Nursing Commons^™

Methodology For Sampling Women At High Maternal Risk In Administrative Data, Jennifer Vanderlaan, Anne Dunlop, Roger Rochat, Bryan Williams, Susan E. Shapiro

Nursing Faculty Research

Background: In population level studies, the conventional practice of categorizing women into low and high maternal risk samples relies upon ascertaining the presence of various comorbid conditions in administrative data. Two problems with the conventional method include variability in the recommended comorbidities to consider and inability to distinguish between maternal and fetal risks. High maternal risk sample selection may be improved by using the Obstetric Comorbidity Index (OCI), a system of risk scoring based on weighting comorbidities associated with maternal end organ damage. The purpose of this study was to compare the net benefit of using OCI risk scoring vs …

Centeringpregnancy: Perceptions Of Providers And Staff In A Private Ob Practice, Allison F. Mills

Doctoral Dissertations and Projects

Traditional prenatal care has been the stalwart of care in the United States since the 1920s; however, a new model of care is emerging: group-style prenatal care. This model of care has been well-documented within literature as having notable maternal and fetal outcomes, including increased patient satisfaction, decreased preterm birth rates, increased breastfeeding rates, and increased patient compliance, to name only a few. With such remarkable outcomes, it begs the question of why the group prenatal care model is not more widely utilized. This project aimed to determine if increasing the knowledge of healthcare providers in a private obstetrics practice …

Adolescent Pregnancy: A Clinical Guideline For School Nurses In New Mexico, Karin Ludi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall purpose of this project is to ensure that school nurses and health assistants are knowledgeable and have the resources to care for pregnant adolescents in the public school system. New Mexico has consistently ranked in the top 10 in the United States for teen births to women aged 15-19 years. The New Mexico School Health Manual is currently used to guide school nurses and health assistants in the care of pregnant adolescents, but it is vague and addresses emergencies such as labor and bleeding.

From this author’s experience as a school nurse in the public school system, it …

Preeclampsia, Melissa Mcguire

Nursing Student Class Projects (Formerly MSN)

Abstract

Preeclampsia is a complication of pregnancy that if left untreated could result in maternal and/or fetal death. Preeclampsia is a pregnancy specific disorder that can affect many different body systems. That pathophysiology of preeclampsia is not completely known, but alterations in placentation are thought to cause the disorder. Signs and symptoms of preeclampsia include: elevated blood pressure, blurred or double vision, epigastric pain, severe headache, proteinuria, thrombocytopenia, kidney failure, and liver failure. Preeclampsia with severe features can lead to the development of HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), disseminated intravascular coagulation, and eclampsia. The only cure for …

Improving Maternal Outcomes Through Labetalol Algorithm Utilization For Hypertensive Disorders Of Pregnancy, Hailee B. Taylor

Dissertations

Hypertensive disorders of pregnancy can have negative effects on both mothers and neonates and are a major contributor to the increasing morbidity and mortality affecting women pregnant women in the United States. Treatment algorithms are available for treatment of hypertensive disorders of pregnancy when treatment criteria are met. With proper use of these algorithms, healthcare personnel can decrease the mortality and morbidity rates, which will increase patient safety and decrease healthcare spending. This research project focused on implementing The American College of Obstetricians and Gynecologists’ (ACOG) Labetalol treatment algorithm to treat patients diagnosed with severe preeclampsia. Prior to implementation, data …

Spousal Factors Associated With Antenatal Psychosocial Stress: A Case Control Study, Asha K. V Ms

Manipal Journal of Nursing and Health Sciences

Stress during pregnancy affects both mother and foetus resulting in unfavourable pregnancy outcomes. Studies regarding the factors linked with increased stress during pregnancy aids to improve the mental status of the mother during gestation and can lead to a reduction in negative pregnancy outcomes. The objective of the study was to identify spousal factors associated with antenatal psychosocial stress among pregnant women seeking prenatal care from a teaching hospital at the Thiruvananthapuram district of Kerala. Methods: Case control design was used for the study. The tools used for data collection were the Antenatal Psychosocial Stress scale (APSS) and a semi-structured …

“I Am A Runner”: A Qualitative Analysis Of Women-Runners’ Pregnancy Experiences, Jennifer M. Ohlendorf, Anna L. Anklam, Lindsay Gardner

College of Nursing Faculty Research and Publications

Background

Women runners are a group with potential for health maintenance and health promotion in pregnancy. When providers counsel women to discontinue or cut back on running without cause, an opportunity for health benefits to both woman and baby may be lost.

Aim

This study aims to explicate the experience women runners have in pregnancy to further providers’ understanding of this population’s unique needs.

