Nursing Commons^™

Prenatal Perception Of Wic Breastfeeding Recommendation Predicts Breastfeeding Outcomes In Infant's First Year, Joanne Guthrie, Qi Zhang, Kelin Li, Kathryn Wouk, Rajan Lamichhane

Community & Environmental Health Faculty Publications

Objectives

Promoting breastfeeding (BF) is a priority of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Prior research found that pregnant mothers who believed WIC recommends BF only (versus BF and formula equally OK) were more likely to initiate BF and continue through 1 month postpartum. We examine whether such mothers are more likely to continue to exclusively BF through 5 months and BF at all through the infant's first year. Methods

Data are from the WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a longitudinal study that includes 2,649 mothers who completed prenatal interviews. Four BF …

Improving Antibiotic Administration Timing In Neonatal Early-Onset Sepsis, Donia B. Bass

Regis University Student Publications (comprehensive collection)

Abstract

Neonatal early onset sepsis (EOS) remains one of the most common causes of neonatal morbidity and mortality. Neonates requiring evaluation and treatment for suspected EOS inconsistently receive antibiotics within one hour of decision to treat as recommended in the 2012 neonatal sepsis guidelines by the National Institutes for Health and Care Excellence (NICE). A mixed method quality improvement initiative was employed in a level three NICU, applying a standardized admission process to mitigate systems flaws impacting delay of first dose antibiotic. A nursing sepsis education module was provided, and the novel SAM admission prioritization tool was developed to guide …

Improving Care Of Women Experiencing A Pregnancy, Belinda T. Ferguson

Doctor of Nursing Practice Projects

The purpose of the Doctor of Nursing Practice (DNP) project was to provide evidence-based staff education at a pregnancy resource center to increase staff/patient engagement and communication by implementing a clinical practice change and use of a DNP student-developed discharge summary referral form (DRF) to assist with assessing patient’s needs, evaluating access to services and utilization of medical care and health promotion services. The overall aim of this project is to increase care with medical follow-up and seek to address improving engagement and communication with patients during their care and after discharge from the Pregnancy Resource Center (PRC). The major …

Risk Factors Contributing To Urinary Tract Infections (Uti) In Neonates, Jennifer V. Harshman

Honors Undergraduate Theses

Urinary tract infections (UTI) in neonates are caused by many types of risk factors such as increased length of maternal labor, physiologic maternal conditions, prematurity, and decreased birth weight. Identification of potential risk factors for UTI in neonates can lead to rapid assessment and early interventions to treat urinary infection in the neonate before it transitions to a severe or life-threatening condition, such as a kidney infection or septicemia.

The primary purpose of this literature review was to examine risk factors predisposing neonates to UTI. The secondary purpose was to identify if length of time to drug therapy used to …

The Effects Of Delayed Initial Bathing In Newborns, Danielle Nitzachon

Honors Undergraduate Theses

Delayed bathing of the newborn infant for twenty-four hours after birth can decrease potential newborn complications such as hypoglycemia, hypothermia, and improve the infants skin integrity and breastfeeding rates. The primary purpose of this literature review was to examine the health benefits of delaying initial bathing in newborns for twenty-four hours. A comprehensive review of the literature was performed using peer-reviewed, research articles from multiple databases focusing on delayed infant bathing after birth and health benefits. 15 articles met the inclusion criteria and answered the research questions. Two studies showed the effects of vernix caseosa on improved skin integrity and …

Obstetrical Nursing Care And Cesarean Section Delivery Rates In Laboring Women: An Integrative Review Of Literature, Ayana Cornelius

Honors Undergraduate Theses

Background: There is a documented overuse of C-sections (CS) in the United States. The majority of research surrounding CS overuse focuses on the physician’s role, location (state, city, hospital), hospital policies, and the reason why the CS is being performed. Little research focuses on the nurse’s influence on CS outcomes, although nurses spend the longest amount of time with the patient. Methods: Data for this literature review examined 13 research articles between 1992 to present, exploring factors relating to the overuse of CS, specifically, data relating to the correlation between CS and the nurse’s role. Results: Recent research has shown …

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

Risk Factors And Compliance Of Surviving Sepsis Campaign: A Retrospective Cohort Study At Tertiary Care Hospital, Farheen Yousuf, Ayesha Malik, Ayesha Saba, Sana Sheikh

Department of Obstetrics & Gynaecology

Background and objective: Sepsis is one of the leading causes of direct maternal mortality in Pakistan. It is recommended that the first three hours after the presentation are crucial. During this time implementation of surviving sepsis campaign resuscitation bundles reduces maternal mortality. Our objective was to assess the factors contributing to puerperal sepsis and the compliance of "surviving sepsis campaign resuscitation bundles in puerperal sepsis" for the management of puerperal sepsis.
Methods: This was a retrospective record review for five years from January 2011-December 2015. All women who fulfilled the inclusion criteria of puerperal sepsis were included and data from …

