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Maternal, Child Health and Neonatal Nursing

Theses/Dissertations

2021

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Modern Representations Of Childbirth In American Comedy Television Shows, Emily Smith Oct 2021

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 …


Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen Aug 2021

Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …


Neonatal Orogastric & Nasogastric Tube Placement: Evidence Based Improvement Prospectus, Jessica K. Nagra Aug 2021

Neonatal Orogastric & Nasogastric Tube Placement: Evidence Based Improvement Prospectus, Jessica K. Nagra

Master's Projects and Capstones

Problem: Variation in gastric tube placement practice has resulted in incorrect placement depth, resulting in four gastric tube perforations in a level III neonatal ICU within the last year. Gastric perforations have increased infant length of stay, increased surgical interventions, delay in oral feeding, increased hospital cost, and potentially lower family satisfaction with care.

Context: IHI’s 5 Why’s: Finding the Root Cause identified a lack of standardization in policy and practice and lack of consistent staff education as the primary reason for misplaced gastric tubes. Additionally, a cost-benefit analysis projected the estimated cost of additional infant length of stay for …


Columbia-Suicide Severity Rating Scale (C-Ssrs) Inpatient Perinatal Clinical Pathway, Kristin M. Schoen Aug 2021

Columbia-Suicide Severity Rating Scale (C-Ssrs) Inpatient Perinatal Clinical Pathway, Kristin M. Schoen

Master's Projects and Capstones

Problem: The potential harm to women and infants due to untreated perinatal anxiety and mood disorders is both a patient safety and a public health concern. Studies show that mental health decline during the postpartum period is associated with increased morbidity and mortality for both the mother and infant. The project aim was to utilize the initial screening of perinatal patients using the Columbia-Suicide Severity Rating Scale (C-SSRS) as the baseline screening tool. The tool will help implement a standardized workflow for patients who screen low, moderate, or high, as this workflow had yet to be developed.

Context: In July …


Enhanced Recovery After Surgery Ambulation Project, Jennifer M. Rose Aug 2021

Enhanced Recovery After Surgery Ambulation Project, Jennifer M. Rose

Master's Projects and Capstones

Abstract

Problem: The enhanced recovery after surgery (ERAS) Ambulation Project aims to increase early ambulation of cesarean section patients in the maternal child inpatient unit. The current data has shown inconsistency with the application of the ERAS program with the maternal population. Instituting standardization of care and documentation, along with increasing patient centered care, has the potential to decrease the hospital length of stay (LOS).

Context: This quality improvement project standardizes the education provided to staff nurses and patients; allotting more time for staff to create meaningful relationships with their patients. A microsystem culture utilizing patient centered care …


Decreasing Floor Morphine Equivalents Per Day Rates In The Mother/Baby Department, Jessica Welsh Aug 2021

Decreasing Floor Morphine Equivalents Per Day Rates In The Mother/Baby Department, Jessica Welsh

Master's Projects and Capstones

Problem: Cesarean sections (C/S) are among the most common operations in the United States and result in moderate visceral and somatic pain. Historically, C/S pain has been treated with opioid pain relievers. The U.S. Department of Health and Human Services declared the misuse of opioids an epidemic in 2017, leading healthcare providers and organizations to look inward at how opioids are prescribed and used at all levels of patient care.

Context: A microsystem assessment on a 60-bed mother/baby unit indicated one of the highest average opioid administration rates per day for postoperative C/S patients in the organization’s region for the …


Polycystic Ovarian Syndrome: Pathophysiology And Chronic Health Implications, Makilah Witt Aug 2021

Polycystic Ovarian Syndrome: Pathophysiology And Chronic Health Implications, Makilah Witt

Nursing Student Class Projects (Formerly MSN)

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. If untreated, women suffer a myriad of secondary sequala and chronic diseases. The prevalence of PCOS is rising and greatly impacts patients' physical, mental, and emotional health, diminishes community health, and increases healthcare costs. However, many providers fail to properly diagnose patients, understand how this disease impacts women, or provide appropriate interventions to prevent chronic health problems. This paper outlines the pathophysiology of PCOS, identifies signs and symptoms, and provides recommendations for treatment and holistic patient care for the role of the Advance Practice Nurse.


