Nursing Commons^™

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown

Theses & Dissertations

African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. …

Reducing The Postpartum Readmission Rate With Standardized Discharge Teaching, Darlene Day-Herzog

Master's Projects and Capstones

Problem: Hospital readmission rates are one of the quality metrics that matter for hospital reimbursements. In a large Northern California healthcare system, the postpartum readmission rate is often above the national average.

Context: The hospital designated as the main location for high-risk deliveries within a 30-mile radius has an Acute Care Obstetric postpartum population where twenty percent of the patients are at an increased risk for readmission.

Interventions: The project implemented the use of a standardized discharge teaching script and educational materials to be used by nursing staff throughout the patient’s hospital stay to see if multimodal standardization leads to …

Implementation Of Maternal Fetal Triage Index To Improve Nurse Knowledge And Timeliness In Obstetric Triage: A Pilot Project, Emilie Long

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to implement an obstetric triage acuity scale in a labor and delivery setting and study the effect on nurse knowledge and timeliness of care.

Design: A quasi-experimental pre and post-test design was used for this pilot project.

Setting: This project was conducted in an obstetric triage unit located within a fourteen-bed labor and delivery unit in the Midwest.

Methods: This pilot project was conducted over a two-month time period. Fifteen registered nurses qualified to care for obstetric triage patients were given education on the chosen triage acuity scale. A pre-test was administered before …

Preventing Maternal Falls, Blair Burkhart

Master's Projects and Capstones

Patient falls are unfortunate events in healthcare that are an essential quality improvement focus during patients’ hospital stays. At Hospital X, a private institution located in the suburbs of a large city, there had been 23 maternal falls within the last three years. This increase in maternal fall rate puts this hospital’s maternity unit above the average of other hospital’s fall rates according to the National Database of Nursing Quality Indicators. This quality improvement project aimed to reduce the rate of maternal falls on postpartum units through various forms of staff education. Education included Morse Fall Scale scoring, Sara Stedy …

Reducing Postpartum Maternal Falls: A Quality Improvement Project, Sarah L. Iroz

Master's Projects and Capstones

Falls are an unfortunate, common occurrence in the healthcare system and are often not thought to be a problem in the obstetrics population. Key stakeholders in a Northern California hospital brought the issue of maternal falls to leaders of the quality improvement team on the maternity unit. In the last three years, there have been 23 falls on the maternity floor, making their fall rate above the national average. It is the purpose of this project to aid the quality improvement team in reducing postpartum maternal falls over the next three years. After conducting a unit assessment, performing a literature …

Increasing Lactation Consultant Support To The Mch Unit, Daniella Grace Mcclendon

Master's Projects and Capstones

Problem: Breastfeeding is the most beneficial feeding choice for newborns and one of the best ways for mothers to bond with their newborns. In the current Maternal Child Health (MCH) unit, exclusive breastfeeding rates have fallen lower than the unit’s goal of 82%.

Context: Exclusive breastfeeding, when a newborn consumes only human breastmilk, is not always an easy process to initiate immediately after birth and in the early postpartum period. On this specific unit, there is not enough lactation consultant support to provide all patients on the unit.

Interventions: This project considers adding additional lactation consultants to support the MCH …

Decreasing Maternal Breastfeeding Dissatisfaction During The Night Shift Related To Lactation Support, Robyn Caston

Master's Projects and Capstones

Abstract

Problem

This paper will discuss the Clinical Nurse Leader (CNL) project's specific aim: to decrease maternal dissatisfaction during the night shift related to lactation support in a high-risk maternal department.

Context

Research has shown that adding lactation support improves the decision to exclusively breastfeed and increases the duration. Breastfeeding for all infants starting at birth and continuing until at least 6 months of age has been recommended by the World Health Organization, UNICEF, and the American Academy of Pediatrics. Many studies about lactation support have demonstrated the health benefits to mothers and their infants.

Interventions

A baseline survey will …

Implementation And Evaluation Of A Registered Nurse Pre-Eclampsia Education Program Within A Women's Urgent Care Center, Amber Vetter

Doctoral Projects

Pre-eclampsia can be a serious development for both mother and fetus during pregnancy. Increased mortality and morbidity rates have been shown in women diagnosed with pre-eclampsia. Higher education for registered nurses on a Women’s Urgent Care (WUC) center will help diagnose the mother more quickly and inevitably receive treatment sooner leading to better outcomes for the birth of her newborn. The educational tools used in the study were a pre-and post-test and an educational video for the registered nurses to watch. A retrospective chart review before and after the intervention will help to see if there is any decrease in …

Quality Improvement Project: Communication Guidance During And Following Maternal Hemorrhage, Kathleen Giramur

Doctor of Nursing Practice

Background. Maternal hemorrhage is a significant cause of worsening maternal morbidity and mortality in the United States. If timely, effective, and compassionate communication is not provided during and following traumatic birth events, negative mental health problems may result that affect maternal well-being, bonding with the baby, and family relationships. A gap analysis carried out at the clinical site showed that a written, evidence-based guidance on communication with patients and families during and after a maternal hemorrhage event was needed. Compliance through documentation is required by the Joint Commission. Trauma-Informed Care is an evidence-based communication approach that incorporates principles of safety, …

Formalizing An Obstetrical Program For High-Risk Patients: Focus—Diabetes During Pregnancy, Valeria Jimenez

Doctor of Nursing Practice

Within the last 10 years, the number of pregnant women with gestational diabetes increased 56%, and the number of women with Type 1 or Type 2 diabetes before pregnancy increased 37% (CDC, 2018). The management of a pregnancy complicated by diabetes involves a multidisciplinary approach, medical nutrition therapy, glycemic control, and occasionally, pharmacological therapies (Nurain et al., 2019). In 2017, the total cost of diabetes in the United States was $237 billion (Riddle & Herman, 2018). The purpose of this DNP project was to standardize a Federally Qualified Health Care’s (FQHC) High-Risk Obstetrical (OB) Initiative, which attempted to provide in-person …

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 …

Expansion Of A Comprehensive And Standardized Well-Woman Exam Program In A University-Based Clinic, Gabriela Trevino

Doctor of Nursing Practice

Background. Well-woman exams are an opportunity for women to receive focused screening, counseling, education, and care from a healthcare provider. Studies have found that 68% of women received well-woman exams between 2010 and 2016. During COVID-19 well-woman exams decreased by 80% in the United States. Standardized, comprehensive exams facilitate identification of the need for lifesaving care. Objective(s). The purpose of this quality improvement project was to expand a comprehensive and standardized well-woman exam program in a university-based clinic. Methods. Processes were implemented to promote well-woman exams, patient comfort measures, and completion of an evidence-based standardized comprehensive exam …

Nicu Experiences Of Adoptive Parents & Desired Preparation, Catherine J. Howe

MSU Graduate Theses

Parents who have newborns admitted into the Neonatal Intensive Care Unit (NICU) have multiple experiences and emotions. Additional social and emotional layers are experienced by adoptive couples when the infant they wish to adopt needs specialized care. This research study was completed to find out what adoptive parents experience in the NICU and what preparation would have been helpful. The method included semi-structured, open-ended interviews with seven couples who adopted a newborn at a Midwestern adoption agency within the past three years and had a NICU experience. The results described adoptive couples’ experiences on the unit, bonding and attachment, fears …

Nicu Nurse Burnout: The Influence Of Moral Distress, Compassion Fatigue, And Spirituality On Burnout In Neonatal Intensive Care Unit Nurses, Lucia D'Andrea

Undergraduate Theses

Nurses face a multitude of interpersonal and individual expectations, challenges, and hardships every day of their profession. These experiences accumulate and can lead to burnout. This is especially true for nurses in Neonatal Intensive Care Units (NICUs) who care for infants struggling with prematurity, congenital diseases, withdrawal, and more, all while working closely with grieving parents. This thesis specifically focuses on research discussing moral distress, compassion fatigue, and spirituality as variables associated with the experience of burnout. A critical review of current literature revealed patterns and inconsistencies in the relationships between these factors. Workplace Stressors and moral distress were found …

Stress As A Contributing Factor For Pediatric Obesity: Literature Review And Internship Experience, Jessica Handley

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This article is an examination of how stress drives diet and physical activity behaviors that contribute to pediatric obesity in the United States. An increasing rate of childhood obesity is being reported in the United States and therefore a multitude of studies and reviews have been conducted on the topic. This review of the literature systematically analyzes how stress, diet, and physical activity behaviors contribute to this rising rate of pediatric obesity. An analysis of the chosen articles for review indicates that stress and its counterpart (resilience) tend to be driving forces in how American children and adolescents participate in …

The Relationship Between Gestational Diabetes And Stress: A Literature Review, Morgan Mcgrath

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The incidence of gestational diabetes has been increasing over the past ten to twenty years. The purpose of this literature review is to gather existing literature to examine the relationship between gestational diabetes and oxidative stress. Twenty peer-reviewed articles from two databases were selected to be examined in this review. From these studies, it was found that oxidative stress was higher in women who were diagnosed with gestational diabetes, and supplementation with vitamins and minerals was beneficial in decreasing stress in these women. While these studies can help healthcare providers in educating women who have been diagnosed, more research should …

The Effects Of Doula Care On Birth Outcomes And Patient Satisfaction In The United States, Lynae Carlson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The visitor policies related to the COVID-19 pandemic limited doula care and called into question the importance of doulas in the birth process. While the Cochrane Systematic Review presents compelling evidence of the benefits of continuous birth support on outcomes ranging from shorter labors to higher 5-minute Apgar scores, there are gaps in literature that exclusively focus on continuous support from doulas. The literature review aims to determine both qualitative and quantitative outcomes of doula care on the mother and baby during the labor and post-partum periods, focusing on specific aggregates, such as adolescents, women with low incomes, and women …

Breastfeeding In Public And The Impact Of Mass Media On Breastfeeding: An Expanded Literature Review, Hannah Underwood

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The choice a mother makes to breastfeed or to formula feed is a hotly debated topic in the United States today. The benefits of breastfeeding for both mother and baby are undeniable, but breastfeeding is difficult for some due to a plethora of barriers, notably a lack of social support. This literature review evaluates attitudes towards breastfeeding in public and how varying mass media formats can impact perceptions of breastfeeding and potentially breastfeeding implementation. Twenty articles with both qualitative and quantitative data were obtained from Medline Complete EBSCO Host and PubMed for a comprehensive analysis. Among 283 total articles retrieved, …

The Influence Of Gender Bias On Male Nurses And Nursing Students In The Obstetric, Maternal, And Pediatric Nursing Profession., Julian Alvarez

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This literature review analyzes if gender bias influences the disproportionate number of male nurses and male nursing students in the pediatric, maternal, and obstetric nursing fields as compared to nursing as a whole. PubMed and CINAHL databases were utilized to find 15 research articles focused on the experiences of male nurses and male nursing students. These articles were compared amongst each other to find common themes of the male experience in the nursing fields of pediatrics, maternity, and obstetrics. The three common themes found were 1) Men tend to encounter situations where their professionalism will be monitored more closely when …

Implementing 2nd Milk’S Use Of The World Health Organization Standardized Growth Charts To Better Track The Growth And Development Of The Malnourished And Orphaned Infants In Their Supplemental Nutrition Program In Malawi, Allie Wycoff

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This article considers the history and implications of the World Health Organization (WHO) standardized growth charts as well as the significant impact that growth chart utilization may have on 2^ndMilk’s ability to understand and track the nutritional status of the malnourished orphaned infants in their formula program. Specifically, this literature review examines whether or not the WHO growth charts are a meaningful tool for 2^ndMilk to adopt into their monthly baby assessments. The WHO growth charts are calibrated to express an accepted international “norm” for what an adequately nourished child looks like. In a recent service-learning …

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 …

Characteristics Of Substance Addicted Mothers That Predict Graduation From The Family Treatment Court, Katherine Barnett

Doctorate of Nursing Science Dissertations

In the United States, substance addiction is a major contributing factor to incarceration of mothers and separation of children from their families. Five hundred Family Treatment Courts (FTC) operate across the country to combat the growing problem of women addicted to drugs. The FTC model provides mothers with substance addiction treatment, intensive judicial monitoring, repeated drug testing, counseling, incentives or sanctions, and case management with the goal of reaching long term sobriety and reunification with their children. Understanding characteristics that may influence graduation from the Family Treatment Court will provide valuable information on developing interventions to support participants’ success and …

Nursing Perceptions For Utilizing Essential Oil Application In Labor And The Effect Of Targeted Education, Joni R. Beckham

Electronic Theses and Dissertations

This Doctor of Nursing Practice project was implemented to determine how a nurse’s perception of aromatherapy influences their decision to provide aromatherapy for patients during labor and the effect of targeted education on a nurse’s perception. The purpose of this project was to determine how nurses view the use of aromatherapy resources at their disposal and the likelihood that they would offer the intervention to their patients. This project provided education to increase nurses’ confidence in providing optimal care to patients using a traditional and holistic avenue of aromatherapy while determining if education can positively influence nurses to support essential …

The Opioid Crisis: Evaluating Current Practices And Outcomes For Neonatal Abstinence Syndrome, Deborah A. Mendoza

Nursing | Senior Theses

Neonatal Abstinence Syndrome (NAS) in the infant are severe symptoms from opioid exposure in utero. These symptoms include: “central nervous system irritability, autonomic over-reactivity, and gastrointestinal tract dysfunction” (Ko et al., 2016). The treatment for NAS can be a combination of drug therapy and non-pharmacological interventions, but a standardized treatment is lacking. A review of this literature aims to evaluate the available interventions that lead to decreased symptom severity, reduction of length of hospital stay, and a reduction in the use of drug therapy. As a result of the literature review, the nurse researcher supports the standardization of treatment and …

Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada

Nursing | Senior Theses

The literature shows that Black women face many disparities in terms of health care access and the quality of care. These obstacles could negatively affect the health of the mother and their child. This paper includes a literature review and proposed research study. The objective of this research study is to identify the outcomes of Black women compared to White women and other women of color in terms of maternal health. A literature review is provided in order to identify how race affects the following factors: obstacles that limit access to healthcare, rates of obtaining prenatal care, postpartum outcomes and …

A Rollout Of A Blood Pressure Remote Patient Monitoring Program To Improve High-Risk Maternal Outcomes At A Pilot Clinic For Systemwide Expansion, Laura Geron

Seton Hall University Dissertations and Theses (ETDs)

An existing virtual care platform provides an innovative means of early recognition, identification, and intervention for women with elevated blood pressures during pregnancy, known as preeclampsia. A pilot program took place at a Northeastern prenatal care clinic where patients were identified as high-risk for preeclampsia, enrolled, educated by their providers, and equipped with Bluetooth-enabled blood pressure cuffs.

Through remote patient monitoring (RPM) technology, blood pressure readings could transmit from a patient’s residence to a portal accessible by their clinic provider at any time. This doctoral-level quality improvement project focuses on the identification of patients at high-risk for preeclampsia, their enrollment …

The Creation Of A Template For The Incorporation Of A Human Milk Analyzer Into A Human Milk Bank, Sarah Rieber

Seton Hall University Dissertations and Theses (ETDs)

Abstract

A milk bank is a nonprofit service that collects, screens, and processes by pasteurization human milk that is donated by mothers not biologically related to the infant in need. Milk is then dispensed to hospitals and private homes to babies with a prescription. A milk bank collects and analyzes human milk, as breast milk is the ideal nutrition source and the gold standard feeding method for infants. Breast milk significantly reduces premature babies' chance of developing necrotizing enterocolitis (NEC) and offers gastrointestinal protection, increases immunity, decreases the likelihood of asthma, allergies, ear infections, obesity, and respiratory ailments. Some mothers …

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …

Modern Representations Of Childbirth In American Comedy Television Shows, Emily Smith

Senior Theses

This is a concurrent, mixed methods pilot study that combines quantitative analysis and qualitative observations with the aim of examining the portrayal of childbirth in modern American comedy shows. 38 episodes airing from 2010 to 2020 (n=38) were analyzed according to objective elements of representation (e.g., location of birth, interventions employed, etc.), as well as coded for common themes. Quantitative data revealed that the most represented births in comedy shows on American television from the 2010s were vaginal (82.1%), in the hospital (69.2%), uncomplicated (66%), and represented technological interventions (66%). Qualitative analysis found six main themes: chaos surrounding childbirth; disgust …