Splanchnic Oxygenation And Feeding Intolerance In The Very Low Birthweight Infant, Melissa C. Dollings

Theses and Dissertations

SPLANCHNIC OXYGENATION AND FEEDING INTOLERANCE IN THE VERY LOW BIRTHWEIGHT INFANT

By Melissa C. Dollings, Ph.D.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2022

Major Director: Lisa F. Brown, Ph.D., RN, School of Nursing

Background. Feeding intolerance is common in preterm infants but can be an ominous precursor of necrotizing enterocolitis, a life-threatening gastrointestinal disease. The definition and management of feeding intolerance vary widely. This research examined the relationship

between feeding intolerance, intrauterine factors, extrauterine factors, and intestinal immaturity and circulatory immaturity in the …

Comparing The Effectiveness Of Methods Meant To Reduce Perineal Laceration Rates, Danielle E Horovitz

Nursing | Senior Theses

Background

Perineal lacerations are a common occurrence in childbirth- with tears occurring in 53-79% of women. Trauma to the perineum is classified into 4 categories, with each class increasing in severity. Severe perineal lacerations have long term consequences for the women who experience them.

Objectives

To compare the effectiveness of methods which aim to reduce the rate and severity of perineal lacerations, including: hands on vs hands off technique, slow and controlled birth, use of lubrication, perineal massage, etc.

Summary of Findings

The literature review suggests that it is critical to employ methods to reduce laceration incidence and severity as …

Best Practices For The Prevention And Treatment Of Microcytic Hypochromic Anemia In Infancy, Janelle Paredes

Nursing | Senior Theses

Background: Microcytic hypochromic anemia is the most common nutritional deficiency in the world. This type of anemia is commonly found during infancy due to the lack of iron-fortified foods after six months of age. The effects linked to this deficiency can cause developmental delays and behavioral disturbances in infants if not treated immediately. Therefore, it is important for nurses to find the best practices to prevent microcytic hypochromic anemia to decrease its prevalence in infancy.

Objective: To find the best nursing practices for the prevention and treatment of microcytic hypochromic anemia in infancy.

Methods: This research will utilize …

A Comparison Of Perceptions Of Labor Support Before And During The Covid-19 Pandemic, Sarah Grace Krein

Honors Theses and Capstones

Satisfaction with the experience of birth has been shown to be affected by the quality of support received by the birthing individual and how closely the experience aligns with their expectations. This is important because the hospital and societal restrictions put in place during the COVID-19 pandemic may have altered individuals’ experiences of birth during this time. This is further concerning as there is a known correlation between a negative birth experience and the risk for postpartum depression. This study aimed to identify birthing parents’ perceptions of support during birth and how the COVID-19 pandemic impacted support practices. A survey …

Perinatal Patient Education On Substance Use Risk Factors In The Age Of The Opioid Crisis, Rebecca Ane Leary, Alyssa O'Brien

Honors Theses and Capstones

From 2014 to 2016, NH ranked first for fentanyl and all opioid-related overdose deaths per capita in the United States (Moore et al., 2021). In 2016 the New Hampshire Department of Health and Human Services (NH DHHS) found that there are many repercussions of this opioid crisis including overdose deaths, child and elder abuse, and newborns experiencing withdrawal. In utero substance exposure places a child at a higher risk for developmental, behavioral, and physical health concerns. To address this gap, a secondary data analysis using NH Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2013 to 2020 was conducted. PRAMS …

Mother's Own Milk Compared With Formula Milk For Feeding Preterm Or Low Birth Weight Infants: Systematic Review And Meta-Analysis, Natalie A. Strobel, Claire Adams, Daniel R. Mcaullay, Karen M. Edmond

Research outputs 2022 to 2026

Objectives: We assessed the effect of feeding preterm or low birth weight infants with infant formula compared with mother's own milk on mortality, morbidity, growth, neurodevelopment, and disability. Methods: We searched Medline (Ovid), Embase (Ovid), and Cochrane Central Register of Controlled Studies to October 1, 2021. Results: Forty-two studies enrolling 89 638 infants fulfilled the inclusion criteria. We did not find evidence of an effect on mortality (odds ratio [OR] 1.26, 95% confidence interval [CI] 0.91-1.76), infection (OR 1.52, 95% CI 0.98-2.37), cognitive neurodevelopment (standardized mean difference -1.30, 95% CI -3.53 to 0.93), or on growth parameters. Formula milk feeding …

Nurses’ Perceptions Of Their Role Utilizing Eat, Sleep, Console, In The Management Of Neonatal Abstinence Syndrome, Cerys Eldred

Honors Theses and Capstones

Background: There is a rising prominence of infants being born and diagnosed with Neonatal Abstinence Syndrome (NAS) in the United States. In recent years, a new non-pharmacological method of managing these infants called Eat, Sleep, Console (ESC) has emerged. While there is mounting evidence demonstrating the positive outcomes for infants treated with this method, there is limited research regarding nurses’ perceptions of this new intervention. This study seeks to understand the nurse’s experience and role during caring for infants with NAS utilizing the ESC method in comparison to the past practices.