Methods

An online, qualitative inquiry was employed to explore the experiences of an online community of women runners in pregnancy (N = 22). The Doing Pregnancy framework provided guidance for final stages of the analysis.

Findings …

Labor Management Protocol For Parturients On Buprenorphine, Erik Sanders

Doctor of Nursing Practice Projects

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Opioid dependence during pregnancy may lead to negative outcomes for both the parturient and the fetus. Opioid dependent parturients are often prescribed buprenorphine, a form of medication- assisted therapy. The use of buprenorphine within the parturient population is a relatively new practice and anesthesia providers are encountering difficulties in managing this population during the peripartum period. Literature has demonstrated anesthesia providers may best serve this population by utilizing a multimodal approach when providing analgesia (Jones et al., 2008; Meyer et al., 2010; Reddy et al., 2017). A combination of oral, intravenous and neuraxial modalities, in conjunction with the daily …

Associations Of First Trimester Co-Use Of Tobacco And Cannabis With Prenatal Immune Response And Psychosocial Well-Being, Kristin Ashford, Amanda Fallin-Bennett, Andrea Mccubbin, Amanda T. Wiggins, Sheila Barnhart, Joshua A. Lile

Perinatal Research and Wellness Center Faculty Publications

PURPOSE: This study aims to describe the association of first trimester co-use of tobacco and cannabis with maternal immune response and psychosocial well-being, relative to tobacco use only.

METHODS: A preliminary midpoint analysis included 138 pregnant women with biologically verified tobacco use, 38 of whom (28%) also tested positive for recent cannabis use. Maternal perceived stress (Perceived Stress Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and serum immune markers (IL-1β, IL-2, IL-6, IL-8, IL-10, TNFα, CRP, MMP8), were collected, although cytokine data were only available for 122 women.

RESULTS: Participant average age was 29.1 years, approximately half had a high …

A Practical Understanding Of Preeclampsia For A Nurse In A Third World Setting, Anna Lovin

Senior Honors Theses

Preeclampsia is a disease of pregnancy that affects approximately 3-5% of women with child. It is one of the primary causes of mortality in mothers and babies across the globe. The exact cause, pathogenesis, or disease progression is unknown. Therefore, there is no definition of which patients are at risk for developing preeclampsia and what can work as a preventative measure. In high socioeconomic settings where there is good healthcare, standard treatment is established to manage the symptoms and decrease the progression of preeclampsia to eclampsia. However, in more rural, third-world settings of developing countries, caring for patients with preeclampsia …

Psychometric Development Of The Patient Engagement In Prenatal Care Scale, Phyllis M. Dyess-Nugent

Nursing Theses and Dissertations

The value of prenatal care in improving maternal and neonatal outcomes has been evident in research for many years, and yet in the U.S. where prenatal care is widely accessible to women, maternal and neonatal morbidity and mortality remain higher than many developing countries (CDC, 2019). Attributes of prenatal care have been studied, such as the number of visits and timing of entry into care. Additional aspects of prenatal care deserve exploration in order to make improvements in this established, valuable intervention. A woman’s engagement in her care during pregnancy has not been previously measured. The focus of this dissertation …

Screening For Depression During The Early Perinatal Period, Loretta Ann Donnelly-Moreno

Walden Dissertations and Doctoral Studies

The clinical practice guideline (CPG) is the implementation of a depression screening tool to be used in the early perinatal period. The practice change occurred in a rural Obstetrical and Gynecological (OBGYN) practice in the southern United States. The CPG change has been guided by recommendations from both the American Congress of Obstetrics and Gynecology and the American College of Nurse Midwives. Implementation of this CPG change addresses the gap in practice of not doing depression screening during the perinatal period, and only screening during the postpartum period, which was being done at the OBGYN office. Theorist Lewin’s ‘change theory’ …

Improving Interdepartmental Care Collaboration For Pregnant Patients, Michelle Anne Ott

Walden Dissertations and Doctoral Studies

Communication is vital to improve patient care outcomes, especially with high acuity patients. Pregnant patients differ from other patient populations because their care involves 2 entities: the patient (mother-to-be) and her unborn fetus. There has been a noted gap in communication and care collaboration between the emergency department (ED) and obstetric (OB) teams at the project site, resulting in delays for patients and lack of appropriate maternal/fetal assessment and contributing negatively to patients' experiences. Using transitions theory and the Rosswurm and Larrabee model, a clinical practice guideline (CPG) inclusive of an obstetrically focused algorithm was developed and presented for use …

Use Of Antipsychotic And Mood Stabilizing Medication In Pregnancy, Elizabeth Ann Murphy

Nursing Capstones

No abstract provided.

