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2022

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Articles 1021 - 1050 of 2475

Full-Text Articles in Nursing

Stop The Bleed And Seize Control: The Use Of Simulation And Video Modules In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage, Jared Maxwell Talsky May 2022

Stop The Bleed And Seize Control: The Use Of Simulation And Video Modules In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage, Jared Maxwell Talsky

Master's Projects and Capstones

In order to address shortcomings of the health care system within the United States surrounding the early recognition and response to preeclampsia (PreE) and postpartum hemorrhage (PPH) emergencies The Joint Commission (TJC) revised the accreditation requirements regarding implementing yearly maternal hypertension and hemorrhage simulation scenarios in emergency departments. A Quality improvement team of Clinical Nurse Leader (CNL) students at University of San Francisco, working alongside the emergency department and labor and delivery department nurse educators assisted a dual hospital system in the Bay Area of California to develop and implement training materials and simulations for the hospital system’s Emergency Department …


Save Lives And Sanitize: Prevention Of Surgical Site Infections Post-Cesarean Section Through Increased Hand Hygiene Compliance, Lindsay N. Nance May 2022

Save Lives And Sanitize: Prevention Of Surgical Site Infections Post-Cesarean Section Through Increased Hand Hygiene Compliance, Lindsay N. Nance

Master's Projects and Capstones

Problem: Surgical site infections (SSIs) occur in 3-15% of cesarean sections, making SSIs one of the most common hospital-acquired infections (HAIs). Surgical site infections (SSIs) have increased within a Labor & Delivery (L&D) unit in a large California teaching hospital for the past three years, affecting reimbursement and creating a range of adverse outcomes for patients. Performance of consistent and thorough hand hygiene practices is key to preventing infection, yet the unit’s hand hygiene compliance of 66.7% is well below the facility’s target goal of 90%. Based on recommendations from the organization’s Infection Prevention & Control (IPC) specialist, the …


Addressing The Phenomena Of Nursing Burnout: Seeking The Need For Mental Health Interventions To Support The Nursing Workforce, Cialina L. Moy May 2022

Addressing The Phenomena Of Nursing Burnout: Seeking The Need For Mental Health Interventions To Support The Nursing Workforce, Cialina L. Moy

Master's Projects and Capstones

Problem: Nursing burnout has been an existing phenomenon, which the COVID-19 pandemic has only exacerbated. Burnout has contributed to escalated mental health concerns, increased staff turnover rates, and the nationwide nursing shortage.

Context: Studies indicate that depression, anxiety, and stress significantly correlate to burnout; studies also reveal that burnout consequently contributes to job dissatisfaction and organizational turnover. To reduce perceived burnout and increase nurse retention at the ambulatory COVID-19 clinics, nurses completed a pilot program that integrated two mental health tools.

Intervention: Nurses responded to a pre-survey to identify burnout factors and measure perceived burnout, using a modification of the …


Surgical Site Infections: Reducing Excessive Foot Traffic In The Surgical Room To Minimize The Risk Of Surgical Site Infections, Christopher D. Pobre May 2022

Surgical Site Infections: Reducing Excessive Foot Traffic In The Surgical Room To Minimize The Risk Of Surgical Site Infections, Christopher D. Pobre

Master's Projects and Capstones

Problem: In 2021, a perioperative unit experienced 21 different surgical site infections (SSIs). SSIs are associated with increased medical complications and financial costs. One risk factor for SSIs is the increased or excessive operating room (OR) foot traffic, which increases airborne contaminants within the OR.

Context: A seven-room operating department performing 5,800 surgical procedures annually. The unit specializes in general, elective, and emergent procedures for the adult population predominately in the East Bay Area. A diverse mix of surgical procedures was observed throughout this project.

