Nursing Commons^™

The Effect Of Breastfeeding And Rooming-In Care On Neonatal Abstinence Syndrome, Rachel Boyer, Lindsay Gal, Mahaylie Cline

Williams Honors College, Honors Research Projects

Concurrent with a rise in opioid abuse during pregnancy is an increase in the number of babies born with Neonatal Abstinence Syndrome (NAS). Despite this crisis, no single treatment has been identified for NAS. This paper sought to analyze and synthesize research evaluating the effectiveness of breastfeeding and rooming-in care on the need and length of pharmacologic treatment and length of hospital stay for neonates with NAS. Twenty-six peer reviewed research articles published between 2006 and 2017 were selected from PubMed and CINAHL for analysis. The studies focused on neonates with NAS born to mothers addicted to opioids or undergoing …

Intimate Partner Violence And Its Impact On Pregnant Women And Their Infants: A Systematic Review, Rachel Ashley, Emily Pagni, Alissarh Choujaa

Williams Honors College, Honors Research Projects

Abstract

In the United States, about 324,000 pregnant women are victims of Intimate Partner Violence (IPV) annually. IPV is any type of physical, sexual, or emotional abuse of women or men in family units. IPV has detrimental effects on pregnant women and their babies, from their physical health to their mental health. It is important for nurses and other healthcare providers to have knowledge and understanding about IPV in this population and to use effective interventions and screening procedures. The purpose of this systematic review is to review and critically analyze evidence about IPV in pregnant women. The literature search …

Development Of A Nurse Practitioner Newborn Hospitalist Service, Kristi Gordon, Elizabeth Simpson, Sarah Forge, Eileen Almon

Posters

Background/Problem

•In 2012, our hospital expanded obstetrical services resulting in the delivery over 3700 infants per year.
•Approximately 35% of these infants had no relationship to a primary care physician with privileges at our hospital.
•These infants were either uninsured, Medicaid insured or privately insured but whose primary care physician did not have hospital privileges.
•Private Pediatricians “on call” were given these unassigned infants and were attempting to evaluate infants in the mornings, prior to seeing their scheduled office patients
•This resulted in an unmanageable daily census for them.
•This led to Pediatrician dissatisfaction, delayed medical evaluations of some infants, …

Redirecting Care, Directing Support: End Of Life Huddles In The Intensive Care Nursery, Tiffany Willis, Sandra Ganey

Posters

No abstract provided.

Breast Milk Supply Establishment For Mothers Of Nicu Infants: A Retrospective Chart Review Examining Milk Volume, Maternal Factors And Pump Type, Cynthia C. Jackson

Books, Presentations, Posters, Etc.

No abstract provided.

Antibiotic Prescribing For Treatment Of Acute Pediatric Illnesses By Advanced Practice Nurses, Deborah J. Whitehurst

DNP Projects

Antibiotic over-prescribing by physicians for the treatment of acute respiratory tract illnesses have been examined in a variety of settings. Different studies have examined nurse practitioner (NP) prescribing practices both in the United States and various international settings. There have been limited studies specifically examining antibiotic prescribing practices in the pediatric population. However, no studies were found which compared population specific NP groups. The purpose of this study was to understand differences in antibiotic prescribing practices among advanced practice pediatric providers.

The goal of this project was to describe and compare antibiotic prescribing practices of pediatric nurse practitioners (PNP) and …

Optimization Of Folic Acid Supplementation In The Prevention Of Neural Tube Defects, Shona Cawley, Daniel Mccartney, Jayne V. Woodside, Mary Rose Sweeney, Robert Mcdonnell, Anne M. Molloy, Michael J. Turner

Articles

Background We examined the relationship between timing and duration of folic acid (FA) supplementation in achieving red blood cell (RBC) folate levels in early pregnancy which are optimal (>906 nmol/l) for the prevention of neural tube defects (NTDs). Methods Clinical, FA supplementation and dietary folate details were computerized at the first antenatal visit. Maternal blood samples were analysed for RBC and serum folate. Results Of the 502 women, 98.2% (n = 493) reported taking FA. There was a positive correlation between duration of supplementation and both RBC folate (r = 0.43, P < 0.001) and serum folate (rho = 0.29, P < 0.001). The optimal RBC folate level was achieved in 80.4% (n = 46) of women who started FA 400 μg 4–8 weeks before their LMP compared with only 53.6% (n = 153) in women who started 4–8 weeks after their LMP (P < 0.001). Conclusions This study provides, for the first …

Ghanaian Parents’ Experiences Of Caring For Their Preterm Infants After Discharge From The Neonatal Unit - A Narrative Inquiry Study, Esther Abena Adama

Theses: Doctorates and Masters

The care of preterm infants is associated with stress. In the busy neonatal unit where highly skilled healthcare workers are always present, parents have reported being stressed when caring for their preterm infants in the neonatal unit. In Ghana, preterm birth is the highest cause of neonatal mortality with 70% of these morbidities and mortalities occurring in the community. Yet to date, no study in Ghana has explored how parents experience their care giving role after discharge from the neonatal unit into the community.

This study explored the experiences of caring for preterm infants in the neonatal unit and after …

Psychometric Testing Of The Healthy Eating And Physical Activity Self-Efficacy Questionnaire And The Healthy Eating And Physical Activity Behavior Recall Questionnaire For Children, Jane Lassetter Phd, Rn, Christopher I. Macintosh, Mary Williams, Martha Driessnack, Gaye Ray, Jonathan Wisco

Faculty Publications

Purpose: The purpose of this study was to develop and assess the psychometric properties for two related questionnaires: the Healthy Eating and Physical Activity Self-Efficacy Questionnaire for Children (HEPASEQ-C) and theHealthy Eating and PhysicalActivity Behavior RecallQuestionnaire for Children (HEPABRQ-C). Design andMethods: HEPASEQ-C and HEPABRQ-C were administered to 517 participating children with 492 completing. Data were analyzed to evaluate for reliability and validity of the questionnaires. Results: Content validity was established through a 10-person expert panel. For the HEPASEQC, item content validity index (CVI) ranged from 0.80 to 1.00. The CVI for the total questionnaire was 1.0. AllHEPASEQ-C items loaded on …

Maternal Life Course Adversity: The Intersection Of Psychosocial And Biobehavioral Adaptive Response In Pregnancy, Crystal Modde Epstein

Theses & Dissertations

The link between life course adversity and adverse health outcomes is well established, particularly early life adversity (ELA). There is also evidence that the physiologic adaptations associated with stress, depression and ELA can be transmitted intergenerationally via long-term set-point changes within the maternal hypothalamic-pituitary-adrenal axis (HPA). It is unknown how the type and timing of maternal stress and adversity influences HPA regulation during pregnancy and whether maternal coping attenuates this relationship. Manuscript 1 was an integrative review of studies examining the association between maternal ELA and HPA regulation during pregnancy. In manuscripts 2 and 3 the findings of the dissertation …

Coping With Labor Education For Nurses, Donna Vo

Master's Projects and Capstones

The “Coping With Labor Education for Nurses” education plan is substantiated by data from the California Maternal Quality Care Collaborative (CMQCC) vaginal birth initiative toolkit and other research. Evidence-based data from multiple sources indicates that improving how labor support is offered at the bedside for the laboring patient can potentially decrease cesarean rates, reduce expenses, and increase savings. The objectives of this plan are to improve patient advocacy and the level of labor support interventions labor and delivery nurses will provide for patients to improve patient satisfaction score above 80%, decrease or maintain cesarean rates below 24.9%, and improve patient …

Reducing Intraventricuar Hemorrhage, Nakia Green

Master's Projects and Capstones

Abstract

Global Aim:

Between September 2017 and September 2018 we aim to reduce the rate of grade III and grade IV intraventricular hemorrhage (IVH) in infants less than or equal to 32 weeks gestation, or less than or equal to 1500 grams from 11% to 5%.

Project Aim:

Develop a best practice bundle for the Prevention of Intraventricular Hemorrhage with implementation of best practice of midline head positioning for infants less than or equal to 32 weeks gestation or less than or equal to 1500 grams by October 2017.

Setting:

Level III, 64 bed Neonatal Intensive Care Unit

Quality …

Pregnancy Loss In The Emergency Department, Gudrun Reiterhiltebrand

Master's Projects and Capstones

Abstract

The aim of this project is to improve the care for patients experiencing pregnancy loss in the emergency department (ED). Objectives are to enhance understanding of staff about the patients’ experience and their knowledge on how to best care for emotional needs, thus improving quality of patient care, work satisfaction, knowledge, confidence and comfort levels, while decreasing experienced stress. The project was implemented in a midsized community hospital with 117 beds, which discharged 74 patients with “interrupted pregnancies” over the previous year from the ED. The project was directed toward nurses, doctors, care partners, chaplains, and social workers. The …

