Nursing Commons^™

Antenatal Clinic: Using Ethnographic Methods To Listen To The Voices Of Pregnant Adolescents, Deborah Ireson

Theses: Doctorates and Masters

Aim: This research aims to explore the motivating reasons and external influences that affect pregnant adolescents’ reasons for attending an antenatal clinic. Background: Pregnancy during adolescence has been researched from perceived ‘poor’ decision making during pregnancy and postnatal perspectives involving high-risk outcomes for mother and baby. Antenatal clinic attendance by pregnant adolescents is often characterised by late and infrequent attendance, limiting midwifery contact with this inexperienced group. Gaps in the literature exist where the real-time voices of pregnant adolescents offer their current experiences of antenatal clinic as a relevant means to inform midwifery practice.

Research design: Using ethnographic methods, this …

Kangaroo Care And Preterm Infants, Natalie Schindler, Kathryn Lynn

Williams Honors College, Honors Research Projects

Infants that are born near-term or before they reach their full gestational age of 40 weeks are at risk for facing future health problems and disparities in terms of proper development (Ladewig, London, & Davidson, 2012). This has been a major concern in the medical realm because of the high cost of managing preterm newborns and the complications that can develop. However, kangaroo care may aid in physical growth and cognitive development of these infants. The purpose of this integrative review was to determine if current research shows that kangaroo care has a positive effect on preterm infants in the …

The Effect Of An Educational Hunger Cues Intervention On Awareness In Mothers With Infants, Juliana F. Gill, Ellen A. Vierheller

Williams Honors College, Honors Research Projects

Stress to an infant can inhibit the ability to properly feed and gain the nutrients that are essential for efficient growth. Mothers who are unaware of early hunger cues from their infant have the potential to stress the infant if their early hunger cues are not attended to. The purpose of this study was to examine the effect of an educational hunger cues intervention on awareness in mothers with an infant. The following research question will be answered: Will new mothers who complete an educational intervention show increased awareness of hunger cues in their infants, in comparison to before the …

Induced And Spontaneous Labor Education: Evaluation, Knowledge, And Intent To Discuss Options In Pregnant Women, Kathleen Hartzell, Katherine Bartolotta

Williams Honors College, Honors Research Projects

Labor inductions are increasing worldwide, with rates continuing to rise each year. Currently 30% of labors in the United States result from inductions. The purpose of the study was to examine the effect of an educational intervention about induced and spontaneous labor on knowledge and intent to discuss options with health providers in pregnant women. This study was guided by the health-belief model which explains that people’s beliefs about how a health care decision may affect their lives affect how they make the decisions. This study was conducted using a quantitative and descriptive design with pre and post paper and …

Study Development: Measuring First-Time Parents' Knowledge Of Newborn Suctioning, Megan Breland

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Identifying Caregiver Knowledge Acquisition And Use Of Blue Bulb Syringe, Rebecca Stillwell

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Self-Management Education In Hispanic Women With Gestational Diabetes Mellitus (Gdm), Laura B. Hieronymus

DNP Projects

The purpose of this Practice Inquiry Project was to develop, implement, and evaluate the effectiveness of a diabetes self-management education intervention in a population of Hispanic women at risk for gestational diabetes mellitus within a CenteringPregnancy(R) model of care.

Prenatal Anxiety And Cesarean Delivery In A Clinic Population, Carol A. Kirby

DNP Projects

Although there is an abundance of literature on the topics of prenatal anxiety, stress, depression, etc. during pregnancy, very little research has been conducted on the impact of prenatal anxiety on cesarean delivery and the studies which have been conducted have resulted in conflicting results. This study focused on prenatal anxiety in a clinical population, the characteristics of participants with reported high anxiety, and its association with cesarean deliveries. Prenatal anxiety was defined as Spielberger’s state anxiety and measured with the STAI. Data was collected over all three trimesters of pregnancy and post-delivery. The characteristics of participants who reported high …

Assessment Of Organizational Readiness: Parent Advisory Councils In A Children's Hospital Within A Hospital, Suzanne R. Springate

DNP Projects

Background: A children’s hospital within a hospital (CHWH) in the Midwest region of the United States established a strategic goal to become the preferred provider for children in the region. Outcomes in patient and family experience had fallen short of established organizational expectations. Recognizing that parent advisors are an essential component of patient and family centered care, the strategic plan called for integrating parents into formal, advisory roles.

Purpose: The purpose of this practice improvement project was to perform an assessment of organizational readiness to incorporate parents into formal advisory roles at this CHWH.

Methods: A cross-sectional survey design was …

Childhood Nutrition And Lifestyle In Owensboro, Kentucky, Mckenzie J. Mattingly

DNP Projects

According to the CDC, childhood obesity is now one of the leading health problems in the United States. Thirty-five percent of adults in the United States are obese. Kentucky is the 12th most obese state for adults. and the 7th most obese state for children. The State of Obesity: Better Policies for a Healthier America, states that Kentucky’s adult obesity rate is currently 31.6 percent. This is up from 21.7 percent in 2000 and 12.7 percent in 1990. Primary care providers must work to help prevent these numbers from continuing to climb. Since our population of children who are overweight …

Recommendations For Enhancing Psychosocial Support Of Nicu Parents Through Staff Education And Support, S L. Hall, J Cross, Nancy Selix, C Patterson, L Segre, R Chuffo-Siewert, P A. Geller, M L. Martin

Nursing and Health Professions Faculty Research and Publications

Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents’ functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU …

Relocation Of Orc To Or2, Svetlana N. Schopp

Master's Projects and Capstones

The goal of this Clinical Nurse Leader (CNL) internship project was to maintain safety and quality of care of obstetric (OB) patients undergoing Cesarean Sections (C/S) after operating room for cesarean sections (ORC) is relocated from obstetric unit to the main operating room (OR). The microsystem will accomplish this through effective teamwork, clear interdisciplinary communication, collaboration, and standardization of processes involved. The institution is a not for profit rural health care facility and is a designated Critical Access Hospital; it is located in Northern California. A general obligation bond was passed in 2007 to fund seismic upgrades. Old OB unit …

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Nicu Culture Of Care For Infants With Neonatal Abstinence Syndrome: A Focused Ethnography, Monica M. Nelson

Electronic Theses and Dissertations

Purpose: The purpose of this ethnographic study was to describe the culture of care and nonpharmacological nursing interventions performed by NICU nurses for infants with NAS. Background: Infants with NAS are increasingly being cared for in the inpatient hospital setting by NICU nurses. Interventions used for the care of premature and sick infants in the NICU may or may not be the exact interventions that should be used for the care of the fragile infant with NAS. Research studies on the nonpharmacological nursing care of infants with NAS encompass 5 main areas of practice: environment, adequate rest and sleep, feeding, …

Government Efforts And Personal Opinion Explain The Medicalization Of Pregnancy And Childbirth Through Time In Lower Mustang, Nepal, Ruth Baker

Independent Study Project (ISP) Collection

The way that women approach pregnancy and childbirth in rural Nepal has seen an amazing change in the past twenty to thirty years. The medicalization of this entire process, from pre-­‐ to post-­‐natal care, comes with government efforts for the increased education of women about family planning, nutrition, hygiene, and the proposed benefits of institutional versus in-­‐home delivery. In 9 villages of Lower Mustang, interviews conducted with Government Health Post workers, Female Health Volunteers, and women of different ages sought to discern personal experience and opinion about pregnancy and childbirth from the perspective of both local women and those with …

Premature Births And Maternal Health: An Analysis Of Risk Factors That Affect The Rate Of Prematurity / Los Nacimientos Prematuros Y La Salud Materna: Un Análisis De Los Factores De Riesgo Que Afecta La Tasa De Prematuridad, Alexandria Mickler

Independent Study Project (ISP) Collection

Research Question: What are the major socio-demographic risk factors influencing the rate of preterm birth in Valparaiso, Chile? Objectives: The objective of this study is to identify risk factors that influence the rate of preterm birth in an urban population of women living in Valparaiso, Chile. This study aims to understand whether a relationship exists between socio-demographic characteristics, such as economic level, education, lifestyle, access to medical attention and resources and the risk of prematurity. The outcomes of this study seek to determine the major biological, cultural, and social relationships and identify at-risk social groups. Additionally, this study considers the …

Sexual And Reproductive Health And Rights Of Aymara Women In The Intercultural Health System In Chile / Salud Y Derechos Sexuales Y Reproductivos De Las Mujeres Aymara En El Sistema De Salud Intercultural De Chile, Ariela Schnyer

Independent Study Project (ISP) Collection

This investigation seeks to understand how Aymara women navigate their sexual and reproductive health and rights (SRHR) in Chile’s intercultural health care model. Indigenous communities have their own practices that complicate the provision of sexual and reproductive health by requiring health care providers to be aware of two different worldviews and how they may conflict, as well as what is necessary to provide respectful care. However, an ethnically and culturally pertinent framework is vital to actually assuring successful SRHR provision, whose tenants include autonomous choice and care free of discrimination, coercion or violence. These interactions were investigated through semi-structured interviews …