Methods: This study used a qualitative descriptive design to …

Still Birth Classification: Application Of Relevant Condition At Death (Recode) Classification System In A Tertiary Care Hospital Of Pakistan, Urooj Kashif, Shelina Bhamani, Asma Patel, Zaheena Shamsul Islam

Department of Obstetrics & Gynaecology

Objectives: To determine the cause of stillbirth after application of relevant condition at death (ReCoDe) classification system.
Methods: This was a retrospective cross sectional study of 207 women diagnosed with stillbirth after 24 completed weeks of pregnancy at the Aga Khan University Hospital (AKUH), Karachi between 1st January 2015 and 31st December 2019. The primary objective was to find the cause of stillbirth according to the new classification of relevant condition at death (ReCoDe).
Results: There were a total of 32413 live births and 207 stillbirths during the study period thus stillbirth rate of 6 per 1000 live births. In …

Promoting Postpartum Knowledge And Support Through The Provision Of Educational And Support Resources During The Postpartum Admission Stay: A Quality Improvement Project, Danielle Woodman

Master's Theses and Capstones

BACKGROUND: The postpartum period is often imbued with heightened emotions, unfamiliar challenges, and an abundance of uncertainty. Postpartum depression and anxiety are well discussed in literature, yet postpartum mothers may lack knowledge of these conditions and their associated risk factors, signs, and symptoms as well as the support resources which are available to them. Improved postpartum support and awareness may alleviate the prevalence, severity, and progression of these conditions into more severe cases.

LOCAL PROBLEM: Within the given microsystem, a gap in postpartum educational and support resources exists due to a lack of resource awareness and ease of accessibility.

METHODS: …

Improving Breastfeeding Establishment By Reducing The Use Of Bottles And Artificial Nipples With Medically Needed Supplementation In Full-Term Breastfed Infants: A Quality Improvement Project, Sara Fazzi Garcia

Master's Theses and Capstones

Background: Breastfeeding has long been strongly recommended by national and international organizations as a prevention of many common and chronic diseases. Baby-Friendly Hospital Initiative (BFHI) was developed to motivate hospitals to protect, promote, and support breastfeeding. This Quality Improvement (QI) project aims at supporting the continuation of the Baby-Friendly designation at the organization is being implemented, by focusing on reducing the use of bottles and artificial nipples for medically necessary supplementation for full-term breastfed newborns.

Methods: The Plan-Do-Study-Act (PDSA) framework was utilized to guide this quality improvement project.

Intervention: Educational posters on the interference of the use …

Effect Of Anticipatory Guidance On Parental Knowledge And Anxiety Prior To Discharge Of Infant From The Neonatal Intensive Care Unit To Home, Stephanie Kelty

DNP Projects

Background: Lack of adequate parental education and discharge readiness from the Neonatal Intensive Care Unit (NICU) increases the risk for poor infant outcomes, hospital readmissions, postpartum depression, parental anxiety, and post-traumatic stress disorder. One component of parental readiness at discharge is receiving anticipatory guidance from a trusted healthcare provider prior to discharge.

Purpose/Objectives: This study aimed to evaluate the effectiveness of provider-led anticipatory guidance to enhance parents’ knowledge regarding high-risk infant behaviors and decrease anxiety related to caring for their high-risk infant after NICU discharge. Additionally, this study aimed to assess parental opinions about the value of anticipatory guidance sessions. …

Evidence For Global Health Care Interventions For Preterm Or Low Birth Weight Infants: An Overview Of Systematic Reviews, Karen Edmond, Natalie Strobel

Research outputs 2022 to 2026

Contex: Twenty-four research questions (framed as population, intervention, comparator, and outcomes) for global health care interventions for preterm and low birth weight (LBW) infants were identified at a World Health Organization guideline development group expert meeting in December 2020. Objective: To describe which systematic reviews had addressed these research questions in the last 3 years. Data sources: Medline (Ovid); the Cochrane Database of Systematic Reviews; the Cochrane Database of Systematic Review Protocols; and the PROSPERO International prospective register of systematic reviews databases from January 1, 2019 to December 31, 2021 were used.Randomized controlled trials or observational studies. Two reviewers independently …

Assessment Of Maternal Factors Associated With Low Birth Weight At A Tertiary Care Hospital Of South India - An Exploratory Study., Shilpa Varghese, Priya Reshma Aranha

Manipal Journal of Nursing and Health Sciences

Background : Low birth weight is a major public health problem in many of the developing countries. Though the causes are multiple, maternal factors of low birth weight are significant. A large number of infant deaths can be prevented if these factors are identified early and prompt management of low birth weight babies could save life.