Prenatal Opioid Exposure And Intermittent Hypoxemia In Preterm Infants: A Retrospective Assessment, Elie G. Abu Jawdeh, Philip M. Westgate, Amrita Pant, Audra L. Stacy, Divya Mamilla, Aayush Gabrani, Abhijit R. Patwardhan, Henrietta S. Bada, Peter J. Giannone

Pediatrics Faculty Publications

Introduction: Intermittent hypoxemia (IH) is defined as episodic drops in oxygen saturation (SpO₂). Preterm infants are at increased risk for IH due to their immature respiratory control/apnea of prematurity. The clinical relevance of IH is a relatively new observation with rising evidence linking IH to neonatal morbidities and long-term impairment. Hence, assessing factors that influence IH in preterm infants is imperative. Given the epidemic of opioid misuse in the USA, there is an urgent need to understand the impact of prenatal opioid exposure on neonatal outcomes. Hence, we wanted to assess the relationship between isolated prenatal opioid exposure …

Influence Of Social And Economic Factors On Elementary Student Health In Northwest Arkansas, Megan Marks

The Eleanor Mann School of Nursing Undergraduate Honors Theses

A child’s wellbeing is influenced by many factors related to the environment they are raised in. The purpose of this study was to investigate the relationship between a child’s social and economic factors and his or her health. A convenience sample of 588 2nd and 4th grade children was taken from three elementary schools in Springdale Independent School District. Health status was represented by calculations of each child’s body mass index (BMI) and number of days counted absent from school. Socioeconomic and demographic factors examined include the child’s grade level, gender, ethnicity, number of parents over the household, number of …

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin …

Utilization Of Care By Infants With Neonatal Abstinence Syndrome In Delaware, Michele K. Savin, Dnp, Aprn, Nnp-Bc

College of Nursing Posters

Introduction: There is little information regarding use of expected well care by infants diagnosed with neonatal abstinence syndrome (NAS) post initial discharge. We describe expected and unexpected utilization of care by infants with NAS in the first year of life.

Methods: A de-identified State of Delaware Medicaid data set was obtained. Included were all infants with an ICD-9 code for NAS from 01/01/2012-12/31/2014. All associated medical claims were extracted for one year after birth. Utilization rates of primary care, immunizations, urgent or emergency care, and re-hospitalization were quantified.

Results: 499 of 522 babies were able to be fully analyzed. The …

Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman

Electronic Theses and Dissertations

With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive …

Challenges Associated With Advanced Maternal Age, Krupa Patel

Grace Peterson Nursing Research Colloquium

Abstract

Background: Advanced maternal age is a growing social phenomenon. The proportion of first births to women ages 35 years and over in the United States have increased. Women are prolonging childbearing to accommodate their careers. One’s socioeconomic status, culture, and a movement towards a women making herself and career a priority has contributed to the increasing number of advanced maternal age births.

Objective: The aim of this study was to gain a better understanding of the challenges associated with advanced maternal age pregnancies. This study looked into the challenges the mother faced at an older age, their reason behind …

Effects Of Chronic Illness On Self-Image In Adolescents, Krista Stillson

Grace Peterson Nursing Research Colloquium

EFFECTS OF CHRONIC ILLNESS ON SELF-IMAGE IN ADOLESCENTS:

AN INTEGRATIVE LITERATURE REVIEW

Krista Stillson

Abstract

Background: Chronic illness can pose more than just pathological effects on an individual. During the vulnerable developmental stage of adolescence, the psychological effects of disease can be equally as damaging. In adolescence, manifestations of chronic illness can cause a distorted self-image which may potentiate negative outcomes such as depression, anxiety and low self-esteem. For this reason, it is important for nurses to be aware of the broad impact that can accompany disease and use interventions to counteract such effects. Implementation of coping interventions can help …

Impact Of A Mastectomy On Female Body Image And Sexuality, Hilary Tingley

Grace Peterson Nursing Research Colloquium

Impact of a Mastectomy on Female Sexual Expression: An Integrative Literature Review

Hilary Tingley

Nursing Student, DePaul University, School of Nursing

Background: Women diagnosed with breast cancer are often treated with a combination of therapies, one of which may be a mastectomy. There are an increasing number of women who are undergoing preventative mastectomies, many as a result of BRCA gene testing.

Objective: The purpose of this literature review was to examine the impact of a mastectomy on female sexual expression and body image.