Examining Predictors Of Attitudes And Knowledge Of Registered Nurses And Nursing Students In Tennessee Toward Pregnant And Perinatal Women With A Substance Use Disorder, Jessica Patrylo Aug 2021

Examining Predictors Of Attitudes And Knowledge Of Registered Nurses And Nursing Students In Tennessee Toward Pregnant And Perinatal Women With A Substance Use Disorder, Jessica Patrylo

Electronic Theses and Dissertations

Substance use disorders (SUDs) among pregnant and perinatal women continue to be a national public health crisis. Furthermore, nursing students and perinatal nurses have historically negative and punitive attitudes toward this vulnerable population of women. As nurses are primary care providers for pregnant and perinatal women, this is troublesome as perinatal patients express feeling stigmatized by nurses whom they should be able to trust. This contributes to the reluctance of women to seek needed medical and prenatal care. Tennessee was the first state to criminalize drug use in pregnancy and has higher neonatal abstinence syndrome (NAS) rates, which were more …


Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton Jul 2021

Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton

Dissertations

Abstract

Problem: Hypertensive disorders of pregnancy continue to be on the rise in the United States, contributing to an increase in both maternal morbidity and mortality rates. These disorders not only have an effect on the pregnant women, but also the neonate. Early recognition and treatment of increased blood pressure findings can improve maternal and fetal outcomes.

Methods: This Quality Improvement (QI) project used a descriptive design and was comprised of a retrospective chart review, focused on the effectiveness of evaluating a hypertension bundle to improve maternal outcomes. The data collected for this project encompassed six months pre and post …


Post-Cesarean Section Pain Management Using Pre-Built Computerized Order Entry Sets, Ashleigh Hunkins Jul 2021

Post-Cesarean Section Pain Management Using Pre-Built Computerized Order Entry Sets, Ashleigh Hunkins

Dissertations

Abstract

Problem

Electronic medical records (EMR) have helped decrease common medication errors. However, prescribing errors are still elevated. Creating pre-built order sets can decrease medication errors for post-cesarean section women.

Methods

This project used an evidence-based practice approach to create new order sets. Women undergoing a cesarean section between January 15, 2021 and April 14, 2021 received the new order sets. A retrospective data review was conducted pre and post-implementation between the dates of October 15, 2021 and April 14, 2021 to view medication errors.

Results

Before implementation of the order sets, there were 239 cesarean deliveries and eight errors …


Effect Of Purposeful Nurse Rounding On Patient Satisfaction, Jayne Mangi Jul 2021

Effect Of Purposeful Nurse Rounding On Patient Satisfaction, Jayne Mangi

Dissertations

Problem Delayed nurse response times in an inpatient setting can have a negative impact on patient experience, and is reflected in patient satisfaction surveys such as The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The purpose of this project is to improve HCAHPS scores related to “responsiveness” in an antepartum unit.

Methods A prospective observational study designed to improve HCAHPS scores regarding nurse response time conducted as a retrospective and prospective review of data. Results of HCAHPS scores related to “responsiveness”, and actual nurse response times were examined before and after a nurse education tool was implemented. …


Intimate Partner Violence Education For High School Students, Morgan Foster Jul 2021

Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …


Can Provision Of Additional Education For Nursing Staff Increase Breastfeeding Knowledge And Feelings Of Self-Efficacy?, Akeba Deqwan Thompson Jul 2021

Can Provision Of Additional Education For Nursing Staff Increase Breastfeeding Knowledge And Feelings Of Self-Efficacy?, Akeba Deqwan Thompson

Doctor of Nursing Practice Projects

Background: Post-partum nurses are responsible for preparing new mothers with the necessary skills to feed and care for their infants and need proper education to effectively and confidently discuss feeding options with their patients.

Purpose: This quality improvement project aims to increase nursing knowledge of breastfeeding and their feeling of self-efficacy in promoting breastfeeding as an option to new mothers.

Design Methods: A quasi-experimental design including a pre-test/post-test used to quantify the effect of education on therapeutic communication, nursing responsiveness, and feelings of self-efficacy.