Aim :To identify the maternal factors associated with low birth weight in new born among postnatal mothers

Methods : An exploratory research design was adopted to assess the maternal factors associated with low birth weight in new born. Non probability convenience sampling technique was …

Implementing A Robust Process Improvement Program In The Neonatal Intensive Care Unit To Reduce Harm, Klaus G Nether, Eric J Thomas, Amir Khan, Madelene J Ottosen, Lauren Yager

Faculty, Staff and Student Publications

INTRODUCTION: Preventable harm continues to occur with critically ill neonates despite efforts by hospital neonatal intensive care units (NICUs) to improve processes and reduce harm. Attaining significant and sustainable improvements will require training including leadership support, mentoring, and patient family engagement to improve care processes. This paper describes the implementation of a robust process improvement (RPI) program in the NICU to reduce harm.

METHODS: Leaders, staff, and parents were trained in RPI concepts and tools. Multidisciplinary teams including parent members applied the training and received regular mentorship for their improvement initiatives.

RESULTS: Participants (N = 67) completed pretraining and post-training …

Invasive Haemophilus Influenza Type B In An Infant During The Covid-19 Pandemic: The Return Of Diseases We Hoped Never To See Again…, Christy Tabarani, Stephen A Fletcher, Gloria P Heresi, Susan H Wootton

Faculty, Staff and Student Publications

No abstract provided.

Decreasing Maternal Breastfeeding Dissatisfaction During The Night Shift Related To Lactation Support, Robyn Caston

Master's Projects and Capstones

Abstract

Problem

This paper will discuss the Clinical Nurse Leader (CNL) project's specific aim: to decrease maternal dissatisfaction during the night shift related to lactation support in a high-risk maternal department.

Context

Research has shown that adding lactation support improves the decision to exclusively breastfeed and increases the duration. Breastfeeding for all infants starting at birth and continuing until at least 6 months of age has been recommended by the World Health Organization, UNICEF, and the American Academy of Pediatrics. Many studies about lactation support have demonstrated the health benefits to mothers and their infants.

Interventions

A baseline survey will …

Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown

Theses & Dissertations

African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. …

Preventing Maternal Falls, Blair Burkhart

Master's Projects and Capstones

Patient falls are unfortunate events in healthcare that are an essential quality improvement focus during patients’ hospital stays. At Hospital X, a private institution located in the suburbs of a large city, there had been 23 maternal falls within the last three years. This increase in maternal fall rate puts this hospital’s maternity unit above the average of other hospital’s fall rates according to the National Database of Nursing Quality Indicators. This quality improvement project aimed to reduce the rate of maternal falls on postpartum units through various forms of staff education. Education included Morse Fall Scale scoring, Sara Stedy …

Reducing Postpartum Maternal Falls: A Quality Improvement Project, Sarah L. Iroz

Master's Projects and Capstones

Falls are an unfortunate, common occurrence in the healthcare system and are often not thought to be a problem in the obstetrics population. Key stakeholders in a Northern California hospital brought the issue of maternal falls to leaders of the quality improvement team on the maternity unit. In the last three years, there have been 23 falls on the maternity floor, making their fall rate above the national average. It is the purpose of this project to aid the quality improvement team in reducing postpartum maternal falls over the next three years. After conducting a unit assessment, performing a literature …

Increasing Lactation Consultant Support To The Mch Unit, Daniella Grace Mcclendon

Master's Projects and Capstones

Problem: Breastfeeding is the most beneficial feeding choice for newborns and one of the best ways for mothers to bond with their newborns. In the current Maternal Child Health (MCH) unit, exclusive breastfeeding rates have fallen lower than the unit’s goal of 82%.

Context: Exclusive breastfeeding, when a newborn consumes only human breastmilk, is not always an easy process to initiate immediately after birth and in the early postpartum period. On this specific unit, there is not enough lactation consultant support to provide all patients on the unit.

Interventions: This project considers adding additional lactation consultants to support the MCH …

Implementation Of Maternal Fetal Triage Index To Improve Nurse Knowledge And Timeliness In Obstetric Triage: A Pilot Project, Emilie Long

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to implement an obstetric triage acuity scale in a labor and delivery setting and study the effect on nurse knowledge and timeliness of care.

Design: A quasi-experimental pre and post-test design was used for this pilot project.

Setting: This project was conducted in an obstetric triage unit located within a fourteen-bed labor and delivery unit in the Midwest.

Methods: This pilot project was conducted over a two-month time period. Fifteen registered nurses qualified to care for obstetric triage patients were given education on the chosen triage acuity scale. A pre-test was administered before …

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …