Nursing Commons^™

Goals Of Exclusive Breastfeeding And The Effectiveness Of Programs And Initiatives In Attaining Them, Natalie Scott

Senior Honors Theses

Over recent years, breastfeeding has gained renewed significance in research and practice. Both in the United States and around the world, especially in poor countries that do not have easy access to quality healthcare, breastfeeding has been shown to dramatically and positively affect the health and lifespan of infants. However, there is still a low prevalence of effective breastfeeding practices universally. Even with the presence of global programs and goals that are geared toward exclusive breastfeeding habits, global rates are lower than what is desired. There are various determinants of breastfeeding that factor into a woman’s decision and practice of …

Influence Of Contextual Factors And Self Efficacy On Self- Management In Parents Of Children With Cystic Fibrosis, Erin B. Booth

Theses and Dissertations

Cystic Fibrosis, a life threatening autosomal recessive genetic disease, is characterized by a defective gene resulting in the production of thick mucus that obstructs the lungs and pancreas. CF requires intensive management performed at the home. An initial pilot study was performed to describe knowledge of CF related diabetes (CFRD) in adults with CF. The findings of this study, which demonstrated that adults with CF lacked sufficient knowledge about CFRD confirmed the need to explore additional factors of self-management guided by a theoretical framework. The second study presented in this dissertation used the Individual and Family Self-Management Theory (IFSMT) to …

Delayed Umbilical Cord Clamping: A State Of The Science, Landynn E. Ouellette

Senior Honors Projects, 2010-2019

The purpose of this paper is to explore the state of the science related to delayed versus early umbilical cord clamping. This interprofessional change in practice and protocol needs to take place within obstetric practice, which can be made up of obstetricians, midwives, nurse practitioners, and nurses. Patients must be educated by their providers so that they can better understand the care being performed. A search of the literature published through PubMed was conducted using the key phrases delayed umbilical cord clamping (DUCC), benefits of delayed cord clamping, and umbilical cord protocols. The search yielded 133 titles, which was limited …

Lactation Clinic: Improving Patient Lactation Support, Iana Johnson

Master's Projects and Capstones

Despite the numerous health benefits and recommendations that breastfeeding is the optimal method for nourishing infants, many still choose other ways to feed their babies during the first year of life. This project considers the initiation and future implementation of a Lactation Clinic as an additional patient support service provided in the inpatient and outpatient settings. A Failure Modes and Effects Analysis (FMEA) was conducted in an effort to evaluate and eliminate “what could go wrong” before such an establishment becomes operational. The Risk Priority Numbers (RPNs) from the analysis reveal the lack of use (RPN 50) and streamlining (RPN …

The Use Of Electroacupuncture For Cervical Ripening In Pregnant Women, Becky A. Nauta

Theses & Dissertations

The purpose of this study was to compare cervical ripening outcomes, based on Bishop scoring methodology, of pregnant women receiving usual care treatment (UC) with those receiving electroacupuncture plus UC. A sample of 36 pregnant women completing their 39^th week of gestation was randomized into one of the two groups. The women in the UC group continued to meet with their provider on a weekly basis until delivery. The women in the electroacupuncture plus usual care group met with their provider on a weekly basis and also received electroacupuncture treatments: three in the 39th gestational week and two in …

Birthing Center Versus Hospitalized Birth, Nicolette Larsen

CrissCross

There are many risks and benefits of giving birth at a birthing center versus a hospital. Determining the location of birth is an important decision, as women in the world today have many options of where to have their child. Hospitals and birthing centers are two places where medical professionals provide prenatal, labor and delivery, and postpartum care for the mother and fetus during this memorable time. While hospital nurses and physicians provide advanced medical care, birthing centers focus on holistic care of the family unit emphasizing mental, spiritual, and physical health. Doctors often perform cesarean sections (C-sections) for non-medical …

Reducing Annual Emergency Department Visits Through Improved Asthma Discharge Teaching, Alvin R. Walters

Master's Projects and Capstones

Asthma is the most common pediatric condition in the United States, and a child's home environment plays an impactful role in the triggering of asthma exacerbations (Harper et al., 2015). Current emergency department (ED) ideology focuses on symptoms management, with little time spent on education, and virtually no attention paid to the home environment. Evidence shows that programs which incorporate home environmental assessments into asthma patient education produce a reduction in annual ED visits, fewer missed school days, decreased use of rescue medications, and improvements in quality of life (Gruber K.J., et al, 2016, Hollenbach J.P. & Cloutier M.M., 2015, …

An Examination Into The Relationship Between Iron Deficiency And Postpartum Depression, Sara A. Burroughs

Senior Honors Theses

Postpartum depression is recognized as the most common complication of childbearing; however, its etiology remains fairly undetermined. Many different influences have been hypothesized as to what may cause postpartum depression, including changes in levels of various hormones (such as estrogen and progesterone), a decrease in serotonin, low levels of vitamin D, social factors, and iron deficiency. The lack of strong evidence for one specific cause makes it fairly clear that there are many factors that play a role in the development of postpartum depression. Iron deficiency is one issue that is thought to contribute to the development of postpartum depression …

Socio-Demographics And Exclusive Breastfeeding In The Medicaid/Women Infant And Children (Wic) Population In Spartanburg County, April D. Miller

Nursing Theses and Capstone Projects

Breast milk is recognized as the optimal source of nutrition for infants because of its unique nutritional and immunological characteristics. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of an infant’s life. "Exclusive breastfeeding (EBF)" is defined as no other food or drink except breast milk for the first six months of life. Despite its countless benefits to children and mothers, the continuation rates of exclusive breastfeeding are low in the United States, especially in the Medicaid/Women Infant and Children population. It is vital to understand how multiple factors affect breastfeeding practices in order to …

Parturient Safety: Proper Positioning Education Prior To Neuraxial Anesthesia, Christina Joy Young

Doctoral Projects

In the United States, 61% of parturient patients elect neuraxial anesthesia for labor pain (Koyyalamudi et al., 2016). The incidence of postdural puncture headache is estimated up to 81% following accidental dural puncture-especially in pregnant women receiving elective epidurals (Ragab & Facharzt, 2014). Although the combined rates of complications for spinal and epidural anesthesia are low (2.78%) (American Society Anesthesiologists, 2014), patient safety is extremely important and should be addressed by the overall healthcare system. The purpose of this project assessed a willingness to change which focused on the CRNAs incorporation of proper positioning education prior to neuraxial anesthesia into …

Reducing Hypotension In Elective Cesarean Section Patients With Administration Of Ondansetron Prior To Spinal Anesthesia: A Retrospective Chart Analysis, Linsey Erin Phipps

Doctoral Projects

The birth of a child is one of the most memorable moments in a woman’s life, and many women undergo an elective cesarean section, requiring spinal anesthesia. At this time, the patient and the unborn child’s well-being become the anesthetist’s main focus. The ultimate goal of anesthesia providers is to provide the safest care to the patient. Spinal anesthesia has many benefits, but has a common side effect of hypotension, which can also result in nausea. Hypotension, dangerous to mother and child, is often treated with vasopressors, but can also cause nausea, which is treated by the administration of ondansetron. …

Intergenerational Hispanic Perceptions Of Childhood Obesity, Janelle Weiss

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Childhood obesity is on the rise in the United States especially among minority families. This study investigates how Hispanic parents perceive their child's weight based on years of acculturation, education level, age, child’s gender and 1^st or 2^nd generation status.

Objective: To assess if there are differences in perception between more acculturated Hispanic immigrants and their less acculturated counterparts.

Methods: Data were collected using the Child's Body Image Scale. Participants were asked to arrange the images based on a series of questions inquiring about their perception of their child and health in general. BMI's were then …

Efficacy Of Intravenous Ondansetron In Relieving Nausea/Vomiting And Pruritus Post Epidural Administered Opioids In The Obstetric Patient, Benjamin Stephen Butler

Doctoral Projects

One prominent side effect in the use of a neuraxial anesthesia is pruritus, with an incidence in the obstetric patient of 60-100% (Kumar & Singh, 2013). Another side effect of an epidural placement is nausea and vomiting. Nausea and vomiting occurs frequently during the progress of labor and is difficult to determine an incidence that is related to epidural opioid administration (Chestnut, Wong, Tsen, Ngan Kee, Beilin, & Mhyre, 2014). A review of literature was performed and established evidence that ondansetron is effective in reducing incidence of pruritus in intrathecal administered opioids for cesarean sections in the obstetric patient. No …

Home Visiting Programs For Families Of Children Who Are Deaf Or Hard Of Hearing: A Systematic Review, Nannette Nicholson, Patti Martin, Abby Smith, Sheila Thomas, Ahmad A. Alanazi M.Aud.

Journal of Early Hearing Detection and Intervention

Prelingual hearing loss greatly restricts a child’s language development, hindering his or her behavioral, cognitive and social functioning. Although technology such as hearing aids and cochlear implants are an option for providing access to sound, they fail to teach the child how to listen or attend, how to process language (whether visual or spoken), or how to produce language and communicate. Home visiting is widely recognized as a cost-effective intervention service delivery model. Home visiting programs for promoting language development in children who are diagnosed as deaf or hard of hearing have been in existence for over 50 years, yet …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

Neonatal Mortality Within 24 Hours Of Birth In Six Low- And Lower-Middle-Income Countries., Abdullah H. Baqui, Dipak K. Mitra, Muhammad Imran Nisar, Fyezah Jehan, Muhammad Ilyas, Murtaza Ali, Imran Ahmed, Shabina Arif, Sajid B. Soofi, Sachiyo Yoshida

Department of Paediatrics and Child Health

Objective: To estimate neonatal mortality, particularly within 24 hours of birth, in six low- and lower-middle-income countries.

Methods: We analysed epidemiological data on a total of 149 570 live births collected between 2007 and 2013 in six prospective randomized trials and a cohort study from predominantly rural areas of Bangladesh, Ghana, India, Pakistan, the United Republic of Tanzania and Zambia. The neonatal mortality rate and mortality within 24 hours of birth were estimated for all countries and mortality within 6 hours was estimated for four countries with available data. The findings were compared with published model-based estimates of neonatal …

Development Of A Breastfeeding Class Specifically For Working Moms, Maryleah S. Needels

Master's Projects and Capstones

Successfully breastfeeding mothers who are planning to return to work and remain exclusively breastfeeding their infants have a knowledge deficit as to the federal law protecting their rights along with the basic skills for pumping, storing, and bottle-feeding of breast milk. There is a significant drop in breastfeeding rates at both the 3 and 6-month marker, which coincides with maternal return to employment. After attending the Working Moms Breastfeeding Class, 100% of mothers reported an increase in knowledge surrounding the law and the CDC’s basic skills for handling pumped breast milk based on a pre/post questionnaire. Bandura’s theory of self-efficacy …

Human Papilloma Virus-Related Cervical Dysplasia, Shaylyn D. Webster

Nursing Student Class Projects (Formerly MSN)

Among sexually active men and women, the human papilloma virus (HPV) is one of the most common sexually transmitted infections. With more than 200 different genotypes of HPV known, there are more than 500,000 cases each year in the United States alone (Lowy, 2016). The virus is associated with nearly all cervical cancers, anal cancers, vaginal cancers, penile cancers, and head and neck cancers (Jorge & Wright, 2016). In women, the virus is capable of causing slow cellular changes on the cervix, and this dysplasia is graded based on severity (Jorge & Wright, 2016).

The statistics related to the prevalence …

Type 1 Congenital Pulmonary Airway Malformation: The Most Common Lung Lesion In Newborns., Delilah Penn

Nursing Student Class Projects (Formerly MSN)

A poster project on Type 1 Congenital Pulmonary Airway Malformation: The most common lung lesion in newborns.

Weight, Temperature, And Transcutaneous Bilirubin Of The Term Neonate At Discharge: A Comparative Study Between A Traditional Nursery And Rooming-In Model Of Care, Jennifer L. Pass

Master of Science in Nursing Final Projects

Purpose: The purpose of this study was to examine day of discharge term neonate outcomes of percent weight change, body temperature, and transcutaneous bilirubin from a traditional nursery and a rooming-in model of care.

Design: A retrospective, descriptive, comparative design was used, comparing two groups for differences between outcomes.

Methods: A total of 102 electronic neonate records from one hospital in north Georgia were examined and divided based on when the model of neonate care changed from the traditional nursery care setting to full rooming-in, which was early November 2010: Group 1 (traditional care) consisted of 51 …

Factors That Influence Mothers' Decisions Concerning Breastfeeding, Kimberly M. Futrelle

Nursing Theses and Capstone Projects

The purpose of this study was to explore factors that influence decisions concerning breastfeeding in a group of 30 mothers who are employed, place their children in a childcare center, and whose children are five years of age and under. The study utilized Fishbein and Ajzen’s Theory of Reasoned Action as the conceptual framework. The descriptive study allowed for determination of the factors of attitudes, beliefs, and opinions that influence mothers’ decisions concerning breastfeeding. Statistical data compiled from survey results revealed many participants believed that breast milk is less expensive than formula. However, a significant number of mothers were neutral …

Appropriate Gestational Weight Gain, Eugelyn Opalec Santos

Doctor of Nursing Practice Final Manuscripts

Abstract

Over the past 30 years, excessive weight gain during pregnancy among American women has been a significant concern, resulting in serious health consequences to mothers and their newborns. During 2011, 48% of U.S. women gained more than the ideal amount of weight during pregnancy. Several international studies have also documented that excessive weight gain during pregnancy is associated with adverse maternal and neonatal outcomes. As a result, one in ten babies were born prematurely in the United States in 2014. Based on the Institute of Medicine's (IOM) guidelines (2009), the purpose of this project was to implement the Healthy …

A Quality Improvement Project On Diagnosis And Management Of Asthma In A Private Pediatric Setting., Sosamma Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Although national guidelines exist for the diagnosis and management of asthma, general practice differs significantly from recommendations. Quality improvement methodology when implemented can narrow quality gaps.

Objective: The objective of the project was to create and implement a plan of action to address identified gaps in key clinical activities of asthma care among pediatric population in a private pediatric setting in Northern California

Methods: The project was centered on the use of Education in Quality Improvement for Pediatric Practice (EQIPP), a program of the American Academy of the Pediatrics. Both the pediatrician and the DNP student took this …

Reducing Iv Infiltrates In The Neonatal Population, Stephanie L. Miller

Master's Projects and Capstones

Abstract

The objective of the CNL project is to improve the quality of care provided to our patients. The project focuses efforts to reduce IV infiltrates by auditing all running IV lines, IV management monitoring and auditing infiltrate grading and documentation to find commonalities that could be causing infiltrates.

The project is focusing on the neonatal population at a children’s hospital in the Neonatal Intensive Care Unit (NICU). This NICU is an 80 bed unit that houses both critical care patients and intermediate care neonates.

Auditing was a major component to the project and helped with identifying common causes so …

Obstetric Triage Improvement, Whitney Depaoli

Master's Projects and Capstones

The objective of the obstetric triage improvement project is to decrease the average length of stay for perinatal patients presenting to the obstetric triage. The setting is a university hospital in a large urban city. The population includes pregnant patients with obstetric complaints presenting to triage for further evaluation. Methods used include a root cause analysis, process mapping, lean transformation methodology, and standardization of workflow. The results of the project include reducing the average length of stay in obstetric triage from a baseline of 152 minutes to 120.58 minutes, which represents a 21% decrease. The creation of standard workflows, the …

Rural Nebraska Women's Explanatory Models Of Postpartum Depressive Symptomatology, Elizabeth Mollard

Theses & Dissertations

The purpose of this study was to construct the explanatory models of postpartum depressive symptomatology (PPDS) from the perspective of rural Nebraska women and to compare these models with the medical model of PPDS. A sample of 20 rural Nebraska women were interviewed in a one-on-one qualitative descriptive telephone interview using questions based on Kleinman’s (1980) explanatory model of illness. This study used feminist pragmatism as a guiding philosophical paradigm. Qualitative data were analyzed using content analysis, and results were compared and contrasted with the medical model of PPDS, which included the onset, symptoms, and duration listed in the DSM-5 …

Evidence-Based Obstetric Emergency Team Training And Drills, Michelle R. Cox

Nursing Theses and Capstone Projects

Obstetrical emergencies occur in less than two percent of all pregnancies in the United States. These emergency situations are unanticipated and occur rapidly. According to the American Congress of Obstetricians and Gynecologists, the most common obstetric emergencies in the United States are postpartum hemorrhage and shoulder dystocia. When these emergency medical situations occur, the entire medical team should respond immediately with precision and confidence. There is evidence to support planning and collaboration of interdisciplinary teams with ongoing education and training, leading to prompt recognition and response to critical situations, which can ultimately mitigate poor outcomes during obstetric emergencies. This capstone …

The Influence Of Socioeconomic Status And Ethnicity On Body Mass Index In Children In Northwest Arkansas, Madison E. Davidson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Body Mass Index (BMI) is a measure of body fat that is calculated based on the height, weight, age, and gender of a child. Body Mass Index (BMI) is an important indicator of potential health risks in children. Determining correlations between ethnicity, socioeconomic status, and BMI may assist in identifying children at risk for comorbidities associated with either an elevated or low BMI. An elevated BMI may lead to complications later in life such as hypertension, hyperlipidemia, type 2 diabetes, obesity in adulthood, and psychosocial issues (Geason & Dodd, 2009). On the other hand, a low BMI could lead to …

The Influence Of Birth Weight On Body Mass Index In Young Children In Northwest Arkansas, Margaret Frame

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Body Mass Index (BMI) is a screening tool to measure body fat that is calculated based on the height, weight, age, and gender of a child. Being overweight as a child is defined as having a BMI between the 85^th and 95^th percentiles. Obesity is defined as having a BMI at or above the 95^th percentile (“Basics About Childhood Obesity,” 2012). Having a high BMI comes with an increased risk of multiple co-morbidities, both physical and psychosocial (Pulgarón, 2013). Birth weight has been presumed to play a role in the prevalence of obesity in children. The purpose …

Breast Milk Exposure And The Incidence Of Necrotizing Enterocolitis In Very Low Birth Weight Pre-Term Infants, Meaghan Sullivan

Honors Scholar Theses

Purpose: To determine what degree of exposure to breast milk feeding is protective against Necrotizing Enterocolitis (NEC) in very low birthweight (VLBW) preterm infants.

Data Sources: This is a secondary data analysis of 56 VLBW preterm infants diagnosed with NEC and 56 age-matched VLBW infants who served as controls. All infants were born between 1997 and 2009 and cared for in the Newborn Intensive Care Unit (NICU). Infants were born at or before 29 weeks gestation and with a birth weight less than 1500 grams. Data included the volume fed daily and type of feeding along with demographic birth data. …