Conclusion: An overall increase in feelings of self-efficacy and knowledge of breastfeeding was noted amongst nursing …


Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale Jul 2021

Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale

Doctor of Nursing Practice Projects

Postpartum depression (PPD) affects approximately 19% of all postpartum women. Evidence indicates an increased risk for mothers of hospitalized infants, with estimates ranging from 28% to 67%. The American Academy of Pediatrics and Bright Futures recommend mothers be screened for postpartum depression at the infants’ well-child appointments. During hospitalizations, there are no well-child appointments; thus, no postpartum depression screening. This project aims to 1) improve knowledge of PPD in the staff of the Neonatal Intensive Care Unit (NICU) and 2) investigate the staff’s interest level in implementing a PPD screening protocol. Utilizing the Plan-Do-Study-Act (PDSA) framework, a protocol was developed …


Telehealth Breastfeeding: Best Practice Guideline, Laura Amabile May 2021

Telehealth Breastfeeding: Best Practice Guideline, Laura Amabile

Doctor of Nursing Practice Final Manuscripts

Background: Only 24.9% of United Stated infants are exclusively breastfed through six months. Healthy People 2020 breastfeeding goals include increasing the proportion of infant breastfed through six months to 60.6%. The Surgeon General’s Call to Action identified increasing access to International Board-Certified Lactation Consultants as a priority to improve breastfeeding percentages.

Purpose: Implementation of an evidence-based telehealth breastfeeding guideline, will provide mothers with consistent education regarding breastfeeding practices and guidance to overcome common obstacles, which will then result in increased confidence levels regarding breastfeeding and increase breastfeeding durations.

Study and Design: The Iowa model was utilized to guide this project. …


Managing Pediatric Atopic Dermatitis In The Allergy Clinic: Use Of An Eczema Action Plan To Improve Caregiver Understanding And Self-Efficacy, A Pilot Study, Danielle Hubacek May 2021

Managing Pediatric Atopic Dermatitis In The Allergy Clinic: Use Of An Eczema Action Plan To Improve Caregiver Understanding And Self-Efficacy, A Pilot Study, Danielle Hubacek

Doctor of Nursing Practice Final Manuscripts

Eczema, or atopic dermatitis, is a complex and chronic condition that affects approximately 10% of children throughout the United States (Brown et al., 2018). The American Academy of Allergy Asthma & Immunology (AAAAI) (2017) estimates the average cost of eczema management for each patient is approximately $3,302 per year. The complex nature of atopic dermatitis indicates a need for individualized treatment plans. Research has shown that standardized patient teaching, written education materials, and Eczema Action Plans (EAP) reinforce patient teaching, parental understanding, and improve quality of life. This evidence-based practice (EBP) project introduces the use of a written Eczema Action …


Standardizing And Documenting Decision-To-Incision Intervals For Unscheduled Cesarean-Section Deliveries, Molly Bloom May 2021

Standardizing And Documenting Decision-To-Incision Intervals For Unscheduled Cesarean-Section Deliveries, Molly Bloom

Master's Projects and Capstones

The term decision-to-incision interval (DII) refers to the interval between when a laboring patient and their healthcare provider agree to an unscheduled surgical cesarean section (C/S) delivery and when the first incision is made in the operating room. The ideal length for this interval varies with the urgency of each case, and there is no international consensus regarding the timing. In an urban labor and delivery unit in a private hospital, examination of this interval revealed inconsistent documentation of the decision, as well as unclear guidelines on the DII for two of the three unscheduled C/S urgency levels. This quality …


Utilizing A Stress And Coping Model Into A Preventive Abusive Head Trauma Parent/Caregiver Educational Program, Camile Williams May 2021

Utilizing A Stress And Coping Model Into A Preventive Abusive Head Trauma Parent/Caregiver Educational Program, Camile Williams

Doctor of Nursing Practice (DNP) Projects

Abusive head trauma (AHT) is a serious form of child maltreatment that is the primary cause of fatal head injuries in children younger than 24 months and is the cause for over 50% of severe or fatal traumatic brain injury incidences. These injuries can be caused by impact, shaking, or the combination of shaking and impact. These multi-factorial injuries can cause intracranial and spinal damage, retinal hemorrhages, and fractures of ribs and other bones. The age and severity of injuries will be used to assess the diagnosis of AHT. When AHT occurs, it is often tied to the behavior from …


Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee May 2021

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 …


Implementation Of A Nurse-Led Family Centered Engagement Intervention For Caregivers Of Extremely Premature Infants In The Neonatal Intensive Care Unit, Emily Keenan, Michaela L. Ranallo, Kathleen A. Walsh, Haley Chapko, Tiffany A. Moore May 2021

Implementation Of A Nurse-Led Family Centered Engagement Intervention For Caregivers Of Extremely Premature Infants In The Neonatal Intensive Care Unit, Emily Keenan, Michaela L. Ranallo, Kathleen A. Walsh, Haley Chapko, Tiffany A. Moore

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this feasibility study was to examine the implementation and usefulness of an intervention for extremely premature infant (EPI) caregivers.