A Review Related To Midwifery Led Model Of Care, Shahnaz Shahid, Rafat Jan, Rahat Najam Qureshi, Salma Rattani

School of Nursing & Midwifery

Background: Midwifery led care (MLC) is a model of care in which perinatal care is provided to women throughout different phases of childbirth by a midwife.
Objective: This paper aims to provide a literature review on MLC.
Methods: A variety of databases and reports were considered to do the literature review on MLC. The search was limited from 1991 to 2011 by using keywords. A total of 50 articles were critically appraised for this review.
Findings: The main theme that emerged was women ^’s satisfaction with MLC. Satisfaction was integrated with midwife ^’s presence throughout childbirth, experience to …

The Importance Of Access To Benefits Under The Family Medical Leave Act For Low-Income Families For Bonding And Attachment Facilitation With A Fragile Infant And The Role Of The Social Worker, Theresa Stewart Moran

21st Century Social Justice

Lack of universal family leave discriminates against low-income families with infants who require care in the Neonatal Intensive Care Unit. Birth complications tend to occur more frequently in families living with low socioeconomic status, placing a disproportionate burden on an already vulnerable population. Parents in this group tend to be employed in jobs that do not include the benefit of parental leave. Considering that attachment relationships form as the result of bonding transactions during a critical time in development, limiting contact curtails secure attachment. This, combined with other risk factors, increase the odds of lifelong negative outcomes. Family leave policy …

Don’T Diss The Reninjaza: A Case For Integrating Traditional Birthing Attendants Into The Allopathic System To Improve Prenatal Health In Rural Madagascar, Shenna Bannish

Independent Study Project (ISP) Collection

This project seeks to prove the practicality of using Reninjazas (traditional birthing attendants) in rural Madagascar to better prenatal care and diminish the maternal and infant mortality rates in this country. Prenatal care is of vital importance to expecting mothers. Without it, birth defects, complicated labor and delivery, miscommunications concerning fetal development, and even death can occur (Mayo Clinic, 2014). There is no doubt that the lack of adequate prenatal care in Madagascar contributes to its unfortunately high maternal and infant death statistics. While listed as “moderate” in terms of severity, the maternal and infant mortality rates in Madagascar are …

Unmet Need For Contraception And Unintended Pregnancies Among Women Of Reproductive Age Group: A Situation Analysis, Sumera Aziz Ali, Savera Aziz Ali

School of Nursing & Midwifery

Each year approximately 210 million pregnancies occur worldwide and more than one-third (75 to 80 million) of these are unintended, more than half of these (46 million) unintended pregnancies undergo unsafe abortions. In Pakistan 16% of the births are reported to be unwanted and if the unwanted fertility is eliminated, total fertility in Pakistan would be 3.1 births per woman. Total demand for family planning in Pakistan is 55%, while the contraceptive prevalence rate is 35% and unmet need for family planning is 20%. Reasons for unmet need and unintended pregnancy include lack of permission, fear of side effects, poor …

Evaluation Of An Educational Breastfeeding Program For A Non-Profit Agency In South Texas, Marcela Urbina Zavala

Theses and Dissertations - UTB/UTPA

Breastfeeding has been recognized as the most cost effective practice to promote healthier babies among populations (Dennis, 2002). The purpose of the study was to evaluate the effect of an educational breastfeeding and a prenatal + breastfeeding program for individuals attending group classes and to compare the differences between Spanish only and English only versions of the curriculum. Two research questions were stated to know if there were significant differences between pre and post-tests scores and if there were any significant differences in the impact of the intervention between English only and Spanish only versions of the classes. The present …

Very Low Birth Weight And Perinatal Periods Of Risk: Disparities In St. Louis, Pamela Xaverius, Joanne Salas, Deborah Kiel, Candice Woolfolk

Faculty Scholarship

Very low birth weight (VLBW) is a significant issue in St. Louis, Missouri. Our study evaluated risk factors associated with VLBW in this predominantly urban community. Methods. From 2000 to 2009, birth and fetal death certificates were evaluated (𝑛 = 160, 189), and mortality rates were calculated for perinatal periods of risk.The Kitagawa method was used to explore fetoinfant mortality rates (FIMR) in terms of birth weight distribution and birthweight specific mortality. Multivariable logistic regression was used to assess the magnitude of association of selected risk factors with VLBW. Results. VLBW contributes to 50% of the excess FIMR in St. …