Assessment: A microsystem assessment was conducted to determine the causes and patterns that lead to …


Stop The Bleed And Seize Control: The Use Of Simulation In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage: A Quality Improvement Project, Raquel Andreina Torres May 2022

Stop The Bleed And Seize Control: The Use Of Simulation In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage: A Quality Improvement Project, Raquel Andreina Torres

Master's Projects and Capstones

A quality improvement (QI) initiative was geared to assess and prepare Emergency Department (ED) nurses and clinical staff preparedness of pre-eclampsia and postpartum hemorrhage (PPH). The Non-Profit Hospital, with two different Emergency Room locations, currently does not have a Labor and Delivery (L&D) unit at one of their campuses. Additionally, there is no current policy or procedure set in place for the treatment of preeclamptic or postpartum women in the emergency room. As a direct result of The Joint Commission (TJC) standards and a very short timeline, a group of University of San Francisco Clinical Nurse Leader (CNL) graduate students …


Implementing Aidet And Commit To Sit To Increase Patient Satisfaction In The Pediatric Outpatient Setting, Tiffany Nguyen May 2022

Implementing Aidet And Commit To Sit To Increase Patient Satisfaction In The Pediatric Outpatient Setting, Tiffany Nguyen

Master's Projects and Capstones

Problem: This quality improvement initiative aims to implement AIDET, Commit to Sit, and culturally competent care in a pediatric outpatient surgery clinic to increase patient satisfaction. The microsystem falls beneath the 85th percentile of patient satisfaction scores on their unit. They have a pre-intervention Net Promoter Score (NPS) of 80.7, indicating about 80% of patients were "promoters" and would likely return to the clinic, and 20% of patients were "detractors" and unlikely to return (Appendix F). "Detractors" were found in areas including patients trusting providers with care, care providers listening, care providers explaining things, and patients recommending the facility to …


Using Group Interviews To Innovate The Selection Process For New Graduate Nurses, Karen T. Descent May 2022

Using Group Interviews To Innovate The Selection Process For New Graduate Nurses, Karen T. Descent

DNP Qualifying Manuscripts

A pilot program in two hospitals using a group interview approach for new graduate nurse selection enabled multidisciplinary leadership participation. The interview process incorporated structured behavioral and scenario-based questions. The pilot shortened the traditional one-to-one interview process by 70% and improved retention one year from hire by 17.5%.


A Two-Step Approach To Increase Breastfeeding Adherence In Mothers With Preterm Infants, Jessica J. Glinski May 2022

A Two-Step Approach To Increase Breastfeeding Adherence In Mothers With Preterm Infants, Jessica J. Glinski

Evidence-Based Practice Project Reports

Breastfeeding provides multiple benefits for mothers and infants. An overwhelming amount of evidence indicates that breastmilk optimizes infant growth and develops the immune system (Yu et al., 2018). Apart from the health benefits for infants, the immediate effects of breastfeeding for mothers include a decreased risk for hemorrhage, stress, and postpartum depression (Flemming, 2021). A mother’s psychological state impacts lactation success, mainly by affecting milk ejection (Dabas et al., 2019). Despite evidence suggesting that relaxation techniques are beneficial for all human beings, it is one of the least commonly used approaches for postpartum mothers (Joseph et al., 2019). The PICOT …


Deconstructing Tiktok Videos On Mental Health: Cross-Sectional, Descriptive Content Analysis, Corey H. Basch, Lorie Donelle Phd, Rn, Fcan, Joseph Fera, Christie Jaime May 2022

Deconstructing Tiktok Videos On Mental Health: Cross-Sectional, Descriptive Content Analysis, Corey H. Basch, Lorie Donelle Phd, Rn, Fcan, Joseph Fera, Christie Jaime

Publications

BACKGROUND: Social media platforms that are based on the creation of visual media, such as TikTok, are increasingly popular with adolescents. Online social media networks provide valuable opportunities to connect with each other to share experiences and strategies for health and wellness. OBJECTIVE: The aim of this study was to describe the content of the hashtag #mentalhealth on TikTok. METHODS: This cross-sectional, descriptive content analysis study included 100 videos with the hashtag #mentalhealth on TikTok. All videos that included the hashtag #mentalhealth were analyzed and coded for the presence of content categories. Additionally, the comments to each video were viewed …


Increasing Vaccination Rates In The Latin X Communities Through A Public Health Initiative For Increasing Education And Vaccination, Gabriela Carrico May 2022

Increasing Vaccination Rates In The Latin X Communities Through A Public Health Initiative For Increasing Education And Vaccination, Gabriela Carrico

Doctor of Nursing Practice (DNP) Projects

Background: The COVID-19 disease has been found to cause an estimated 570,003 deaths in the United States (Centers for Disease Control and Prevention [CDC], 2021). Statistics showed that the elderly, immunocompromised, and vulnerable populations are the most at risk for this disease. Vaccination is an important aspect of disease prevention in healthcare issues around the world. Vaccination against the COVID-19 prevents this communicable disease from the spread and serious adverse health outcomes.