Prevalence And Risk Factors For Fear Of Birth In Pregnant Women In The United States, Whitney Gray Mildren

Nursing Dissertations - Archive

Fear of birth is an extreme state of anxiety from phobia about childbirth. It causes severe distress and anxiety. Women experiencing this distress may decide to avoid pregnancy, terminate pregnancy, or elect cesarean delivery without medical necessity. Prevalence of fear of birth in the United States has been reported in only three studies and has ranged from 27% to 52%, but the populations studied were healthy, college-aged, women who were not pregnant and were nulliparous. In other countries, the average prevalence rate of fear of birth in nulliparous and multiparous women at various points during pregnancy was 23%. Researchers from …

Increasing Use Of A Tobacco Cessation Quitline In A Rural Prenatal Population, Rachel T. Schleenbaker

Master's Projects

This paper addresses prenatal smoking rates within in a rural northern Michigan district health department (HD) through a Master of Science in Nursing (MSN) quality improvement project. The paper provides a detailed microsystem assessment of the Maternal Infant Health Program (MIHP) at the district HD describing the clinical problem and identifying a practice gap in care of prenatal smokers. The literature review describes the three most effective prenatal smoking cessation interventions: counseling, incentives, and feedback. The literature review also addresses the effectiveness of and barriers to smoking quitlines. The clinical protocol followed the Model for Improvement framework with the completion …

Optimizing The Involvement Of Women With Opioid Use Disorder In The Care Of Their Infants Experiencing Neonatal Abstinence Syndrome, Rebecca Boedeker

Dissertations

The incidence of opioid use disorder (OUD) has grown to epidemic proportions. Infants exposed to opioids inutero are likely to experience withdrawal symptoms during the hours and days immediately following birth, known as Neonatal Abstinence Syndrome (NAS). Research indicates maximizing non-pharmacologic, supportive management decreases Neonatal Intensive Care Unit (NICU) admissions, the length of stay, and the severity of NAS. The purpose of this project is to evaluate the effects of an antepartum consult designed to prepare mothers with OUD to participate in this nonpharmacologic care. The Women and Infants Substance Help (WISH) Center delivers prenatal care for women with OUD. …

Anesthetic Considerations For The Parturient With Idiopathic Intracranial Hypertension, Levi G. La Porte

Nursing Capstones

No abstract provided.

Anesthetic Considerations For The Parturient With Immune Thrombocytopenic Purpura, Leah A. Davis

Nursing Capstones

No abstract provided.

Group B Streptococcus In Pregnancy, Lindsay Doyle

Nursing Student Class Projects (Formerly MSN)

Group B Streptococcus (GBS) is the ‘leading infectious cause of neonatal morbidity and mortality in the United States” (Colicchia, Lauderdale, Du, Adams, & Hirsch, 2015, p. 173). GBS is a bacterium present in the vagina and/or anorectal flora of women and is considered to be normal flora which generally does not cause infection, however, if a pregnant woman is GBS positive and left untreated during birth, the newborn passing through the birth canal is at risk for becoming colonized (Bicheno & Geraghty, 2015, p. 224). Infants exposed to GBS may develop sepsis, pneumonia, and meningitis within the first week after …

Influence Of Contraception Use On The Reproductive Health Of Adolescents And Young Adults, Richard J. Fehring, Thomas Bouchard, Maria Meyers

College of Nursing Faculty Research and Publications

Oral contraceptives (OCs) are often prescribed to adolescents and young adults for the treatment of health problems and to avoid unwanted pregnancies. We hypothesized that the use of OCs, among adolescents and young adults, is associated with a greater likelihood of pregnancy, abortion, sexually transmitted diseases (STDs), pelvic inflammatory disease (PID), and sexual behaviors that will enhance those problems (i.e., earlier sexual debut and more sexual partners) than adolescents and young adults not using OCs. To test this hypothesis, data from 1,365 adolescents and young adults in the 2011–2013 National Survey of Family Growth (NSFG) were used to describe the …

Perceptions Of Chinese Women Coming To The United States To Give Birth: Birth Tourism, Juanita Childs Jaramillo

Doctoral Projects

Birth experiences and perceptions vary greatly among different cultures. There has been an increase in Chinese women who specifically come to the United States (US) to give birth to their child and return back to their native country after being cleared at the postpartum checkup. This practice is known as birth tourism. The aim of this study is to explore the perceptions of childbirth and postpartum experiences among Chinese birth tourists. Twelve women self-identifying as Chinese, between the ages of twenty-four and thirty-eight, who came to the US to give birth to their child, and who were able to read …

Comparison Of Serum And Cervical Cytokine Levels Throughout Pregnancy Between Preterm And Term Births, Kristin Ashford, Niraj R. Chavan, Amanda T. Wiggins, Molly Malany Sayre, Andrea Mccubbin, Agatha S. Critchfield, John O'Brien

Nursing Faculty Publications

Objective To assess differences in cytokine levels in cervicovaginal fluid (CVF) and serum across trimesters between women with preterm births (PTBs) and full-term births.