Influence Of A Palliative Care Protocol On Nurses' Perceived Barriers To Palliative Care And Moral Distress, Christina Cavinder

Evidence-Based Practice Project Reports

The World Health Organization (2013) states palliative care for children should begin at diagnosis which may even occur prenatally. Neonatal palliative care is variable due to the high technological, curative environment in the newborn intensive care unit, and the uncertain prognoses of infants born at the edge of viability. The purpose of this EBP project was to determine the influence of establishing a neonatal palliative care protocol on nurses’ perceived barriers to palliative care and moral distress. Corley’s Moral Distress theory and Stetler’s Model were used as guides for the framework of the project. The protocol, based on guidelines supported …

Birthing Positions: Is There A Connection Between Acutal Nursing Experience And Evidence-Based Research?, Leah M. Latham

Undergraduate Honors Theses

The objectives of this study were to determine whether there was an association between clinical nursing knowledge of four birthing positions and current evidence-based research of those same positions and also to identify possible areas where nursing knowledge of those birthing positions was inadequate. This pilot study used convenience sampling to survey registered nurses (RNs) and licensed practical nurses (LPNs) on labor and delivery units. The survey was distributed to three hospitals in the southeastern United States, and twenty-four RNs and LPNs participated. Participants’ knowledge did not reflect current clinical evidence in two key areas, (1) the best position to …

How Do Black Nulliparous Women Cognitively Construct Birth?, Marianne F. Moore

Dissertations and Theses (Open Access)

A focused ethnography was conducted to determine the cognitive constructions about birth described by nulliparous Black women in an urban area of the Southwestern US; also, during postpartum, how do these women reconcile expectations with the actual birth? Semi-structured interviews were conducted before birth and after birth.

Women, 16 or older, 17 - 33 weeks carrying a singleton fetus and without anomalies or problems like pre-gestational diabetes, NYHA Cardiac Class III/IV, cancer, renal failure, or sickle cell anemia that eliminated vaginal birth were sequentially recruited and sampled in an affiliated ultrasound clinic. Women scheduled for an anatomy scan were approached. …

Impact Of Cue-Based Feeding Protocol On Premature Infants' Outcomes And Hospital Length Of Stay, Diana Michele Easley Cormier

Doctoral Projects

The project was an oral feeding practice change from traditional, gestational-age/volume-driven feeding progression to developmentally-based, infant-driven feeding progression. The infant-driven (cue-based) feeding protocol was implemented with goals to improve premature infants' feeding outcomes, and decreased the infant's length of hospitalization. The project was designed to implement a cue-based feeding protocol for oral feeding initiation and progression, within the neonatal intensive care unit (NICU) at Community Regional Medical Center (CRMC), and then retrospectively evaluate the impact of the cue-based feeding protocol on feeding outcomes. In order to realize full implementation of a NICU feeding practice change, multiple components, such as electronic …

Factors Associated With Abnormal Weights In Infants In The First Year Of Life: Results From The 2010 National Ambulatory Medical Care Survey, Nikaela R. Larossa

Honors Scholar Theses

Purpose: To examine the predictors associated with abnormal infant weights for lengths in the first year of life as seen in ambulatory care settings.

Data Sources: A secondary data analysis was conducted using the 2010 National Ambulatory Medical Care Survey (NAMCS), in which practitioners documented single patient visits. World Health Organization (WHO) growth charts and recommendations were used to evaluate infant weight for length. Of the total visits, 603 infants were less than one year old, and 595 infants were within the length range of the WHO growth charts. Of the 595 cases, 13.6% were underweight, 5.5% were overweight, 41.2% …

The Impact Of Inappropriate Gestational Weight Gain On Pregnancy, Delivery, And Neonatal Outcomes, Morgan L. Isom

Undergraduate Honors Theses

Inappropriate weight gain during pregnancy is a widespread problem associated with adverse maternal and newborn outcomes. This study’s objective was to examine the impact of gestational weight gain (GWG) above and below the Institute of Medicine (IOM) guidelines on pregnancy, delivery, and newborn outcomes in a rural population. Women were recruited at the first prenatal visit, and data was collected through research interviews and examination of prenatal and delivery medical records. Prepregnancy weight and weight at delivery were obtained, and the final sample (n=913) was restricted to women with singleton pregnancies. Participants were categorized by prepregnancy body mass index (BMI) …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …