health care thereby incurring both direct and indirect cost. Therefore, this study explored pregnancy back pain and the practice of ergonomic behaviors among pregnant women. …

A Qualitative Investigation Of Individual, Interpersonal, And Institutional Contributions To Postpartum Work-Family Balance, Sidney Smith, Laura Schwab Reese, Kilian Kelly, Tessa Bauman, Madison Wierenga, Anna Bohning, Andrea L. Demaria

Health Behavior Research

Managing personal and professional responsibilities may be challenging during the postpartum period, as employees navigate new roles, responsibilities, and family dynamics. The purpose of this paper was to understand the work/life balance experiences of diverse stakeholders and identify opportunities to improve the work environment. We conducted a series of in-depth focus groups with faculty, staff, and graduate students (n = 22), and in-depth interviews with administrators (n = 10) at a research-intensive university in the United States. A six-phase thematic analysis approach was used to examine the experiences and perspectives of individuals with different roles. Three themes with …

Improving The Delivery Of Discharge Instructions On The Postpartum Unit By Increasing The Nurses' Knowledge, Judy Anne Settles

Master's Projects and Capstones

Abstract

The field of nursing prides itself on two critical functions: safety and patient education. One of the mechanisms for both education and safety is the discharge process. Improvements in the discharge process have been shown to increase patient comprehension and safety. This study is grounded in the (Barach & Johnson, 2006) healthcare organizational framework called the 5 Ps microsystems assessment to explore the impacts and improvements in the discharge instruction process on a postpartum unit in a large organization. It was found that HCAHPS scores regarding discharge instructions were 55-60%, which is below what is considered satisfactory. Utilizing the …

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 …

Quantification Of Obstetric Hemorrhage, Alma Garcia

Student Scholarly Projects

Practice Problem: The practice problem identified involved the inconsistent measurement of blood loss during the postpartum period due to the standard practice of estimating blood loss. Estimates are subjective measures that can have variable results based on interpretation and thus provide minimal meaningful data.

PICOT: The question that guided this project was structured in the following PICOT format. In postpartum women (P), how does the implementation of quantitative blood loss measurements (I), compared to estimated blood loss measurement (C), affect the early identification of severe hemorrhage (O), during the recovery period (T)?

Evidence: Obstetric hemorrhage is a preventable event that …

The Lived Experience Of Postpartum Anxiety During Covid-19: A Hermeneutic Phenomenological Study, Walker Ladd Phd, Jenny De Decker

The Qualitative Report

The experience of pregnancy and postpartum anxiety disorders results in adverse birth outcomes and the disrupted development of infants and children. Since the COVID-19 Pandemic, the Centers for Disease Control and Prevention (CDC) has designated pregnant and postpartum women as more vulnerable to COVID-19 (CDC, 2021), and perinatal mood and anxiety disorders rates have increased. However, research regarding the lived experience of women with postpartum anxiety (PPA) during a global pandemic remains lacking. Using van Manen’s hermeneutic phenomenological research method, we interviewed eight women self-identifying as having had PPA during the COVID-19 pandemic. Analysis revealed five themes describing the lived …

Increasing Rooming-In Rates On A Mother Baby Unit, Scotti Manes

Dissertations

Problem: For new postpartum mothers, rooming-in has much evidence-based benefit; yet it is not widely accepted. Recent trends show the standard of care has changed to have newborns cared for in the nursery during parts of the postpartum period. Healthcare providers have unintentionally lacked providing ample education to new mothers regarding the benefits of rooming-in for mothers and newborns.

Methods: For this quality improvement (QI) project, a descriptive observational study design was used to identify if implementing standardized rooming-in education for patients influences rooming-in rates or the rates of exclusive breastfeeding at discharge. Thirteen staff nurses were identified as “champions” …

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 …

Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King

Doctor of Nursing Practice Projects

Background: The benefits of breastfeeding are commonly known; however, the rates of exclusive breastfeeding among the Black community are less than those of other ethnic groups. Providing breastmilk or formula to an infant is an individual decision. Influential factors such as cultural background, employment status, socioeconomic status, level of education, and availability of support from family members and health care providers correlate with the method a mother chooses to feed her infant. Increasing breastfeeding initiation immediately after birth is a necessary precedent for uptake in the exclusivity of breastfeeding.

