Nursing Commons^™

The Late Preterm Infant: How Much Transition Time Is Needed To Prevent Hypothermia?, Sandi Lane

Nursing Theses and Capstone Projects

Late preterm infants are those infants born between 34 weeks and 36 and 6/7 weeks gestation. They are generally the same weight and appearance of full term infants and are treated in level 1 or well baby nurseries the same as full term infants. Late preterm infants are not as physiologically mature as full term infants and have problems that may go overlooked. Late preterm infants experience complications such as hypothermia, hypoglycemia, respiratory difficulties, and feeding problems that lead to hyperbilirubinemia. These complications can lead to longer hospital stays or readmissions and higher healthcare costs. It is the purpose of …

Breast Milk For Preterm Infants: A Nursing Education Program, Lynn Root

Theses and Graduate Projects

The incidence and duration of breast milk feedings for preterm infants, via gavage, bottle and/or breast, is less than that of full-term infants despite scientific-based benefits of breast milk for preterm infants. Maternal-neonatal nurses play a critical role in supporting mothers of preterm infants and promoting breast milk for this population. However, when caring for the mother-preterm dyad, the maternal-neonatal nurse may encounter several barriers in the promotion of breast milk. It has been identified that one of the major barriers to the initiation and maintenance of lactation in mothers of preterm infants is the inconsistent information and lack of …

Standardized Care Of The Late Preterm Infant In Upper Midwest Hospitals, Michelle Susanne Foy

All Graduate Theses, Dissertations, and Other Capstone Projects

Standardizing care or critical pathways have delivered evidence-based care in adult medicine and have positive patient outcomes. Some aspects of standardized care have been used in neonatology, but less often in caring for the late preterm infant (gestational week 34-37 weeks). With each level of care nursery, Level-I, level-II or level-III, there can be a wide range of how to care for the late preterm infant. The purpose of this study was to determine if nurseries or various levels of care had established standards of care specific to the late preterm infant and what barriers existed that prohibited standards of …

Barriers To Effective Pain Management In Preterm And Critically Ill Neonates, Sharon W. Lake

Theses and Dissertations--Nursing

The purpose of this dissertation is to explore potential barriers nurses experience in providing effective pain management for preterm and critically ill infants in neonatal intensive care units (NICUs). The specific aims of the study conducted are to examine (a) NICU caregivers’ knowledge about pain, (b) scales used to evaluate pain in infants, (c) NICU nurses’ documented pain practices, and (d) bias in treating pain of certain types of infants.

This dissertation is comprised of three manuscripts. The first manuscript is an integrated review of the literature describing caregiver knowledge, barriers, and bias in the management of pain in neonates. …

The Factors That Influence Duration Of Exclusive Breastfeeding: A Mixed Methods Design, Roxanne K. Bowman

Theses and Dissertations--Nursing

Breastfeeding is the gold standard of infant feeding and its benefits extend beyond the mother and child. Multiple organizations recommend exclusive breastfeeding for the first six months of an infant’s life. Exclusive breastfeeding rates nationally and in the state of Kentucky fall below the Healthy People 2020 goals. A mother’s intention to breastfeed has been shown to impact actual breastfeeding behavior. The current state of the measurement of intention was explored through a literature review. A majority of the measures were single item scales. The reliability and validity of the scales should be further tested in diverse populations.

The purposes …

Adolescent Athletes With Type 1 Diabetes: Experiences With Continuous Subcutaneous Insulin Infusion, Regina Tow

UNF Graduate Theses and Dissertations

Adolescent athletes with type 1 diabetes (T1DM) face unique challenges when compared to peers with and without diabetes. Continuous subcutaneous insulin infusion (CSII) provides a method of insulin delivery that can enhance flexibility in insulin regimens and lifestyle that may be especially appealing to the adolescent athlete. No studies have explored the impact of athletics in this population. This descriptive qualitative study explored and described the experiences of adolescent athletes using CSII as their primary insulin delivery method, with a focus on athletic participation and performance.