Results: One caregiver and five nurses provided feedback with a mean score of 4.4 out of 5 pertaining to helpfulness.

Conclusions: Implementation of the Caregiver’s Guide was feasible and was positively received by NICU nurses and caregivers. We recommend implementing a revised version of this tool based on nurse and caregiver feedback. The delivery of education should be divided between dayshift and nightshift nurses so that one nurse is not responsible for providing all the information. The …


Neonatal Abstinence Syndrome Nonpharmacological Intervention Education For Healthcare Professionals Caring For Newborns, Darby Harvey May 2021

Neonatal Abstinence Syndrome Nonpharmacological Intervention Education For Healthcare Professionals Caring For Newborns, Darby Harvey

Doctor of Nursing Practice Scholarly Project

Neonatal abstinence syndrome has increased significantly in the United States over the past few decades due to the increase of maternal substance abuse. The overall goal of caring for these infants is effective management of the withdrawal symptoms, including both pharmacological and nonpharmacological interventions. However, nonpharmacological interventions have been shown to improve infant outcomes and reduce length of hospitalization. This project sought to increase healthcare professionals’ knowledge and confidence regarding neonatal abstinence syndrome and the utilization of nonpharmacological interventions when caring for infants diagnosed with neonatal abstinence syndrome through the provision of an educational presentation. This study utilized a one-group …


Genetics In The Nicu: Nurses’ Perceived Knowledge And Desired Education, Kathleen Shields May 2021

Genetics In The Nicu: Nurses’ Perceived Knowledge And Desired Education, Kathleen Shields

Dissertations & Theses (Open Access)

A large proportion of infants admitted to neonatal intensive care units (NICUs) have genetic conditions. NICU nurses play an important role in providing comprehensive care to these patients and their families. Previous research has demonstrated gaps exist in the genetics knowledge of nurses and that they lack comfort applying genetics information to clinical practice, but no research has been done assessing the knowledge of or comfort with genetics of NICU nurses specifically. NICU nurses (n=122) completed an online survey assessing their perceived knowledge of genetics, comfort with clinical scenarios involving genetics, and desired genetics education. Participants reported the highest levels …


Neonatal Toxic Stress And Long-Term Neurodevelopment In Premature Infants, Rachelle Sey May 2021

Neonatal Toxic Stress And Long-Term Neurodevelopment In Premature Infants, Rachelle Sey

Dissertations

Background: Evidence suggests the presence of complex biologic connections between the social environment, neurologic development, and long-term health. Premature infants spend many months in the Neonatal Intensive Care Unit (NICU) often separated from their parent(s). Decrease in the age of viability threshold allows extremely preterm infants to benefit from lifesaving therapies; however, they are frequently exposed to significant stressors that increase their risk for adverse neurodevelopmental outcomes.

Purpose: The purpose of this study is to examine the relationship among socio-demographic factors, exposure to stressors in the NICU environment, stress modifiers/buffers, neonatal morbidities at discharge, and 1. 2-year neurodevelopmental outcomes and …


Complementary And Alternative Medicine: The Effects Of Aromatherapy On New And Expectant Mothers, Heather Tran May 2021

Complementary And Alternative Medicine: The Effects Of Aromatherapy On New And Expectant Mothers, Heather Tran

Nursing | Senior Theses

Complementary and alternative medicine (CAM) is vastly expanding and is now being used in the clinical setting as an effective management of various symptoms. Pregnancy, labor, and the postpartum period can be beautiful yet overwhelming moments in a woman’s life. The symptoms that are usually accompanied along this journey include nausea, vomiting, anxiety, pain, fatigue, stress and more. Aromatherapy has been proven to be a safe and natural, non-pharmacological method in reducing these symptoms that may make it harder for the mother to enjoy her pregnancy. This holistic approach to treatment is inexpensive, noninvasive, does not require a prescription from …


Exploring Relationships Among Race, Mothers' Perceptions Of Discrimination During Perinatal Healthcare Visits, And The Prevalence Of Adverse Maternal And Neonatal Health Outcomes, Fiona So May 2021

Exploring Relationships Among Race, Mothers' Perceptions Of Discrimination During Perinatal Healthcare Visits, And The Prevalence Of Adverse Maternal And Neonatal Health Outcomes, Fiona So

Nursing | Senior Theses

The institutionalized marginalization of the Black, Indigenous, and People of Color (BIPOC) population is not an uncommon theme throughout American history. Although a majority of American society actively refers to racial discrimination in the past tense, recent events such as the Black Lives Matter movement demonstrates that countless biases based solely on skin complexion are still ingrained into the minds of many. Due to the pervasiveness of implicit biases, American healthcare professionals are also subject to believing and acting upon these biases, either consciously or subconsciously, which could directly affect the quality of care that their BIPOC patients receive.

A …


Understanding How Mothers Perceive Doulas During Childbirth, Eva J. Huff May 2021

Understanding How Mothers Perceive Doulas During Childbirth, Eva J. Huff

Chancellor’s Honors Program Projects

No abstract provided.


Tiny Tusk Internship: The Relationship Between Duration Of Breastfeeding And The Development Of Attention-Deficit / Hyperactivity Disorder, Mckenna Gribble May 2021

Tiny Tusk Internship: The Relationship Between Duration Of Breastfeeding And The Development Of Attention-Deficit / Hyperactivity Disorder, Mckenna Gribble

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that remains highly prevalent in the youth community, yet its cause cannot be definitively placed. With the idea that this condition is primarily targeting children, the problem and possible solution may lie in infancy. The purpose of this literature review was to integrate evidence from studies published from 2015 to 2021 on the relationships between duration of breastfeeding during infancy and the development of ADHD. The results of this review supported the hypothesis that a longer duration of breastfeeding has a protective effect on childhood development and reduces the risk of developing ADHD …


Reflections On Labor And Delivery Internship, Olivia Ozier May 2021

Reflections On Labor And Delivery Internship, Olivia Ozier

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breastfeeding is very beneficial for the health of both mothers and babies. Despite this fact, not enough mothers are breastfeeding. It is important for nurses to help facilitate successful breastfeeding. The purpose of this literature review was to determine what interventions from healthcare staff impact the success of breastfeeding. Articles were retrieved from reliable sources such as CINAHL, Pub Med, and Medline in order to compare what research shows as beneficial for breastfeeding to what was observed in the clinical setting. The results revealed that health care support, educated staff, and baby friendly policies impact the success of breastfeeding. It …


Tiny Tusks Internship: Does Breastfeeding Education In An Undergraduate Nursing Program Affect Student Knowledge And Attitudes Concerning Breastfeeding?, Grace Murphy May 2021

Tiny Tusks Internship: Does Breastfeeding Education In An Undergraduate Nursing Program Affect Student Knowledge And Attitudes Concerning Breastfeeding?, Grace Murphy

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks provides honors nursing students enrolled in the Eleanor Mann School of Nursing at the University of Arkansas an opportunity to support mothers in the community by providing breastfeeding services, education, and assistance at public Razorback sporting events. Interns provide this support by setting up designated lactation spaces at sporting events, such as gymnastics meets, football, and basketball games, for mothers to breastfeed or pump. In this thesis, I reflect on my internship experience and provide a review of literature. Since the aim of Tiny Tusks is to provide breastfeeding education and support to mothers in the community, the …


Tiny Tusks Internship: The Effect Of Health Care Providers' Education And Attitudes Toward Breastfeeding On The Mother's Decision To Breastfeed, Jocelyn Clark May 2021

Tiny Tusks Internship: The Effect Of Health Care Providers' Education And Attitudes Toward Breastfeeding On The Mother's Decision To Breastfeed, Jocelyn Clark

The Eleanor Mann School of Nursing Undergraduate Honors Theses

There is a stigma surrounding breastfeeding in the public community, places of employment, and health care facilities. This paper focuses on the impact health care workers have on the mother's decision to breastfeed her infant, and her ability to continue breastfeeding as the primary source of infant nutrition. This paper includes experiences from an internship with Tiny Tusks, which provides breastfeeding support to mothers in the Northwest Arkansas area. Tiny Tusks allows for a better understanding of the community's breastfeeding needs and provides support to breastfeeding mothers in order to reduce the stigma associated with breastfeeding. In health care environments, …