Nursing Commons^™

A Comparison Of The Effectiveness Of Two Educational Interventions Developed To Teach Early Infant Hunger Cues To Junior Level Nursing Students., Melissa D. Gainer

Williams Honors College, Honors Research Projects

Due to multiple learning styles, it can be difficult to teach to large groups of students. The purpose of this study is to compare the effectiveness of two different educational interventions designed to teach infant hunger cues to undergraduate nursing students to increase the knowledge and confidence levels needed for the future teaching of infant hunger cues to new parents. Flemings VARK theory was used to guide this quasi-experimental study. A pretest posttest two-group design was used to evaluate both knowledge and confidence levels in the participants (N= 86). Data was analyzed utilizing a paired t-test. The results noted significant …

A Systematic Review: Effects Of Breastfeeding On Early And Late Childhood, Kara Campbell, Samantha Fritz

Williams Honors College, Honors Research Projects

Abstract

The topic of the long-term impact of breast milk and formula milk composition on the health status of children continues to be a focus of discussion and research. The aim of this systematic review is to describe and critically appraise current evidence regarding the lasting effects of breastfeeding on health outcomes in children throughout early and late childhood. Twenty-one studies focusing on infant feeding were identified using PubMed, CINAHL, and Medline databases. These studies were then categorized according to health outcomes such as: weight, developmental, and immune system effects. Through a critical appraisal of this evidence, it was found …

Evaluation Of Nurses' Knowledge Of "Period Of Purple Crying" Program: Shaken Baby Syndrome Prevention, Cynthia L. Brubaker-Vincent

DNP Projects

Shaken baby syndrome (SBS) and pediatric abusive head trauma (PAHT) continue to be the leading cause of child abuse death and most common causes of mortality and morbidity due to the physical child abuse in the United States (Barr, 2014). According to the CDC of the nearly 2,000 children who die from abuse each year, PAHT and SBS are responsible for 10-12% of those fatalities (CDC, 2015). There are 1450-1700 cases of reported shaken injuries to infants and children reported in the United States each year (Barr, 2014). Shaken Baby Syndrome is 100% preventable through the proper education to our …

A Study Of Provider Practices In The Screening, Diagnosis, And Treatment Of Childhood Overweight And Obesity In A Rural Eastern Kentucky Clinic, Ashley R. Healy

DNP Projects

Objectives: The purpose of this study is to assess the current practices of providers for overweight and obese children at well visits, and how the demographics of age, sex, race, ethnicity, primary language spoken, insurance type, and provider type influence the care provided to overweight and obese children at the study site, which is a rural primary care clinic in eastern Kentucky.

Methods: This study is a retrospective design auditing well child charts (n = 571) from the study site over a two year period. Charts were audited for the data points of age, sex, race, ethnicity, primary spoken language, …

The Effect Of Nurse Dose On Breastfeeding Exclusivity - A Patient Level Analysis, Gwen Moreland

DNP Projects

Background: Breastfeeding is strongly associated with health benefits for children and their mothers. Despite this knowledge, breastfeeding rates in the United States have increased only slightly. Current research examines the relationship between nurse characteristics and patient outcomes in adult intensive care and acute care settings. To date there is very limited research examining nurse variables and outcomes in women and children, and very little knowledge regarding the characteristics of the nurse in relation to patient’s breastfeeding success.

Purpose: The purpose of this practice inquiry project was to evaluate the relationship between the attributes of nurse dose and the immediacy and …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …

Prenatal Alcohol And Nicotine Exposure And The Subsequent Cognitive And Behavioral Deficits Seen In Children, Abigail P. Stewart

Senior Honors Theses

Prenatal alcohol and nicotine exposure have well known physiological effects on the fetus. However, it is the goal of this thesis to inform the reader of of the deleterious effects that these substances can have on cognitive and behavioral development in children. A literature review in relation to this topic was conducted through online databases using key words. Though some of the results were inconsistent, enough evidence exists for women to be educated on the increased risks for cognitive and behavioral deficits in children exposed to alcohol and nicotine in utero.

Use Of A Web-Based Dietary Assessment Tool In Early Pregnancy, Laura Mullaney, Amy C. O'Higgins, Shona Cawley, R. Kennedy, Daniel Mccartney, M.J. Turner

Articles

Background Maternal diet is critical to fetal development and lifelong health outcomes. In this context, dietary quality indices in pregnancy should be explicitly underpinned by data correlating food intake patterns with nutrient intakes known to be important for gestation.

Aims Our aim was to assess the correlation between dietary quality scores derived from a novel online dietary assessment tool (DAT) and nutrient intake data derived from the previously validated Willett Food Frequency Questionnaire (WFFQ).

Methods 524 women completed the validated semiquantitive WFFQ and online DAT questionnaire in their first trimester. Spearman correlation and Kruskal–Wallis tests were used to test associations …

Nutritional Status And Tuberculosis Risk In Adult And Pediatric Household Contacts, Omowunmi Aibana, Xeno Acharya, Chuan-Chin Huang, Mercedes C Becerra, Jerome T Galea, Silvia S Chiang, Carmen Contreras, Roger Calderon, Rosa Yataco, Gustavo E Velásquez, Karen Tintaya, Judith Jimenez, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children.

METHODS AND FINDINGS: We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used …

In-Hospital Factors Associated With Supplementation Among Healthy, Full-Term, Breastfed Infants, Jodi Kae O'Brien

Dissertations

Background: Formula supplementation of healthy, term, breastfed infants born to mothers who plan to exclusively breastfeed persists at high rates, in spite of global reduction efforts. The identification of modifiable risk factors for supplementation and effective nursing care for successful breastfeeding is understudied.

Purpose: This study aimed to better understand the obstetrical, hospital, and nursing factors associated with supplementation during the hospital stay. The aims were: (1) examine the relationships between aspects of hospital care of infants who are supplemented compared to infants exclusively breastfed and (2) determine what in-hospital risk factors increase the odds of formula supplementation among a …

Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn

Master's Projects and Capstones

A three-month time period was used to develop a postpartum education program change by designing a discharge nurse role on the postpartum unit at University of North Carolina Women’s Hospital. The goal of the education change is to increase patient satisfaction scores of discharged post-natal mothers on the postpartum unit by having HCAPS and Press Ganey to improve up to10% over the next 6 months.

An observational assessment revealed a fragmented and antiquated discharge process. This process was paper based and difficult to complete in light of the short stay and high volume patient population. Informal nurse feedback as well …

Implementing Emergency Bedside Backpacks In The Nicu To Improve Patient Outcomes, Melissa M. Garcia

Master's Projects and Capstones

Abstract

Planning for a disaster, by implementing a unit specific disaster plan, has become an essential recommendation for Neonatal Intensive Care Units. Emergent situations have resulted from past natural disasters proving the need for additional planning when it comes to units with fragile populations. Research has shown instituting a specialized disaster plan, increases patient safety resulting in improved patient outcomes. This prospectus aims to implement emergency bedside backpacks as the first step in the development of a NICU specific disaster plan. These backpacks are meant to be an addition to the current hospital emergency plan, with the goal being to …

Risk Assessment Strategy For Late Preterm Infants, Nisha Nair, Constance Hill

DNP Forum

Late preterm infants (LPIs), born between 34 and 36 6/7 weeks gestation, face many challenges. These infants comprise 71% of preterm births and 8.7% of all births in the United States (Hamilton, Martin, & Ventura, 2010). They have a higher incidence of medical complications than their full-term counterparts leading to longer hospital stays or readmissions (Consortium on Safe Labor, 2010; Khashu, Narayanan, Bhargava, & Osiovich, 2009; Pulver et al., 2010). The nurse’s role in educating parents of LPIs is pertinent as these babies are at heightened risk for a number of significant complications. The purpose of this project is to …

Common Factors In Unplanned Cesarean Section, Lauren C. Compton

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Obstetrical delivery by cesarean section is a prevalent form of delivery. Whether clinically indicated or by maternal request, cesarean delivery rates in the United States have risen to account for over a third of all deliveries. Cesarean section procedures are often clinically indicated and occur because of fetal factors, but they can also be elected by maternal request. The aims of this study are to analyze the frequency of the factors in the study questions that are associated with unplanned cesarean section procedures and to compare the frequency of these factors per cesarean section with the time of day the …

The Impact Of Breastfeeding Education: A Retrospective Look At Breastfeeding Education And Breastfeeding Rates, Hannah Newell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breastfeeding is associated with improved health outcomes for both mother and child. Not only does it provide optimal nutrition for the infant, it also encourages an intimate maternal-infant bonding experience that establishes the basis for parenting and interaction. Major medical organizations including the Surgeon General’s Healthy People 2020 have an aim of increasing the number of women who initiate breastfeeding, and a recommendation of exclusive breastfeeding for the first six months and continued breastfeeding for at least one year. While most women are aware that breastfeeding is the best source of nutrition for infants, they often lack knowledge regarding the …

The Rates Of Mothers Who Continually Breastfeed After Implemented Breastfeeding Teaching, Katherine L. Moore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Many mothers are unaware of the benefits of breastfeeding. This lack of knowledge leads to an inability to weigh the advantages and disadvantages of the potential source of nutrition their infant will receive during his or her first months of life. Many mothers never even attempt to breastfeed their infant. Even among the mothers who do initially choose to breastfeed, the majority deviate to other forms of feeding early in the postpartum period. Despite the fact that most major medical organizations encourage exclusive breastfeeding through the first six months of an infant’s life, the CDC report for 2013 claims the …

Bed Rest And Its Continued Use In Women With High-Risk Pregnancy: A Review Of Literature, Irene De Los Reyes

Senior Theses

Bed rest is defined as confinement to bed and restriction of activity. In the clinical setting bed rest includes strict bed rest, strict bed rest in Trendelenburg position, bed rest with bathroom privileges, and up ad lib (Irion, Irion, Lewis & Giglio, 2012). Bed rest has been the standard treatment for over the past 30 years in preventing preterm birth and complications arising from high-risk pregnancy despite the lack of evidence to support its safety and effectiveness for the mother and fetus (Maloni, 2010). The purpose of this literature review and critique is to provide information about the adverse physiologic …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

Educated Birth: Beliefs Vs. Outcomes, Lauren Presley

Human Nutrition and Hospitality Management Undergraduate Honors Theses

“Our infant mortality rate is a national embarrassment.”¹ The words seem shocking and harsh across the headline of a 2014 Washington Post article. The thought of America not only not being the best at something, but falling upsettingly behind, is a foreign concept to many who view America as a nation inferior to none. However, the statistics on infant mortality rate tell the stark truth that of 26 “wealthy” countries, the U.S. ranks last, with a sobering 6.1 deaths per 1,000 live infant births.²

Part of the Healthy People 2020 Objectives is to reduce the rate of infant …

What Can Pakistan Do To Address Maternal And Child Health Over The Next Decade?, Zulfiqar Ahmed Bhutta, Assad Hafeez

Department of Paediatrics and Child Health

Pakistan faces huge challenges in meeting its international obligations and agreed Millennium Development Goal targets for reducing maternal and child mortality. While there have been reductions in maternal and under-5 child mortality, overall rates are barely above secular trends and neonatal mortality has not reduced much. Progress in addressing basic determinants, such as poverty, undernutrition, safe water, and sound sanitary conditions as well as female education, is unsatisfactory and, not surprisingly, population growth hampers economic growth and development across the country. The devolution of health to the provinces has created challenges as well as opportunities for action. This paper presents …

Impact Of Specialized Nursery Care For Late Preterm Infants On Nicu Admission Rate And Length Of Stay, Laura Hunt, Gene Hallford, Candace Robledo, Edgardo Szyld, Clara Song

School of Medicine Publications

Objective To compare neonatal intensive care unit (NICU) admission rates and length of stay (LOS) of late preterm infants (LPIs) born before and after opening a specialized care nursery (SCN) at our academic, pediatric tertiary care center with 4,500 total deliveries annually

Study Design Retrospective chart review of inborn LPIs (350/7–366/7 weeks) who were asymptomatic or minimally symptomatic at birth and delivered 7 months before the opening of the SCN (pre-SCN) or 7 months subsequently (post-SCN). Infants were excluded for major congenital anomalies or other conditions requiring immediate NICU admission. The pre-SCN options for care were standard couplet care or …

Women’S Perceptions Of Antenatal, Delivery, And Postpartum Services In Rural Tanzania, Gladys Reuben Mahit, Dickson Ally Mkoka, Angwara Dennis Kiwara, Columba Mbekenga, Anna-Karin Hurtig, Isabel Goicolea

School of Nursing & Midwifery, East Africa

Background: Maternal health care provision remains a major challenge in developing countries. There is agreement that the provision of quality clinical services is essential if high rates of maternal death are to be reduced. However, despite efforts to improve access to these services, a high number of women in Tanzania do not access them. The aim of this study is to explore women’s views about the maternal health services (pregnancy, delivery, and postpartum period) that they received at health facilities in order to identify gaps in service provision that may lead to low-quality maternal care and increased risks associated with …

Caregivers Of Underserved Minority Populations: Views And Opinions Of The Role Of Schools In Bmi Screening, Education And Communication, Lori Keough Phd, M.Ed, Fnp-Bc

Journal of Health Disparities Research and Practice

A pilot study exploring caregiver views of the role of schools in students’ health.

Abstract

To date, 20 states in theUnited Statesrequire school-based body mass index (BMI) screening for school-aged populations and for some the requirements include caregiver notification of the findings. Few studies have provided empirical data indicating whether or not caregivers accept or act on BMI communication from schools. Therefore, an exploratory pilot study was conducted in a culturally diverse urban school district to determine how a required (BMI) screening and notification were viewed by caregivers. Most caregivers reported that they felt schools did not have a role …

Pain Management In The Neonatal Intensive Care Unit, Holly N. Hagy

Montview Journal of Research & Scholarship

While pain management in the Neonatal Intensive Care Unit (NICU) was thought to be useless due to the infants’ inabilities to experience pain, research has confirmed that infants can and do experience pain at the same, if not greater, level of intensity as adults experience pain. Painful stimuli cause a system-wide sympathetic nervous system response that can cause damage when prolonged or unmanaged. There are multitudes of ways to treat an infant’s pain, but there seems to be a discrepancy between the knowledge that health care workers have regarding pain management in the NICU and the actual implementation of that …

We Can Do Better: An Argument For Improved Care Of The Opioid Addicted Mother-Infant Dyad, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

As the number of addicted maternal-infant dyads increases, so does the need for nursing to expand its understanding of the addiction process and the evidencebased interventions that best serve mothers and infants. Nursing attitudes toward the opioid-addicted mother and infant dyad are influenced by knowledge deficits and communication difficulties. Care required encompasses medical, legal, social, and economic perspectives. Professionals and society at large have disagreements regarding whether to approach the phenomenon from a punitive or supportive strategy. Facilities to care for the mother-infant dyad with addiction are limited. Increasing knowledge has great potential for active understanding and ability to impact …

Implementation Of A Debrief “Takeaway” Board, Carly A. Skeath

Master's Projects and Capstones

Abstract

My original focus of my project was to implement Team STEPPS, to help improve the communication and teamwork within our entire perinatal service department. However, as I started I ran into barriers with time and with other projects put out by our management that needed to take president. It is then that I decided to narrow my focus on one aspect of Team STEPPS which we are already implementing, and that is debriefs. As a member of the Perinatal Patient Safety Program (PPSP), I was able to learn about all the takeaway’s we received from debriefs that had occurred, …

Quantify Blood Loss To Prevent Escalation Of Blood Loss, Manprit Virk

Master's Projects and Capstones

Abstract

The CNL project’s aim is to implement quantifying blood loss (QBL) after each delivery to prevent the escalation of postpartum hemorrhage (PPH), and decrease maternal mortality and morbidity related to PPH in Maternal Child Health (MCH). This project is initiated in a Northern California acute-care facility’s MCH department, which consists of: childbearing women pregnant at gestation age of more than thirty-four weeks, and women post delivery. According to CMQCC (2014), 1-3% of pregnancies are affected by postpartum hemorrhage, and the acute-care facility has a current postpartum hemorrhage rate of 2.7%. There is lack of standardized method of measuring blood …

Breastfeeding With The Bronson Mothers’ Milk Bank, Marykate Bodnar

Masters Theses

Bronson Methodist Hospital in Kalamazoo is home to one of only 15 certified breast milk banks in the United States. Women have shared breast milk for centuries through wet nurses, but this institutionalized and regulated version of sharing is distinct from previous forms. Breastfeeding has become a symbol of successful motherhood; donor milk adds a new dimension to this aspect of idealized motherhood. This study explores how the milk bank works: its organizational structure within a hospital, how donors are selected, and how recipients qualify for donor milk. It is grounded in Feminist and Medical Anthropology literature. Using semi-structured interviews …

Pregnancy Apps: A Closer Look At The Implications For Childbirth Educators, Christine Frazer, Leslie Hussey, Emily Bosch, Michelle Squire

Walden Faculty and Staff Publications

Most pregnant women download an average of three pregnancy apps during their gestational period. There are no set standards in place for what needs to be included in an app’s description leaving consumers to decide for themselves when it comes to selecting the right app to download. The childbirth educator must be knowledgeable about pregnancy apps, in-tune as to what apps their clientele download, and how to analyze them for credibility. This article presents characteristics associated with women of childbearing age (i.e. Millennial/Net generation); the reasons why pregnant women are turning to apps; the limitations of apps, and the childbirth …

‘What About The Mother?’ Women׳S And Caregivers׳ Perspectives On Caesarean Birth In A Low-Resource Setting With Rising Caesarean Section Rates, Helena Litorp, Andrew Mgaya, Hussein Kidanto, Sara Johnsdotter, Birgitta Essén

Obstetrics and Gynaecology, East Africa

Objective: in light of the rising caesarean section rates in many developing countries, we sought to explore women׳s and caregivers׳ experiences, perceptions, attitudes, and beliefs in relation to caesarean section.

Design: qualitative study using semi-structured individual in-depth interviews, focus group discussions, and participant observations. The study relied on a framework of naturalistic inquiry and data were analysed using thematic analysis.

Setting: a public university hospital in Dar es Salaam, Tanzania.

Participants: we conducted a total of 29 individual interviews, 13 with women and 16 with caregivers, and two focus group discussions comprising five to six caregivers each. Women had undergone …