The purposeful sample consisted of four adolescent athletes, ages 13 to 15 years with …

Workplace Lactation Support: Project Development And Implementation, Peggy Rinehart

Graduate Theses, Dissertations, and Capstones

Objective: A pilot project establishing a lactation support program for staff, faculty, and students at Bluegrass Community and Technical College (BCTC) was introduced in September 2012. The lactation support program is intended to promote and support breastfeeding and decrease barriers to continued breastfeeding for mothers who are employed or attending classes. The purpose of this paper is to report on the: (1) development and implementation of a lactation support program in a regional multi-campus community college; and (2) plans for evaluation of the effectiveness of the new program. Setting: The program was implemented at a community college with campus sites …

Mongolian Women's Voices: A Case Study On Maternal Healthcare, Pregnancy, And Birth In Ulaanbaatar's Public Hospitals, Amelia Olmsted

Independent Study Project (ISP) Collection

Mongolia is a country undergoing an incredible amount of change. Last year, in 2011, they had the fastest growing economy in the world, with a 17.2% increase in their GDP, according to the World Bank. A mere 22 years ago, Mongolia was a communist country, and today they are a parliamentary democracy. The country has opened itself up to the rest of the world and a free market economy, and experienced a very drastic shift in this direction in the early 1990's. Many Mongolians will tell you that the mindset of Mongolia's citizens has made a drastic shift since communism …

An Examination Of Maternal Stress, Inflammatory Markers, And Preterm Labor In Pregnant Women, Cecilia Boateng

Kaleidoscope

No abstract provided.

Breastfeeding Success Among Infants With Phenylketonuria, Sandra Banta-Wright, Kathleen C. Shelton, Nancy D. Lowe, Kathleen A. Knafl, Gayle M. Houck

Faculty Publications - College of Nursing

Breast milk is the nutrition of choice for human infants (American Academy of Pediatrics, 2005; American Association of Family Physicians, 2008; Association of Women’s Health Obstetric and Neonatal Nurses, 2005; Canadian Paediatric Society, 2005; U.S. Preventive Services Task Force, 2008; World Health Organization, 2009). The literature on the benefits of breast milk and breastfeeding for infants and mothers has established multiple positive outcomes for infants (Hoddinott, Tappin, & Wright, 2008; Horta, Bahl, Martines, & Victora, 2007; Ip et al., 2007). Breast milk has advantages for infants that distinguish it from standard commercial infant formulas. These advantages include growth factors, hormones, …

Delivering Quality Care: The Roles And Future Of Midwives In Southern California, Abigail Jones

Scripps Senior Theses

The United States is ranked 27^th in the world for maternal mortality, yet spends twice as much on maternity care services as countries with better maternal health indicators. Stuck in a technocratic and physician-dominated maternity care system, the U.S. depends on expensive technologies to control birth out of fear of pain and litigation, costing Americans billions of dollars and depriving women of the opportunity to have a transformative birth experience. Through an analysis of the medicalization of birth and the current biomedical model in birth, in conjunction with open-ended interviews with 5 hospital midwives and 3 homebirth midwives, the …

Increasing Labor And Delivery Nurse Knowledge Of Triaging Non-Obstetrical Medical Emergencies In Pregnant Women Through The Use Of Simulation, Julie Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the effect simulation training has on an OB nurse's ability to correctly triage pregnant patients. Registered Nurses (RNs) working in OB triage must be able to correctly and expediently identify the care a pregnant patient needs. OB triage nurses are trained to recognize pregnancy related issues that commonly present during the months leading up to delivery. It is as important for these nurses to have the skills to realize when a pregnant patient is having a non-obstetrical health crisis. A group of OB triage RNs participated in simulation-training scenarios based on non- …

Nutritional Management Of The Extremely Low Birth Weight Infant: An Evidence Based Clinical Practice Guideline, Dana J. Lunde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Premature birth has risen steadily over the last decade resulting in an increased number of infants needing neonatal intensive care. The demand for neonatal intensive care has lead to many improvements in the delivery of such care with an increase in the survival of the smallest and most premature infants. However, most of these infants are being discharged from neonatal intensive care units (NICU) with severe extrauterine growth restriction (EUGR).