Method: An integrative literature review design was used with research articles pulled from search engines such …

Why American Parents Circumcise Their Sons: An Integrative Review Of Literature, Lacy Lauber

Grace Peterson Nursing Research Colloquium

Background: Since medical evidence supports both pros and cons of routine neonatal male circumcision, expectant and new parents are left to make the decision to circumcise their sons on their own. There is limited research as to why American parents choose to circumcise their newborn sons.

Objectives: The purpose of this integrative literature review is to identify the reasons behind parental decision making in neonatal male circumcision in the United States. Understanding motivating factors in parental decision-making can highlight areas of prenatal education for expectant parents.

Method: An integrative literature review was conducted utilizing these online databases: PubMed, The Cumulative …

Major Components Of Quality Of Life In Pediatric Oncology Patients, Katelyn Mccabe

Grace Peterson Nursing Research Colloquium

No abstract provided.

Plasma Brain-Derived Neurotrophic Factor Levels In Newborn Infants With Neonatal Abstinence Syndrome, Lochan Subedi, Hong Huang, Amrita Pant, Philip M. Westgate, Henrietta S. Bada, John A. Bauer, Peter J. Giannone, Thitinart Sithisarn

Pediatrics Faculty Publications

Background: Brain-derived neurotrophic factor (BDNF) is a type of growth factor that promotes growth and survival of neurons. Fetal exposure to opiates can lead to postnatal withdrawal syndrome, which is referred as neonatal abstinence syndrome (NAS). Preclinical and clinical studies have shown an association between opiates exposure and alteration in BDNF expression in the brain and serum levels in adult. However, to date, there are no data available on the effects of opiate exposure on BDNF levels in infant who are exposed to opiates in utero and whether BDNF level may correlate with the severity of NAS.

Objective: To compare …

Impacting Women's And Children's Health Care Globally- A United State-Haiti Nursing Partnership., Melissa Motz, Mary Aungst, Karen Groves

Patient Care Services / Nursing

No abstract provided.

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …

Effectiveness Of Breastfeeding Shift Champions On Exclusive Breastfeeding, Comfort Obi

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Purpose. This project evaluated the effect of breastfeeding support on breastfeeding and exclusive breastfeeding rates among postpartum mothers in immediate postpartum period. The breastfeeding support was provided by breastfeeding shift champions (BFSC) following childbirth.

Design. A convenience sample of BFSCs, aged between 18 and 44 years, was utilized.

Method. Pre-and post-intervention questionnaires were used to evaluate breastfeeding knowledge of BFSC. Breastfeeding and exclusive breastfeeding rates were extracted, pre- and post- intervention, from electronic medical records of newborns and their mothers.

Data analysis. Descriptive and inferential statistics were used for data analyses. Descriptive data were displayed using frequency …

Exercise As An Intervention For Prevention Of Gestational Diabetes, Jocelyn Anderson

Grace Peterson Nursing Research Colloquium

No abstract provided.

Tailoring A Nicu-Based Tobacco Treatment Program For Mothers Who Are Dependent On Opioids, Amanda Fallin-Bennett, Kristin Ashford

Nursing Faculty Publications

Objective—To collect formative information to design a tailored tobacco treatment intervention for women with newborns treated or evaluated for neonatal abstinence syndrome and to explore current tobacco use behaviors and facilitators and barriers to smoking cessation.

Design—Qualitative descriptive study.

Setting—An academic medical center in the southern United States.

Participants—Mothers of newborns who were treated or evaluated for neonatal abstinence syndrome at birth within the preceding three months. Women were recruited who were older than 18 and reported opioid dependence and smoking during pregnancy.

Methods—Participants took part in semi-structured individual interviews that lasted approximately one hour. …

The Effects Of Perinatal Oxycodone Exposure On Behavioral Outcome In A Rodent Model, Thitinart Sithisarn, Sandra J. Legan, Philip M. Westgate, Melinda E. Wilson, Kristen Wellmann, Henrietta S. Bada, Susan Barron

Pediatrics Faculty Publications

Opiate addiction is now a major public health problem. Perinatal insults and exposure to opiates such as morphine in utero are well known to affect development of the hypothalamic–pituitary–adrenal axis of the offspring adversely and are associated with a higher risk of developing neurobehavioral problems. Oxycodone is now one of the most frequently abused pain killers during pregnancy; however, limited data are available regarding whether and how perinatal oxycodone exposure (POE) alters neurobehavioral outcomes of the offspring. We demonstrated that exposure to 0.5 mg/kg/day oxycodone in utero was associated with hyperactivity in adult rats in an open field. No significant …