Study Design This multicenter study enrolled 302 women with a singleton gestation. CVF and serum cytokines, interleukin 1α (IL-1α), IL-1β, IL-6, IL-8, IL-10, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and matrix metalloproteinase (MMP)-8, were measured. Women with at least one cytokine assessment and noted PTB status in their medical record were retained in the study (N = 272). Data were analyzed using mixed modeling (main effects of PTBs and time/trimester).

Results For the CVF …

Jam – Winter 2018, Edwin Van Teijlingen, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Pregnant Women's Knowledge About Fetal Movement Count, Jade Hanna Bowen

Honors Undergraduate Theses

BACKGROUND: Fetal movement count (FMC) is a non-invasive tool used to evaluate fetal well-being and prevent stillbirth. FMC decrease the chances of stillbirth occurrence (Tveit et al., 2009), but in other countries, research shows that women are not taught about the benefits of FMC (Berndl, O'Connel, & Mcload, 2013). The purposes of this study were to discover 1) the knowledge of pregnant women in their third trimester about FMC and 2) sources through which women learn about FMC.

METHODOLOGY: The study is a quantitative descriptive design. An original survey consisting of 12 questions was created for the study. Inclusion criteria …

Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing

Walden Dissertations and Doctoral Studies

Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In …

The Effect Of Breastfeeding And Rooming-In Care On Neonatal Abstinence Syndrome, Rachel Boyer, Lindsay Gal, Mahaylie Cline

Williams Honors College, Honors Research Projects

Concurrent with a rise in opioid abuse during pregnancy is an increase in the number of babies born with Neonatal Abstinence Syndrome (NAS). Despite this crisis, no single treatment has been identified for NAS. This paper sought to analyze and synthesize research evaluating the effectiveness of breastfeeding and rooming-in care on the need and length of pharmacologic treatment and length of hospital stay for neonates with NAS. Twenty-six peer reviewed research articles published between 2006 and 2017 were selected from PubMed and CINAHL for analysis. The studies focused on neonates with NAS born to mothers addicted to opioids or undergoing …

Intimate Partner Violence And Its Impact On Pregnant Women And Their Infants: A Systematic Review, Rachel Ashley, Emily Pagni, Alissarh Choujaa

Williams Honors College, Honors Research Projects

Abstract

In the United States, about 324,000 pregnant women are victims of Intimate Partner Violence (IPV) annually. IPV is any type of physical, sexual, or emotional abuse of women or men in family units. IPV has detrimental effects on pregnant women and their babies, from their physical health to their mental health. It is important for nurses and other healthcare providers to have knowledge and understanding about IPV in this population and to use effective interventions and screening procedures. The purpose of this systematic review is to review and critically analyze evidence about IPV in pregnant women. The literature search …

Child Sexual Abuse And Prenatal Care: Understanding Screening, Modifications, And Proper Care, Wendy Abbott-Egnor

Walden Dissertations and Doctoral Studies

Research has shown that 1 in 9 women in prenatal care have a history of childhood sexual abuse. Pregnant women with a history of childhood sexual abuse are at increased risk of depression, somatization, preterm contractions, posttraumatic stress symptomology, and re-traumatization. The purpose of this study was to bridge the gap in literature between research and practice. Data was collected from practitioners regarding the care and treatment of pregnant women with a childhood sexual abuse history. It was hypothesized that screening practices and modification to care and treatment based on practitioner knowledge of prior sex abuse history will vary by …

Maternal Life Course Adversity: The Intersection Of Psychosocial And Biobehavioral Adaptive Response In Pregnancy, Crystal Modde Epstein

Theses & Dissertations

The link between life course adversity and adverse health outcomes is well established, particularly early life adversity (ELA). There is also evidence that the physiologic adaptations associated with stress, depression and ELA can be transmitted intergenerationally via long-term set-point changes within the maternal hypothalamic-pituitary-adrenal axis (HPA). It is unknown how the type and timing of maternal stress and adversity influences HPA regulation during pregnancy and whether maternal coping attenuates this relationship. Manuscript 1 was an integrative review of studies examining the association between maternal ELA and HPA regulation during pregnancy. In manuscripts 2 and 3 the findings of the dissertation …