Extremely low birth weight (ELBW) infants born at 23-27 weeks gestation and who have a weight of less than 1,000 grams are at the highest risk for EUGR because of …

Provider Variations In Cesarean Section (Cs) And Vaginal Birth After Cesarean (Vbac) Practice, Rita Elizabeth Marrero

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Centers for Disease Control and Prevention's National Center for Health Statistics (2010) report that nearly one-third of babies were born by Cesarean section (CS) in 2007. Of interest, six states, including Nevada, experienced increases of more than 70% in the last 10 years (CDC, 2007). Based on the increased rate of CS deliveries, the National Institutes of Health (NIH) convened a consensus panel in 2010, which urged the medical community to reduce barriers to women who want to try a vaginal birth after Cesarean delivery (VBAC) in the hope this would safely decrease the total CS rate. For clinicians …

The Efficacy Of An Audio Program And Discussion Guide In Promoting Exclusive Breastfeeding In Cameroon, Africa, Kathryn R. Reinsma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In the Northwest Region of Cameroon, approximately 90% of women initiate breastfeeding; however, only 34% continue exclusive breastfeeding for the recommended six months (Kakute, et al., 2005; WHO, 2008). Entertainment-education is a mass-media communication strategy of placing educational information into media such as television programs, movies, and radio programs (Siegel & Lotenberg, 2007). This form of behavioral change communication has proven effective in addressing health-related issues in developing countries.

Purpose: The aim was to design an audio program and discussion guide to test the hypothesis that an audio program and discussion guide improves exclusive breastfeeding knowledge, beliefs, benefits, self-efficacy, …

An Investigation Of The Effects Of Pitocin For Labor Induction And Augmentation On Breastfeeding Success, Megan J. Lewis

Scripps Senior Theses

Rates of labor induction and augmentation have been increasing in recent decades (Glantz, 2005). According to the Listening to Mothers II survey, half of all labors in the U.S. are induced or augmented with Pitocin or other synthetic form of the hormone oxytocin (Declercq et al., 2006). Oxytocin, a naturally occurring hormone released in the pituitary gland, is involved in the stimulation of uterine contractions during labor and in the milk ejection reflex during breastfeeding, and research suggests it also has various effects on the brain, such as eliciting maternal behavior. However, studies have shown that exogenous oxytocin can interfere …

Nature Versus Nurture: A Study Of Adopted And Biological Children And Their Behavioral Patterns, Courtney Janaye Grenke

Senior Honors Theses

Nurses encounter many different populations of people every day and they must know how to treat them. Adopted children are a population that nurses encounter and there are disagreements concerning whether they are at an increased risk for developing behavioral problems as compared to biological children. It is also debated whether genetics or environment plays a more prominent role in childhood development. Most studies conclude that adopted children are at an increased risk for more behavioral problems due to the unique struggles and challenges they must overcome with genetics playing a bigger role than environment. Nurses can use this information …

A Social Controversy: Autism Spectrum Disorder's Correlation To The Measles-Mumps-Rubella Vaccination, Lindsay A. Frye

Senior Honors Theses

A 1998 research study lead by Dr. Andrew Wakefield linked the measles-mumps-rubella (MMR) vaccination as a probable cause to autism spectrum disorder. This publication has started a significant debate among healthcare professionals and instigated an anti-vaccination movement within the general population. This vaccination controversy was started by parents who readily accepted Wakefield’s findings as truth and frequently would choose to withdrawal the administration of vaccinations from their children’s care plans. There has also been disapproval by healthcare professionals over Wakefield’s study since numerous research teams have been unable to replicate his findings. This disagreement surrounding the MMR vaccination is likely …

The Current Status Of Maternal Health In Samoa: Maternal Health Perspectives According To Professionals And Women, Yesenia Pedro Vicente

Independent Study Project (ISP) Collection

Countries that face pressure to develop at a rapid pace under the western model must adapt to social change and adopt new policies that will secure their well-being. In an attempt to guide these countries, the United Nations has established the Millennium Development Goals as a framework for national development. The United Nations recognizes the importance of improving maternal health and has established it as one of the eight Millennium Development Goals (MDGs) agreed to by member states. Samoa has agreed to these Goals and is said to be “on track” for improving maternal health by the year 2015. This …

Understanding The Experience Of Weight Gain And Body Image During Adolescent Pregnancy, Jessica L. Hinkley, Liana J. Newcombe

Honors Theses and Capstones

This qualitative descriptive study explores the experience of adolescent pregnancy and the influence of body image and other factors on weight gain. It identified three main themes through content analysis: Continuity of Care, Adolescent Investment in a Healthy Pregnancy, and the Impact of Pregnancy Symptoms.

Nurses' Perceptions Of Intradermal Sterile Water Injection Use In Labor, Abby E. Garlock

Nursing Theses and Capstone Projects

Nurses' perceptions of barriers may influence the type of pain control options offered to women in labor. While effective in relieving low-back pain associated with labor, nurses rarely utilize intradermal sterile water injections for women during labor. Using the Nurses' Perceptions of the Use of Intradermal Sterile Water Injections in Labor survey, labor nurses identified barriers to offering intradermal sterile water injections during labor. Individual and institutional characteristics were associated with higher perceived barriers. Nurses who reported working primarily day shift ( t = 2.06, p = .05), higher epidural rates ( r = .45, p = .018), and higher …

The Impact Of Simulation-Based Learning Experience On Critical Thinking Acquisition, Candice Rome

Nursing Theses and Capstone Projects

The purpose of this comparative experimental project was to compare the impact of simulation-based learning experiences to traditional clinical rotations on critical thinking acquisition of associate nursing students within a maternal-child course. Innovative pedagogies have been integrated in nursing programs to augment inadequate clinical placement and instructor availabilities. A longitudinal convenience sample of 45 second year associate level nursing students enrolled in a maternal-child course was utilized. Four experimental groups, 24 students were exposed to an eight-hour simulation-based learning experience in place of one clinical rotation. During the eight hour simulation day, students participated in three various maternal-child centered simulations. …

Randomized Comparison Of Two Internet-Supported Natural Family Planning Methods (Preliminary Findings), Richard J. Fehring, Mary Schneider

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

The aims of this study were to determine and compare efficacy, satisfaction, ease of use, and motivation in using an internet-based method of Natural Family Planning (NFP) that utilizes either electronic hormonal fertility monitoring (EHFM) or cervical-mucus monitoring (CMM). Four hundred fifty women (mean age 30.1) and their male partners (mean age 31.9) who sought to avoid pregnancy were randomized into either an EHFM (N=228) or CMM NFP group (N=222). Both groups utilized a Web site that provided NFP instructions, an electronic charting system, and support from professional nurses. Participants were assessed for satisfaction, ease of use, and motivation in …

Registered Nurses' Perception Of Hispanic Women's Use, Decline And Preference Of Pain Control During Childbirth, Sarah R. Conte

Nursing Theses and Capstone Projects

The purpose of this descriptive study was to identify registered nurses' perceptions of why Hispanic women use or decline pain control during the childbirth process and to identify preferences of pain control. A convenience sample of registered nurses (N = 30) from a large healthcare system in North Carolina was utilized. An 11-item questionnaire using a Likert scale was used. (Appendix A). The questionnaire instrument was developed specifically for this study, and was validated by Julie Stembridge, certified nurse mid- wife, an experienced mid-level provider in obstetrical care. (Appendix B) Demographic data was collected to provide a basis for variations …

Implications Of Perinatal Safety Nurse Fetal Monitoring Surveillance In The Labor And Delivery Setting, Kellie M. Griggs

Nursing Theses and Capstone Projects

Successful maternal and infant outcomes are the most important safety goals for all obstetrical units providing care for low and high-risk patients. The purpose of this research study was to describe how the implementation of the "Perinatal Safety Nurse" position in the Labor and Delivery setting effected fetal outcomes as well as provided an added level of safety. This study proposed that a direct correlation exists between fetal outcomes and fetal safety initiatives. The research design chosen for this proposal was a retrospective study that utilized a descriptive design. The data compared one hundred deliveries from January 2009 to December …

Parent’S Experiences During Their Infant’S Transition From Neonatal Intensive Care Unit To Home: A Qualitative Study, Sharon W. Hutchinson, Marydee A. Spillett, Mary Cronin

Center for Research Quality Publications

Limited literature exists which examines how parents of infants hospitalized in the Neonatal Intensive Care Unit (NICU) transition from their infant’s NICU hospital stay to home. This study examines the question, “What are the experiences of parents during their infant’s transition from the NICU to home? Grounded theory methods served as the paradigm to explore twelve NICU parents’ experiences during their infant’s transition. The basic social psychological process identified was “becoming a parent” which was based on the core problem “I’m not a parent.” Analysis of data contributed to a model described by the researchers as the resultant Model of …

A Quantitative Examination Of Extreme Facial Pain Expression In Neonates: The Primal Face Of Pain Across Time, Martin Schiavenato, Carl L. Von Baeyer

Nursing Faculty Scholarship

Many pain assessment tools for preschool and school-aged children are based on facial expressions of pain. Despite broad use, their metrics are not rooted in the anatomic display of the facial pain expression. We aim to describe quantitatively the patterns of initiation and maintenance of the infant pain expression across an expressive cycle. We evaluated the trajectory of the pain expression of three newborns with the most intense facial display among 63 infants receiving a painful stimulus. A modified “point-pair” system was used to measure movement in key areas across the face by analyzing still pictures from video recording the …

Providing Maternal And Newborn Health Services: Experiences Of Auxiliary Nurse Midwives In Rajasthan, K.G. Santhya, Shireen J. Jejeebhoy

Poverty, Gender, and Youth

To better understand the experiences of auxiliary nurse-midwives (ANMs) in providing maternal and newborn health services and to obtain their perspectives on Janani Suraksha Yojana (JSY), the Population Council undertook an exploratory study of ANMs in two districts of the north-western state of Rajasthan, India. Findings show that the vast majority of the ANMs were aware of best practices related to the immediate care of the newborn. Nevertheless, the findings also suggested a number of priority areas for action, including increased investment in training, encouraging provision of services on a more regular basis, making special efforts to enable ANMs to …

The Development Of An Interdisciplinary Research Agenda At Ngala: An Innovative Case Study, E Bennett, Y Hauck, S Bindahneem, Vicki Banham, M Owens, L E Priddis, G Wells, W Sinclair, L Shields

Research outputs 2012

Background Ngala is an early parenting, not-for-profit organisation in Western Australia (WA). Research academics from three universities in Perth had been involved in separate research activities over recent years at Ngala. During 2007, a strategic decision was made to forge formal links and articulate an interdisciplinary research framework to promote a research culture amongst Ngala practitioners. Aim To describe an organisational case study of the development of an interdisciplinary research agenda within Ngala. Methods Collaborative methods were used. An action learning project was undertaken over a two-year period with the involvement of researchers, managers and practitioners across the five disciplines …

Comparison Of 12-Hour Urine And Protein: Creatinine Ratio To 24-Hour Urine For The Diagnosis Of Preeclampsia (Poster), Christina Tun Md, Joanne Quiñones Md, Msce, Anita Kurt Phd, Rn, John C. Smulian Md, Mph, Meredith Rochon Md

Department of Obstetrics & Gynecology

No abstract provided.