Problem: The Latin X communities in the Tenderloin District in San Francisco city are confronted with multiple factors that affect their willingness to receive the COVID-19 vaccine. Factors …


Highly Efficient Loading Program For En Route (Helper) App, Melissa A. Wilson, Kaya N. Brown, Brittany L. Fouts May 2022

Highly Efficient Loading Program For En Route (Helper) App, Melissa A. Wilson, Kaya N. Brown, Brittany L. Fouts

Nursing Faculty Publications

Various embodiments of the disclosed subject matter provide systems, methods, architectures, mechanisms, apparatus and/or computer implemented method configured for automatically managing En Route Care (ERC) transport patient and medical equipment loading


Implementation Of A Primary Care Toolkit To Improve Dementia Diagnosis And Management In A Rural Setting, Meredith George-Wieland May 2022

Implementation Of A Primary Care Toolkit To Improve Dementia Diagnosis And Management In A Rural Setting, Meredith George-Wieland

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: There are six million people with dementia living in the United States and this number is expected to rise exponentially due to the aging population. In the United States, it is estimated that only two thirds of dementia cases are recorded during primary care visits and an estimated, one third of cases have been either missed or disregarded.

LOCAL PROBLEM: In a remote primary care clinic on Kodiak Island, off the southeastern coast of Alaska, there is a lack of dementia and related cognitive diagnoses in the primary care setting due to patients’ and families lack access to the …


A Competence-Based Online Learning Video And In-Situ Simulation To Improve Perioperative Anesthesia Nurse Practitioner Self-Efficacy In Responding To Anesthesia Emergencies, Sara Durgerian May 2022

A Competence-Based Online Learning Video And In-Situ Simulation To Improve Perioperative Anesthesia Nurse Practitioner Self-Efficacy In Responding To Anesthesia Emergencies, Sara Durgerian

Doctor of Nursing Practice Scholarly Projects

Background: Nurse Practitioners (NPs) are broadly educated to the population-based role in which they practice. Further education in subspecialties is essential as more NPs are working autonomously in highly specialized care areas.

Problem: In the Department of Anesthesia at a large urban hospital, perioperative anesthesia NPs lack formal training in the subspecialty of anesthesia, which contributed to a lack of self-efficacy when responding to anesthesia emergencies.

Methods: An asynchronous multimodal brief instructional video accompanied by an in-situ simulation of an anesthesia emergency was developed to increase knowledge and confidence in perioperative anesthesia nurse practitioner response to anesthesia emergencies.

Results: A …


Mentorship In Retail Health - A Quality Improvement Project Initiative, Judith Thigpen May 2022

Mentorship In Retail Health - A Quality Improvement Project Initiative, Judith Thigpen

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Nurse practitioners (NPs) practicing in retail health face issues that complicate provision of care including isolation, lack of support staff, and non-clinical administrative and business duties. To address this, a national retail health company implemented a mentorship program for newly graduated, newly hired NPs. This quality improvement project will facilitate the implementation and evaluation of this mentorship program in one of the company’s regions in Georgia.

AVAILABLE KNOWLEDGE: Literature suggests that NPs believe that a mentor can help contribute to professional development, counter stress and anxiety, provide support, increase job satisfaction, and guide in critical decision making.

AIMS: 1. …


Revision And Deployment Of An Oral Anticancer Medication Adherence Toolkit, Kristine Lefebvre May 2022

Revision And Deployment Of An Oral Anticancer Medication Adherence Toolkit, Kristine Lefebvre

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Oral anticancer medications offer state-of-the-art cancer treatment with the convenience and autonomy of self-care in the home. Professional organizations often provide expert guidance and resources to support the provision of high quality, safe, evidence-based care. LOCAL PROBLEM: Many institutions lack a formal oral anticancer medication program, including a process to assess and monitor adherence. Nurses and their colleagues look to the literature, training, collaboration with colleagues, and through practice tools and programs available through their specialty associations for support in their adherence work. The Oral Adherence Toolkit released in 2016 needed updating to reflect current best practices. METHODS: The …


