Nursing Commons^™

Lean Management Principles To The Creation Of Postpartum Hemorrhage Care Bundles, Bethan Faulkner

Doctor of Nursing Practice (DNP) Projects

Postpartum hemorrhage (PPH) is the number one cause of pregnancy-related death in the US. The Maternity local improvement team (LIT), co-led by an Obstetrician and Board Certified Clinical Nurse Specialist found that each month the maternity unit averages 40 PPHs with 1-2 resulting in an emergency. Over a 6-month period, the LIT decreased response time for emergencies significantly. Supply retrieval time decreased by 99.9%, MD response time decreased by 81%, and Family Centered Care increased by 100%. They recently turned their attention to prevention. Given the lack of literature on preventing PPH in postpartum units, the team developed a PPH …

Exploring Neonatal Intensive Care Nurses’ Affective Responses To Providing End-Of-Life Care, Stephanie Lynn Lewis

Doctoral Dissertations

Significance. The Joint Commission established standards to evaluate comprehensive end-of-life infant care and the positive outcomes of such care are well documented. However, findings from multiple studies conducted over the last decade indicate that end-of-life care in the neonatal intensive care unit is not provided consistently or holistically to all dying infants. Because nurses are the healthcare professionals most often responsible for providing this care, anything that detracts from their ability to provide it, including their own affective responses, needs to be addressed.

Aim. The purpose of this study was to explore—through lived and told stories—the affective, interactional, and …

Develop A Sudden Infant Death Syndrome (Sids) Education Package In Jordan: Using Participatory Action Research Approach To Create Ripple Of Change, Shereen Hamadneh, Jehan Hamadneh

eCULTURE

IInfant mortality is high in Jordan, a developing country in the Middle East, at 19 per 1000 live births. Most mortality risk factors are preventable. The SIDS incidence rate has also been extrapolated as 11.22 per 1000 live births [1]. This is much higher than the United State of America (USA), a developed country (0.54 per 1000 live births) [2]. Most of modifiable SIDS risk factors can be reduced by increasing knowledge, change behaviors and practices regarding SIDS risks and prevention measures.

There has not been a major investment in educating Jordanians about SIDS. Heath care providers are identified …

Influence Of Motivation On The Efficacy Of Natural Family Planning, Richard J. Fehring, Mary Schneider, Mary Lee Barron, Jessica E. Pruszynski

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

Purpose: Mutual motivation is recognized as essential for effective behavioral methods of family planning. Few studies have studied this factor in family planning efficacy. The purpose of this study was to determine the influence of mutual motivation on unintended pregnancy rates of couples who used natural family planning (NFP) methods to avoid pregnancy.

Study Design and Methods: Using an online taught NFP method, 358women and ( their male partners) indicated “how much” and “how hard” they wished to avoid pregnancy on a scale of 0-10 before each menstrual cycle charted over 12 month of use. This motivation scale is used …

Preventing Maternal And Early Childhood Obesity: The Fetal Flaw In Australian Perinatal Care, Margaret R. Miller, Lydia A. Hearn, Paige Van Der Plight, Jane Willcox, Karen Campbell

Research outputs 2013

Almost half of Australian women of child-bearing age are overweight or obese, with a rate of 30–50% reported in early pregnancy. Maternal adiposity is a costly challenge for Australian obstetric care, with associated serious maternal and neonatal complications. Excess gestational weight gain is an important predictor of offspring adiposity into adulthood and higher maternal weight later in life. Current public health and perinatal care approaches in Australia do not adequately address excess perinatal maternal weight or gestational weight gain. This paper argues that the failure of primary health-care providers to offer systematic advice and support regarding women’s weight and related …

Taking Family Centered Care To A Whole New Level: Babycam, Cathy L. Bailey Rn, Ms, Crnp

Patient Care Services / Nursing

No abstract provided.

Sonographic Findings In Acute Uterine Inversion, John C. Smulian Md, Mph, Joseph D. Defulvio Do, Liany C. Diven Md, Jose Luiis Terrazas Md

John C Smulian MD, MPH

We present a case of acute uterine inversion in the third stage of labor in which critical management decisions were facilitated by ultrasound imaging in the operating room. Identification of the ovary and adnexa pulled into the inclination of the inversion allowed successful diagnosis and guidance of uterine replacement.

Randomized Comparison Of Two Internet-Supported Fertility Awareness Based Methods Of Family Planning, Richard J. Fehring, Mary Schneider, Kathleen Raviele, Dana Rodriguez, Jessica E. Pruszynski

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

Background: The aim was to compare the efficacy and acceptability of two Internet-supported fertility-awareness-based methods of family planning.

Study design: Six hundred and sixty-seven women and their male partners were randomized into either an electronic hormonal fertility monitor (EHFM) group or a cervical mucus monitoring (CMM) group. Both groups utilized a Web site with instructions, charts and support. Acceptability was assessed online at 1, 3 and 6 months. Pregnancy rates were determined by survival analysis.

Results: The EHFM participants (N=197) had a total pregnancy rate of 7 per 100 users over 12 months of use compared with 18.5 for the …

Tamiah N. Mccoy - African American Women’S Birth Stories As Told To African American Women Interviewers, Tamiah N. Mccoy

Ronald E. McNair Scholars Program 2013

Background: A woman’s birth story allows each woman to tell her own perspectives about her experience of bringing a child into the world. As healthcare providers, it is always important to value listening to and learning from our clients. Researchers systematically analyzing birth stories can yield insights on ways to improve birthing experiences for women. This is especially important for African American women, who differentially encounter the most numerous health disparities of any racial group, with twice as much infant mortality than other groups.

Purpose: This study examined birth stories of African American women in order to gain insights from …

Alternative Hospital Gift Bags And Breastfeeding Exclusivity, Yeon Bai, Shahla M. Wunderlich, Rickie Kashdan

Department of Nutrition and Food Studies Scholarship and Creative Works

The type of gift bags given to new mothers at the time of discharge from the hospital can influence their confidence in breastfeeding. Most hospitals in the US continue to distribute commercial gift bags containing formula samples despite the reported negative influence of commercial bags on the duration of breastfeeding. This study compared breastfeeding outcomes in women receiving three different kinds of gift bags at discharge. A prospective intervention study was conducted during the 2009-2010 in New Jersey. Three breastfeeding cohorts were recruited and assigned to three groups: COMMERCIAL received discharge bags containing formula samples, BF-INFO received breastfeeding information and …

Integrating Evidence For Excellence In The Care Of Women And Newborns - The Evidence-Based Fellows² Program (Poster), Jennifer King Rnc, Bsn

Patient Care Services / Nursing

No abstract provided.

Interprofessional Roles Shoulder Dystocia: Maximizing Safety In Community Hospitals, Elizabeth Yznaga

Doctor of Nursing Practice (DNP) Projects

Prompted by evidence that clinical simulations improve patient safety, team simulations are emerging in hospital settings. Accrediting organizations such as the U.S. Joint Commission on Accreditation of Healthcare Organizations and the American College of Obstetricians and Gynecologists (Joint Commission, 2004, American College of Obstetricians and Gynecologists, 2002) have recommend simulation of obstetrical emergencies, including shoulder dystocia for hospital teams. National patient safety mandates for simulation training of critical events have not been available to small, rural hospitals because of lack of talent and equipment, creating a gap in resources. Other than demonstrations by manikin companies, this author has currently been …

Perception, Expression And Management Of The Pain Of Childbirth, Mary H. Christenson

Senior Honors Theses

In order to be a competent nurse on an American labor and delivery unit it is important to have an understanding of the pain of childbirth. This includes a thorough understanding of pain as a sensation and its manifestation during the birthing experience. An understanding of pain is useless, however, unless standardized pain assessment practices are used. The most accurate pain assessment is associated with a general understanding of cultural trends in pain perception and expression. Along with culture, other factors also influence how a woman senses and copes with the pain of labor. Anxiety is one of these influential …

The Effects Of Nursing Care On The Patient Experiencing A Stillborn Birth, Katherine Totten

Senior Honors Theses

Childbirth has the potential of being one of the most joyous and fulfilling experiences a woman goes through in her entire life. Being a mom, driving the kids to soccer practice, and sitting around the Christmas tree with the family can easily be seen as an ideal life. Conversely, the negative experiences with childbirth are rarely discussed. There is an overlooked category: moms who conceive but lose the baby in the womb. Not only are these women overlooked, but also the hospital care they receive proves inconsistent with the latest research. Nurses and doctors should be aware of the latest …

Nurses’ Perspectives On Neonatal Massage Therapy In The Neonatal Intensive Care Unit, Kayla R. Hanson

Senior Honors Theses

Research in neonatal massage therapy has shown many possible benefits to the baby and family. Though there has been a growing trend towards family-centered care, along with a substantial and growing body of research, the practice of neonatal massage therapy is not routine in most NICUs. This study was conducted to evaluate neonatal intensive care nurses’ perspectives and attitudes towards neonatal massage therapy before and after evidence-based education. Willingness to discuss benefits of neonatal massage therapy significantly increased after education on neonatal massage therapy. The findings suggest that with proper training on the techniques and safety monitoring of massage therapy, …

Kangaroo Mother Care For Premature And Low Birth Weight Infants, Emma Rahn, Bethany Hotchkiss

The Research and Scholarship Symposium (2013-2019)

No abstract provided.

An Evidence-Based Approach To Feeding The Late Preterm Infant, Diane Mcclure

Seton Hall University Dissertations and Theses (ETDs)

No abstract provided.

Final Report: Randomized Comparison Of Two Internet-Supported Methods Of Natural Family Planning, Richard J. Fehring, Mary Schneider

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

Studies consistently show that women want safe, effective, easy to use, and convenient methods of family planning (Arévalo,1997; Severy 2001). Although Natural Family Planning (NFP) methods are free of side effects, they are often ineffective and complex to learn and use (Grimes et al. 2005). Efforts have occurred over the past 10 years to simplify the teaching and use of NFP methods and increase their efficacy. These efforts include the development of low tech calendar-based methods (Arévalo et al. 2004), simplifying instructions (Frank-Herrmann et al. 2005), and developing accurate biological markers of fertility (Guida et al. 1999).

A new high-tech …

Adolescent Athletes With Type 1 Diabetes: Experiences With Continuous Subcutaneous Insulin Infusion, Regina Tow

UNF Graduate Theses and Dissertations

Adolescent athletes with type 1 diabetes (T1DM) face unique challenges when compared to peers with and without diabetes. Continuous subcutaneous insulin infusion (CSII) provides a method of insulin delivery that can enhance flexibility in insulin regimens and lifestyle that may be especially appealing to the adolescent athlete. No studies have explored the impact of athletics in this population. This descriptive qualitative study explored and described the experiences of adolescent athletes using CSII as their primary insulin delivery method, with a focus on athletic participation and performance.

The purposeful sample consisted of four adolescent athletes, ages 13 to 15 years with …

Standardized Care Of The Late Preterm Infant In Upper Midwest Hospitals, Michelle Susanne Foy

All Graduate Theses, Dissertations, and Other Capstone Projects

Standardizing care or critical pathways have delivered evidence-based care in adult medicine and have positive patient outcomes. Some aspects of standardized care have been used in neonatology, but less often in caring for the late preterm infant (gestational week 34-37 weeks). With each level of care nursery, Level-I, level-II or level-III, there can be a wide range of how to care for the late preterm infant. The purpose of this study was to determine if nurseries or various levels of care had established standards of care specific to the late preterm infant and what barriers existed that prohibited standards of …

Barriers To Effective Pain Management In Preterm And Critically Ill Neonates, Sharon W. Lake

Theses and Dissertations--Nursing

The purpose of this dissertation is to explore potential barriers nurses experience in providing effective pain management for preterm and critically ill infants in neonatal intensive care units (NICUs). The specific aims of the study conducted are to examine (a) NICU caregivers’ knowledge about pain, (b) scales used to evaluate pain in infants, (c) NICU nurses’ documented pain practices, and (d) bias in treating pain of certain types of infants.

This dissertation is comprised of three manuscripts. The first manuscript is an integrated review of the literature describing caregiver knowledge, barriers, and bias in the management of pain in neonates. …

The Factors That Influence Duration Of Exclusive Breastfeeding: A Mixed Methods Design, Roxanne K. Bowman

Theses and Dissertations--Nursing

Breastfeeding is the gold standard of infant feeding and its benefits extend beyond the mother and child. Multiple organizations recommend exclusive breastfeeding for the first six months of an infant’s life. Exclusive breastfeeding rates nationally and in the state of Kentucky fall below the Healthy People 2020 goals. A mother’s intention to breastfeed has been shown to impact actual breastfeeding behavior. The current state of the measurement of intention was explored through a literature review. A majority of the measures were single item scales. The reliability and validity of the scales should be further tested in diverse populations.

The purposes …

Breast Milk For Preterm Infants: A Nursing Education Program, Lynn Root

Theses and Graduate Projects

The incidence and duration of breast milk feedings for preterm infants, via gavage, bottle and/or breast, is less than that of full-term infants despite scientific-based benefits of breast milk for preterm infants. Maternal-neonatal nurses play a critical role in supporting mothers of preterm infants and promoting breast milk for this population. However, when caring for the mother-preterm dyad, the maternal-neonatal nurse may encounter several barriers in the promotion of breast milk. It has been identified that one of the major barriers to the initiation and maintenance of lactation in mothers of preterm infants is the inconsistent information and lack of …

Pregnancy Resolution Counseling With Adolescents, Michelle Taylor Skipper

Nursing Theses and Capstone Projects

The results of a positive pregnancy test for an adolescent female mandate a time-sensitive decision to be chosen on the outcome of that pregnancy--whether to continue to pregnancy or terminate. Ambivalence regarding the pregnancy in adolescence is typically high as the rate of unplanned pregnancies has been reported as high as eighty-six percent. In this project, Allanson's Abortion Decision Balance Sheet (ADBS) was modified to an age-appropriate literacy level and completed by nine adolescents in a public health department setting in the project "Pregnancy Resolution Counseling with Adolescents" (PRCA). Providing objective questions related to emotions regarding the pregnancy was proposed …

The Late Preterm Infant: How Much Transition Time Is Needed To Prevent Hypothermia?, Sandi Lane

Nursing Theses and Capstone Projects

Late preterm infants are those infants born between 34 weeks and 36 and 6/7 weeks gestation. They are generally the same weight and appearance of full term infants and are treated in level 1 or well baby nurseries the same as full term infants. Late preterm infants are not as physiologically mature as full term infants and have problems that may go overlooked. Late preterm infants experience complications such as hypothermia, hypoglycemia, respiratory difficulties, and feeding problems that lead to hyperbilirubinemia. These complications can lead to longer hospital stays or readmissions and higher healthcare costs. It is the purpose of …