Purpose: This Doctor of Nursing Practice project aims to improve prenatal …

The Impact Of A Lifestyle Intervention On Risk Factors Of Cardiovascular Disease And Type Ii Diabetes Among At-Risk Hispanic Women, Kathryn A. Wagner

Doctoral Dissertations

Cardiovascular disease and type 2 diabetes are global epidemics affecting approximately 127 and 21 million people in the U.S., respectively. Women who are overweight, obese or who develop glucose intolerance during pregnancy represent high-risk groups for the development of cardiovascular disease and type 2 diabetes. Hispanic women are both more likely to begin their pregnancies as overweight or obese and have a higher prevalence of type 2 diabetes, compared to non-Hispanic whites. However, prior lifestyle interventions have largely been limited to non-Hispanic whites. Therefore, this research assessed how culturally tailored lifestyle modification may affect cardiovascular disease and type 2 diabetes …

Discharged Against Medical Advice In The Postpartum Period: Why Should We Care?, Gurbani Bedi Bs, Mariam Ayyash Md, Mscr, Monique Swain Md

Medical Student Research Symposium

Objective: To understand reasons and events surrounding postpartum discharges against medical advice (AMA) in an urban population in Detroit, Michigan.

Methods: A retrospective chart review was conducted looking at women who left AMA in the postpartum period from Henry Ford Hospital in Detroit, Michigan between 2013 and 2021.

Results: 111 women (0.18%) left AMA in the postpartum period between 2013 and 2021. 35.1% of women were Black, 53% were White, 11.7% were of other races. 4.5% of women had home births and were brought in by EMS shortly after delivery. 44.1% of women had preterm births. 35.1% delivered via cesarean …

Screening For Childbirth-Related Posttraumatic Stress Disorder Using The City Birth Trauma Scale: A Pilot Project, Meredith Kazato

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project is to identify birthing people with childbirth-related posttraumatic stress disorder (CB-PTSD) symptoms using the City Birth Trauma Scale (CBTS). Once identified, at risk birthing people will receive verbal education about CB-PTSD and a social work consultation, if necessary.

Background: A birth is deemed traumatic, and thus fulfills one of eight criteria of posttraumatic stress disorder (PTSD), when during labor, delivery, and/or immediately postpartum, the birthing person perceives themselves and/or their baby’s life to be in danger and/or are at risk of being critically injured. These events include but are not limited to emergency cesarean …

The Impact Of Oral Health On Low-Income Pregnant Women Living In The United States, Jill Diss, Olivia Ward

Virginia Journal of Public Health

Abstract

Introduction: Oral health has a significant impact on pregnancy outcomes. Interprofessional collaboration can assist in bridging the gap between oral and systemic health and assist in optimizing the health of low-income pregnant women, infants, and children.

Methods: A literature review was used to ascertain the impact of oral health on adverse pregnancy outcomes. Research sources used in this literature review were gathered from the U.S. National Library of Medicine at the National Institutes of Health, PubMed, The Centers for Disease Control and Prevention (CDC), Elsevier, Department of Medical Assistance Services (DMAS), the Office of the Surgeon General, and Google …

Every Milliliter Matters: Quantitative Blood Loss In Postpartum, Iana Vatsenko

Master's Projects and Capstones

Postpartum hemorrhage remains a leading cause of maternal mortality in the United States. Postpartum hemorrhage occurs when mothers are bleeding excessively, have uterine atony, or the placenta has failed to come out completely. Research has shown that quantitative methods of blood loss estimation revealed a higher incidence of PPH than visual estimation. That is why using quantitative methods on time is essential for diagnosing PPH. Quantification of blood loss should be replaced by estimated blood loss since it is more accurate. The project's main focus was implementing quantification of blood loss and using the Triton Scale, a smart system to …

Every Milliliter Matters: A Quality Improvement Initiative For Postpartum Quantified Blood Loss, Amy O. Quinones

Master's Projects and Capstones

Problem: The microsystem for maternal-child healthcare in 2020 had 5.9% of deliveries progress to a postpartum hemorrhage. In 2021, the percentage of deliveries that progressed to a postpartum hemorrhage increased to 12.3%. The nearly two-fold increase in postpartum hemorrhage occurrence led to the creation of the Quality Improvement (QI) initiative to identify postpartum hemorrhage at an earlier stage. The QI initiative aims to extend the quantitative blood loss (QBL) measurement beyond labor and delivery, and support identification of postpartum hemorrhage in the postpartum period.

Context: The microsystem that this quality improvement project occurred on were three postpartum units in a …

Counting Every Drop: Preventing Maternal Mortality With Quantifying Blood Loss Through Triton Scale, Summer Le

Master's Projects and Capstones

Postpartum (PP) hemorrhage is one of the leading causes of maternal mortality (AWHONN, 2021). In each of the past three years, the percentage of PP hemorrhage has increased at Hospital X. The PP unit at Hospital X performs around 4,500 total deliveries each year. While the standard of care for PP blood loss is to specifically measure blood in milliliters as Quantifying Blood Loss (QBL) for Labor and Delivery (L&D), it is not yet the standard of care in the 24 hours postpartum after delivery (ACOG, 2019). This quality improvement project involved educating nurses about measuring blood loss – specifically …

Caring For Pregnant And Postpartum Athletes: Athletic Trainers, Strength Coaches, And Athletic Coaches, Aly Matejka, Stephanie Born

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE
A survey was created to assess the experience, education, and self-perceived competence of treating and/or training pregnant and postpartum athletes among athletic trainers, strength coaches, and coaches.

The Baby Blues: Postpartum Depression And The Ways We Can Combat Its Long-Term Effects, Haley Gomez

Nursing | Senior Theses

As nurses, effective interventions for new mothers, both non pharmacological and pharmacological, are essential to improving these patients’ outcomes and minimizing their risk for postpartum depression (PPD). New mothers undergo an immense amount of stress, both physically and mentally. As a result of this, many hospitals have standard postpartum care to minimize the risk of postpartum depression. Despite this, many mothers find themselves at a higher risk for PPD and managing these symptoms. Prescription medications are typically used in treating some symptoms of PPD but many patients may seek other forms of therapies. It is essential that alternative methods in …

A Normal Pattern Of Uterine Involution Using Symphysis-Fundal Distance, Abdel Latife H. M. Othman, Alaa M. Gomaa, Ibrahim A. S. Elnasr, Tarek M. Sayyed

Menoufia Medical Journal

Background Uterine involution is normally completed 6–8 weeks after giving birth. Despite the high variability in uterine involution from one to another parturient, indigent uterine involution has been found to be related to maternal illness. Objective The purpose of this study was to estimate the pattern of uterine involution through the use of symphysis-fundal distance (S-FD) to describe the normal pattern of uterine involution in terms of S-FD measurements. Patients and methods This was a prospective observational study conducted on 80 term primigravidae, who attended the labor ward of the Obstetrics and Gynecology Department at Al Shohada Central Hospital and …

Change Of Policy Regarding Evidence Based Practice Interventions In Postpartum Hemorrhages And Promotion Of Standardization Of Care, Danielle Fulton

MSN Capstone Projects

Postpartum Hemorrhages are occurring at a devastating rate and require intervention, as postpartum women can die from hemorrhages. This project aims to establish interventions that should be a set policy, to help decrease the rate in which postpartum hemorrhages occur and the morbidity rate.

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 …

Deploying A Validated Postnatal Depression Screening Tool & Guideline To Improve Evidence Based Screening For Postpartum Depression In Ambulatory Care, Debbie Ketchum

Doctor of Nursing Practice Projects

Problem Description: Postpartum depression (PPD) is a significant public health problem that is potentially disabling and can be life-threatening. It is one of the most common diagnoses for maternal morbidity and mortality, affecting one in ten women in the United States. Currently, there is no universal process for the identification of PPD within the ambulatory clinics in this regional health system caring for obstetrical patients. A quality improvement project was developed and implemented with a pilot group in the ambulatory setting.

Rationale: Without a standard process for screening, patients and their newborns may be at increased risk for detrimental consequences …

Comparing The Effectiveness Of Methods Meant To Reduce Perineal Laceration Rates, Danielle E Horovitz

Nursing | Senior Theses

Background

Perineal lacerations are a common occurrence in childbirth- with tears occurring in 53-79% of women. Trauma to the perineum is classified into 4 categories, with each class increasing in severity. Severe perineal lacerations have long term consequences for the women who experience them.

Objectives

To compare the effectiveness of methods which aim to reduce the rate and severity of perineal lacerations, including: hands on vs hands off technique, slow and controlled birth, use of lubrication, perineal massage, etc.

Summary of Findings

The literature review suggests that it is critical to employ methods to reduce laceration incidence and severity as …

The Impact Of Oral Health On Low-Income Pregnant Women Living In The United States, Olivia Ward, Jill Jacobs Diss

College of Health Sciences Posters

Introduction: Oral health has a significant impact on pregnancy outcomes. Inter-professional collaboration can assist in bridging the gap between oral and systemic health and assist in optimizing the health of low-income pregnant women, infants, and children.

Methods: A literature review was used to ascertain the impact of oral health on adverse pregnancy outcomes. Research sources used in this literature review were gathered from the U.S. National Library of Medicine at the National Institutes of Health, PubMed, The Centers for Disease Control and Prevention (CDC), Elsevier, Department of Medical Assistance Services (DMAS), the Office of the Surgeon General, and Google Scholars. …

Integrated Care Impact On Postpartum Visit Compliance And Readmissions, Matthew Herrick

Walden Dissertations and Doctoral Studies

The specific research problem that was addressed through this study is the low rate of postpartum visits among Medicaid-enrolled women, leading to increased postpartum complications and readmissions. The purpose of this quantitative study was to evaluate if hospital readmissions can be reduced by integrated care home visiting services relating to postpartum visit compliance. The research questions evaluated the relationships between postpartum visit compliance, hospital readmissions among Medicaid-enrolled women in Indiana, and an integrated care home visiting program. The Donabedian model for quality-of-care grounds this study and is based on structure, process, and outcome. Through this model, healthcare leaders can evaluate …

Pelvic Floor Exercises & Pelvic Physical Therapy Directory For Pregnant & Postpartum Individuals, Matthew Breseman

Family Medicine Clerkship Student Projects

No abstract provided.

The Use Of Complementary Medicine During Childbearing Years: A Multi-Country Study Of Women From The Middle East, Diana Arabiat, Lisa Whitehead, Samia Gaballah, Nazi Nejat, Ebtehal Galal, Eman Abu Sabah, Nazek Smadi, Inas Saadeh, Randa Khlaif

Research outputs 2014 to 2021

The prevalence of self-prescribed complementary medicine (CM) use is an area of concern across the Middle East. We conducted a descriptive qualitative study to describe women’s use of CM during their childbearing years in Egypt, Jordan, Saudi Arabia and Iran. The study conducted using face to face audio-recorded interviews with 70 participants. Our findings showed that women used several herbal plants to ease pain and discomfort during menstruation and/or during pregnancy and in postpartum care. Acupuncture, meditation, and massage were less likely to be used by women. The impact of CM was often described in relation to perceived usefulness and …