Acute Kidney Injury: Evaluating Risk Factors In Hematopoietic Stem Cell Transplant Patients, Jennifer Tenley, Pamela Millin, Austyn Franklin May 2022

Acute Kidney Injury: Evaluating Risk Factors In Hematopoietic Stem Cell Transplant Patients, Jennifer Tenley, Pamela Millin, Austyn Franklin

Nursing Masters Papers

Hematopoietic stem cell transplant (HSCT) patients are at risk to develop acute kidney injury during the transplant process. Acute kidney injury (AKI) can occur due to a multitude of insults related to nephrotoxic medications, hypoperfusion, and dehydration. Additionally, patients who present for HSCT may have risk factors that could pose an increased risk of developing AKI which include chronic kidney disease, hematologic disease, type of transplant, conditioning chemotherapy, and poor pretransplant renal testing. The purpose of this secondary analysis was to identify the contributing factors that may influence the development of AKI, understand the relationships between the variables, and identify …


Utilization Of The Nurse Practitioner Skillset In Partnership With The Medical Device Industry, Daniel C. Rowland May 2022

Utilization Of The Nurse Practitioner Skillset In Partnership With The Medical Device Industry, Daniel C. Rowland

Doctor of Nursing Practice (DNP) Projects

BACKGROUND: Millions of nurse practitioners (NP), physician assistants (PA), and registered nurses (RN) are optimistic that their current employers will help them reach their full potential. One area that can add value to the hospital and empower employees to work to the full scope of their practice, and utilize the skillsets like that of an NP, is to train these providers to support medical device equipment in the operating room instead of relying on medical device representatives (MDRs) of medical device companies.

METHODS: Training NPs, PAs, or RNs how to support neurological medical device equipment will better utilize the skillset …


Assessing Provider Confidence Of Acute Otitis Media Diagnosis And Treatment With An Optical Coherence Tomography Device In The Urgent Care Setting, Meghan Weber, Susan Wolf May 2022

Assessing Provider Confidence Of Acute Otitis Media Diagnosis And Treatment With An Optical Coherence Tomography Device In The Urgent Care Setting, Meghan Weber, Susan Wolf

Doctor of Nursing Practice Projects

Acute otitis media (AOM) is one of the most common causes of pediatric infection worldwide at approximately 350 million visits per year, as well as one of the most challenging illnesses to diagnose for providers (Tong et al., 2018). This dilemma leads to antibiotics being inappropriately prescribed, at a rate of approximately 75% (Islam & Hassinger, 2018). This project sought to explore the impact of implementing an optical coherence tomography (OCT) device in an urgent care setting when assessing otalgia in patients 0 to 17 years of age. The three main objectives of the project were to increase provider confidence …


When Helping Becomes Hurting: Compassion Fatigue In Pediatric Nurses, Annabelle Nagy May 2022

When Helping Becomes Hurting: Compassion Fatigue In Pediatric Nurses, Annabelle Nagy

Undergraduate Theses and Capstone Projects

Compassion fatigue is prevalent in all nursing settings; however, it is particularly important to consider in pediatric nursing because of the unique aspects of this nursing speciality. Compassion fatigue, comprised of burnout and secondary traumatic stress, is a risk to pediatric patients due to the nurse’s inability to care adequately secondary to the overwhelming feelings of physical and mental exhaustion contributing to nursing attrition and inadequate nurse-to-patient ratios. This thesis applies Jean Watson’s Theory of Human Caring to study the problem of compassion fatigue in pediatric nursing. Compassion fatigue must be recognized and managed, and the necessary interventions employed to …


Humanizing The Intensive Care Unit With Animal-Assisted Therapy, Amanda Pugh May 2022

Humanizing The Intensive Care Unit With Animal-Assisted Therapy, Amanda Pugh

Undergraduate Theses and Capstone Projects

This project serves as an exploration into the current research about animal-assisted therapy in the intensive care unit (ICU) population. Incorporating more holistic treatments into the healthcare field improves patient experiences and encourages patients to have an active role in their recovery journeys. Treating both the physical and emotional needs of patients is valuable to nurses because it helps them to better view patients with unique human dignity, improve the quality of care they perform, and make the healthcare system more centered around the patient as a whole. Patients in intensive care units are more susceptible to developing health complications …


Factors Influencing Vaccination Rates In Children Under Two In Southeast Kansas, Danielle Bennett May 2022

Factors Influencing Vaccination Rates In Children Under Two In Southeast Kansas, Danielle Bennett

Doctor of Nursing Practice Scholarly Project

Introduction

A large Federally Qualified Health Center (FQHC) in Southeast Kansas has a 37% compliance of children completing the recommended combo 10 primary vaccination series before their second birthday. An additional 20% of children would be compliant if the flu vaccine was excluded, raising the compliance rate to 57%. This is still below the national average of 68-75%, leaving many children in Southeast Kansas and northeast Oklahoma unprotected from preventable childhood diseases.

Purpose

The purpose of this scholarly project was to identify barriers to vaccination, including vaccine hesitancy and socioeconomic barriers affecting completion of the primary vaccine series, or combo …


Improving Family Involvement Through Dementia Education Using A Video Sharing Service, Marissa Lynn Bernabe May 2022

Improving Family Involvement Through Dementia Education Using A Video Sharing Service, Marissa Lynn Bernabe

Doctor of Nursing Practice Scholarly Project

Dementia is a growing issue among healthcare organizations within the United States (U.S.) with approximately 5.7 million individuals diagnosed. These numbers of affected individuals are expected to increase and reach approximately 152 million by 2050 globally. Dementia is a progressive disease of cognitive loss. Establishing goals or items the patient can perform can have a positive impact on patient care by allowing for a collaborative approach and initiating the family as necessary participants in the care of the dementia patient. Video sharing services such as YouTube have made learning easily accessible for a multitude of varied reasons.

A descriptive quality …


Genetics And Genomics In Nursing Practice: Assessing Barriers, Facilitators, And Tailoring Implementation Strategies, Jaanna Guillory May 2022

Genetics And Genomics In Nursing Practice: Assessing Barriers, Facilitators, And Tailoring Implementation Strategies, Jaanna Guillory

Doctor of Nursing Practice Scholarly Project

The Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics were published in 2006. These guidelines define the minimal competency in genetics expected of all nurses regardless of role, specialty, or level of education. However, research indicates that nurses lack knowledge and confidence in their role in genetics/genomics.

This quality improvement project aimed to assess barriers and facilitators of genetics/genomics integration into nursing. This study followed a cross-sectional design emphasizing a representative subset of the nursing practicing community at the Veterans Healthcare System of the Ozarks. Participants were invited to complete the Genetics and Genomics in Nursing Practice Survey …


Improving Palliative Care Education In The Acute Hospital Setting, Maria Klug May 2022

Improving Palliative Care Education In The Acute Hospital Setting, Maria Klug

Doctor of Nursing Practice Scholarly Project

As the geriatric population grows rapidly, the importance of utilizing and understanding palliative services continues to rise. Although palliative and hospice care are included in different healthcare courses, misconceptions and lack of knowledge continue to serve as barriers to the utilization of palliative care. The purpose was to assess knowledge, improve palliative care education, and increase understanding of the perspectives of the interdisciplinary team involved in acute patient care. The setting was the telemetry unit in a 300-bed acute care Kansas hospital. A mixed design was utilized with a goal of quality improvement in the use of palliative care. The …


Provider Education On Physical Activity For Older Adults, Joseph Morris May 2022

Provider Education On Physical Activity For Older Adults, Joseph Morris

Doctor of Nursing Practice Scholarly Project

PROVIDER EDUCATION ON PHYSICAL ACTIVITY FOR OLDER ADULTS

An Abstract of the Scholarly Project by

Joseph Morris

The purpose of this study was to educate nursing staff and providers on the importance of physical activity for older adults to prevent functional decline and maintain quality of life. The project was conducted online using Qualtrics survey software. Data was collected from October 25, 2021 to November 25, 2021. Nursing staff and healthcare providers (physicians, nurse practitioners and physician assistants) that are actively practicing medicine and have experience interacting with older adults participated by completing a two-part survey. The survey consisted of …


An Educational Project On Guidelines Of Treating Respiratory Syncytial Virus And Bronchiolitis In Rural Pediatric Patients, Mallory Revell May 2022

An Educational Project On Guidelines Of Treating Respiratory Syncytial Virus And Bronchiolitis In Rural Pediatric Patients, Mallory Revell

Doctor of Nursing Practice Scholarly Project

Bronchiolitis is the leading cause of hospital admission for infants. Eighty percent of bronchiolitis cases are caused by the respiratory syncytial virus (RSV). While guidelines on the treatment of RSV/bronchiolitis have been published since 2006, the literature reveals that they are not widely followed. After completing a literature review on the current evidence-based treatment guidelines of RSV/bronchiolitis, nurses from a rural hospital in southeast Kansas were educated on these guidelines to improve their knowledge regarding treatments for RSV/bronchiolitis pediatric patients. This study utilized a pretest-posttest design to determine the knowledge gained after the educational presentation. The nurses completed a survey …


Improving Venous Thromboembolism Prophylaxis Knowledge Among Registered Nurses On A Medical-Surgical Inpatient Unit In The Midwest, Theresa Umscheid May 2022

Improving Venous Thromboembolism Prophylaxis Knowledge Among Registered Nurses On A Medical-Surgical Inpatient Unit In The Midwest, Theresa Umscheid

Doctor of Nursing Practice Scholarly Project

Venous thromboembolism (VTE) is the third most common vascular disease and includes approximately 900,000 cases annually in the United States. The purpose of this quality improvement project was to enhance education regarding VTE prophylaxis for registered nurses on a medical-surgical inpatient unit at a hospital in the Midwest. This study was initiated due to one nurse’s perception that staff on this unit lacked confidence and expertise on the importance of VTE prophylaxis interventions. Participants completed a VTE knowledge pretest, followed by an educational intervention on VTE prophylaxis utilizing Health Stream. After the intervention, participants completed a VTE knowledge post-test. The …


Reducing The Stigma Associated With Maternal Substance Use Disorder In A Rural Midwest Hospital And Clinic, Jami Vineyard May 2022

Reducing The Stigma Associated With Maternal Substance Use Disorder In A Rural Midwest Hospital And Clinic, Jami Vineyard

Doctor of Nursing Practice Scholarly Project

The purpose of this study was to determine if an educational resource provided to maternal healthcare providers, more specifically, providers in a Midwest regional hospital and clinic, would reduce the stigma associated with maternal substance use disorder (SUD). This project also aimed at increasing provider knowledge on the disease process of maternal SUD and current treatment guidelines.

A quantitative research design was used for this study. There was no control group; therefore, it is a quasi-experimental study. Qualtrics were utilized to design a pre-test and post-test. An email including a brief description of the study, an invitation to participate, and …


Provider Education On Non-Pharmacologic Treatment Of Osteoarthritis, Brandi P. Whetzell May 2022

Provider Education On Non-Pharmacologic Treatment Of Osteoarthritis, Brandi P. Whetzell

Doctor of Nursing Practice Scholarly Project

Osteoarthritis is an arthritic condition of the joints commonly found in the elderly population. This condition occurs as intra-articular cartilage wears down over time. Most patients present with joint pain. The pain that occurs from joint pain often impedes physical activity, which can ultimately increase pain levels. There are several treatments for osteoarthritis, however, there is no cure. Providers often prescribe non-steroidal anti-inflammatories and other oral analgesics for pain management. Because osteoarthritis typically occurs in the elderly population, adding medications to what often is a long list of medications can cause issues such as drug interactions and medication toxicities. Other …


Pregnancy Education In Rural Areas, Kayla Tinsley May 2022

Pregnancy Education In Rural Areas, Kayla Tinsley

Doctor of Nursing Practice Scholarly Project

Educating of the pregnancy population before, during and after pregnancy can help to ensure a healthy pregnancy and in turn reduce maternal mortality. The purpose of this research project was to understand education provided in the clinic and hospital setting in a rural area by those who take care of and talk to pregnant women and their support persons. A descriptive research design was utilized to discover the important education topics that are discussed, and the routine tests that are done throughout the pregnancy, during labor and at delivery, and even ask how prepared they feel they are equipped to …