Maternal, Child Health and Neonatal Nursing Commons^™

Skin Is In: Promoting Breastfeeding Through Immediate Cesarean Skin-To-Skin, Autumn Spencer

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and the American College of Obstetricians and Gynecologists identify immediate, uninterrupted skin-to-skin contact as a standard of care that improves neonatal stability, breastfeeding outcomes, and maternal satisfaction. Despite these recommendations, timely initiation following cesarean birth remains inconsistent. At the project site, skin-to-skin initiation averaged 72 minutes after birth, exceeding the 10-minute benchmark, and exclusive breastfeeding rates were below the national standard of 70%. Contributing barriers included workflow variability, unclear role expectations, and inconsistent communication.

Aim of the Project: The aim of the project was to improve infant and maternal …

Improving Iv Access Outcomes In Obstetric Care Through A-Diva Scale Utilization And Point-Of-Care Ultrasound, Parth S. Patel, Matthew T. Komorowski

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric (OB) patients frequently present physiological changes, including edema, obesity, and peripheral vasoconstriction, that increase the risk of difficult intravenous access (DIVA). Multiple IV attempts can delay time-sensitive therapies in obstetric emergencies and increase patient discomfort and provider workload. Research studies have supported the use of the Modified Adult Difficult Intravenous Access (A-DIVA) scale to assess patients for DIVA, and the use of point-of-care ultrasound (POCUS) guided peripheral intravenous access (PIVA). In 2025, a preceding Doctor of Nurse Anesthesia Practice (DNAP) project implemented A-DIVA in the Labor & Delivery (L&D) unit of an OB department and found that 35% of …

Cesarean Births Among Non-Us Born Hispanic Women: A Qualitative Study, Linda Presson, Christopher Arzadon, Cecilia Bustamante-Pixa, Wally Mijangos, Trisha Saul

Publications 2026-present

No abstract provided.

Hypertensive Disorders Of Pregnancy, Covid And Readmission Status, Margaret Luebke, Ross Bindler, Trisha Saul, Linda Trinh

Publications 2026-present

No abstract provided.

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Prenatal Care, Pregnancy Risk, Birth Outcomes And The Role Of Neighborhood Characteristics, Monica Garcia-Perez Phd, Randy Huard Phd, Christopher Thoms Phd, David Tilstra Md

InnovateHER Meeting 2026

This study links 2024 CentraCare Health birth records with neighborhood census tract conditions from the National Neighborhood Data Archive (NaNDA, 2020/2021) to examine how place, prenatal care, and clinical risks influence birth outcomes in Central Minnesota. Neighborhood factors are standardized and paired with measures of prenatal-care adequacy and pregnancy-risk indicators in a series of multivariate linear models to explore their effect on birth outcomes. Analyses adjust for maternal demographics and clinical risks to identify independent neighborhood effects. A privacy-preserving, tract-linked dataset is also created to help local partners target high-need prevention areas.

Utilizing Remote Patient Monitoring With Dnp Students To Provide Pre-Natal Care, Sara Mccumber

InnovateHER Meeting 2026

This educational project introduced Nurse Practitioners to the use of RPM during pre-natal care for a patient with pre-natal hypertension. Hypertension is a risk factor in 16% of pregnancies and 5-8% of US births are impacted by hypertensive disorders and preeclampsia (CDC, 2023).

Identification and effective management of hypertension in pregnancy recently was an initiative of the Minnesota Perinatal Quality Collaborative (MPQC, 2022).

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Navigating The Nicu Without Words: A Case Study Of A Spanish-Speaking Mother’S Healthcare Experience, Emma Norris

Poster Presentations

Research on NICU experiences largely focuses on majority-language families; non-English-speaking families are understudied (Cleveland, 2008). The Family Integrated Care model promotes parent-infant connection and shared decision-making to improve outcomes (Wreesmann et al., 2020). Language barriers impede parent-provider communication, increasing miscommunication and parental anxiety (Kynoe et al., 2020; Ardal et al., 2011). The purpose of this research is to explore communication experiences and barriers between English-speaking and bilingual NICU nurses and a Spanish-speaking NICU mother.

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

Assessing The Impact Of Interprofessional Simulation Training On Perioperative Staff's Confidence In Managing Maternal Hemorrhage, Mallory Duncan, Lidia Vazquez

Scholars Week

Globally, maternal mortality rates remain a critical public health challenge, often related to inadequate healthcare infrastructure in low-income countries. Yet according to the American Journal of Obstetrics and Gynecology (ACOG), maternal mortality rates in the United States are also on the rise, with nearly 32.9 deaths per 100,000 live births. These deaths are largely contributed to maternal hemorrhage (PPH), defined by ACOG as cumulative blood loss of at least 1,000 mL accompanied by symptoms of hypovolemia within 24 hours of the birth process. These findings underscore an urgent need to strengthen the training for perioperative staff in the management of …

3. Skin To Skin Holding To Reduce Neonatal Hypoglycemia, Merebea Danforth

Providence Nursing Research Conference 2023 – Present

No abstract provided.

International Normative Charts For Twin Weight, Length, And Head Circumference At Birth, By Gestational Age And Sex: The Twin Neonatal Cross-Sectional Study Of The Intergrowth-21st Project, Francesca Giuliani, Sonia Deantoni, Enrico Bertino, Yasmin A. Jaffer, Manorama Purwar, Fernando C. Barros, Leila Cheikh Ismail, Wu Qingqing, Ilaria Stura, Maria Carvalho

Obstetrics and Gynaecology, East Africa

Assessing the size of twins at birth using charts developed for singletons may over diagnose small for gestational age in this sub-population. The study aimed to produce international, twin-specific, newborn size normative charts by gestational age and sex. This longitudinal observational study in eight geographically diverse settings prospectively collected data between May 2009 and August 2013 from healthy pregnant women and their newborn twins. The participants were enrolled as part of the INTERGROWTH-21st study, and recruited based on World Health Organization recommendations for evaluation of anthropometric measures. All the women met, in addition to the underlying population characteristics of low …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

Quantification Of Illicit And Prescription Drug Residues In Pasteurized Donor Human Milk: A Comprehensive Analytical Approach, Michelle Brenner, Kaytlin Krutsch, Ashlynn Baker, Dhavalkumar Patel, Palika Datta

Department of Pediatrics Faculty Publications

Objective

To assess the risk of infant exposure to illicit and prescription drug residues, from infant-ready, pooled, pasteurized donor human milk (PDHM) provided by healthy, screened, voluntary non-remunerated donors to a not-for-profit milk bank.

Study Design

A total of 150 pooled samples, representing 742 donor contributions, were analyzed for 15 illicit and prescription drug analytes using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Detected concentrations were evaluated for clinical significance.

Result

All 150 PDHM samples tested negative for residues of marijuana, amphetamines, benzodiazepines, fentanyl, hydrocodone, and morphine. Three samples (2%) contained trace amounts of oxycodone (< 0.6 parts per billion), yielding exposures over 455 times lower than established standards for infant safety (Relative Infant Dose: < 0.022%; standard safety threshold 10%).

Conclusion

Comprehensive analysis detected no clinically …

Feeding Mode Is Associated With Infant Night Sleep Trajectories During The First Postnatal Year, Magdalena Olson, Li Liu, Elizabeth Reifsnider, Dean V. Coonrod, Sarada S. Panchanathan, Megan E. Petrov, Corrie M. Whisner

Ellmer School of Nursing Faculty Publications

Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is crucial for formulating recommendations to support breastfeeding and address sleep concerns. Objective: We examined the association between feeding mode and parent-reported infant night sleep duration during the first postnatal year, while additionally evaluating night-weaning and bedsharing as contextual sleep-related practices. Methods: Infants in the Phoenix Metropolitan Area (n = 193) were followed up at 3, 8, 13, …

Intra-Amniotic Infection (Iai) Prevention, Shelbie Clement, Deanna Conley

Articles, Abstracts, and Reports

No abstract provided.

Comparing Nurse-Led Holistic Pain Relief Strategies And Sole Pharmacological Use In Enhancing Maternal Satisfaction, Reducing Pain, And Lowering Obstetric Interventions During Childbirth, Jessica C. Moore

Nursing | Senior Theses

Background: Childbirth has become heavily reliant on pharmacological management and obstetric interventions such as epidural use, labor induction, and cesarean deliveries (C-sections) even among low-risk pregnancies. While necessary in some cases, excessive reliance on pharmacological interventions can negatively impact the experience of birthing as a whole. Non-pharmacological interventions (NPIs) such as breathing techniques, positioning, hydrotherapy, massage, aromatherapy and continuous support have shown to be effective in reducing pain and supporting physiologic labor. The gaps in education and lack of standard implementation result in inconsistent application in practice. Purpose: This research proposal aims to evaluate the effectiveness of nurse-led NPIs compared …

Human Milk Feeding And Its Impact On The Incidence Of Necrotizing Enterocolitis, Maya C. Kern

Nursing | Senior Theses

One of the leading causes of morbidity and death for preterm and very low birth weight (VLBW) newborns is still necrotizing enterocolitis (NEC). Existing literature consistently shows that the bioactive, anti-inflammatory, and microbiome-supporting components of human breast milk, including donor human milk, significantly lower the incidence of NEC. However, a lot of infants are forced to rely on formula and nutrient fortifiers because they cannot obtain maternal or donor milk. A critical gap persists regarding whether human milk derived fortifiers offer greater NEC protection than bovine derived fortifiers in infants who must receive formula. This thesis examines three interconnected themes; …

The Use Of Human Milk Versus Formula Feeding To Decrease The Incidence Of Nec For Preterm Infants In The Nicu: An Integrative Research Review (Irr), Shelby Everard Larkins-Hutchins

Covenant Nurses Week 2026

No abstract provided.

Proof-Of-Concept Development And Preclinical Evaluation Of A Microarray Patch Platform For Codelivery Of Multiple Broadly Neutralizing Antibodies For Hiv Prevention, M. Melissa Peet, Vivek Agrahari, Parbeen Singh, Lam Luong Hoai Nguyen, Louise A. Ouattara, Eun Sung Yang, Carolina Herrera, Amarendra Pegu, Theodore C. Pierson, Thanh D. Nguyen, Gustavo F. Doncel

CONRAD Publications

Broadly neutralizing antibodies (bnAbs) are advancing as a preventative or treatment option for HIV infection, but currently must be administered parenterally, typically as a large injection or infusion, an invasive method of delivery, especially for the pediatric population. Here, we present proof-of-concept data on a minimally invasive microneedle (MN) patch platform codelivering three bnAbs, PGT121, VRC07-523LS, and PGDM1400LS, from separate MN patch units or pixels. Each 1 cm² patch pixel, fabricated via solvent casting, contained ∼2 mg of one bnAb. In ex vivo porcine skin tests, the MNs effectively penetrated the skin. When tested in vitro in PBS buffer, MNs …

Eeg Signatures Of Motor Development In Early Childhood: A Systematic Review, Sonia Khurana, Ashwini Kulkarni, Thomas C. Bulea, Hunter J. Bennett

Rehabilitation Sciences Faculty Publications

Background

Early identification of motor developmental disorders is limited due to lack of objective neural markers that characterize typical neurodevelopmental patterns. This systematic review interprets and synthesizes existing evidence to propose a framework of EEG signatures associated with motor development in children aged 0-5 years, which may help inform future benchmarks for early assessment and intervention.

Methods

Following PRISMA guidelines, we searched published and gray literature across five databases between 2000 and 2025 (registered protocol). Included studies examined EEG during task-based, resting-state, or sleep studies linked to motor milestones, task performance, or standardized motor assessments. Study quality was assessed using …

Improving Clinic Workflow To Enhance Rubeola Immunity Screening In Pregnant Patients, Courtney Mcduffie

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to improve provider adherence to Rubeola IgG serum order entry for prenatal care visits by implementing a standardized workflow and an electronic medical record (EMR)-based order-entry process in a high-risk maternal outpatient clinic.

Background: Rubeola infection during pregnancy is associated with significant maternal and fetal complications. Despite recommendations from the American College of Obstetricians and Gynecologists (ACOG) to use serologic testing to determine immunity status, inconsistent provider ordering practices and workflow gaps contribute to missed opportunities for identifying non-immune patients and planning post-partum vaccination.

Methodology: A ten-week intervention period utilized …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

Documenting Death: Maternal Mortality And The Ethics Of Care In Tanzania (Adrienne E. Strong 2020), Luluk Oktavia, Megawati Sukarno

Paradigma: Jurnal Kajian Budaya

In recent decades, global efforts to reduce maternal mortality have become a primary focus in health development agendas. However, challenges in providing quality healthcare remain complex, especially in resource-limited countries. Adrienne E. Strong’s book, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, offers an ethnographic perspective on the relationship between bureaucratic structures, resource constraints, and healthcare practices in Tanzania. This review examines Strong’s key concepts, such as good enough care, documented care, and fierce care, which highlight the ethical dilemmas faced by healthcare workers in delivering care under administrative pressures and limited facilities. The critique of the …

Breastfeeding Safety Following Maternal Anesthesia: A Guideline Development, Megan Honea, Mary Johnson

Doctoral Projects

Recommendations regarding breastfeeding following maternal anesthesia are inconsistent and often not up to date with current best practice guidelines. Previous recommendations have led to mothers unnecessarily “pumping and dumping” breast milk has benefits for both mother and baby. These benefits include (a) increasing the infant’s access to colostrum, (b) encouraging mother-baby bonding, (c) improving the mother’s breastfeeding experience, (d) and providing significant health benefits to the infant. The purpose of this scholarly project was to develop a set of evidence-based recommendations that focus on mothers who desire to breastfeed following general anesthesia. These recommendations will highlight maternal- fetal transfer of …

Neonatal Unit Human Resources: Coverage For Six Cadres And Trends For Staff-To-Baby Ratios In 65 Neonatal Units Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca Penzias, Eric Ohuma, Opeyemi Odedere, Olabisi Dosunmu, George Okello, Hannah Mwaniki, Robert Tillya, Josephine Shabani, Vincent Ochieng, Ekran Rashid, William Macharia

Paediatrics and Child Health, East Africa

Background: Implementing small and sick newborn care (SSNC) requires skilled health workers; however, there is a shortage, adversely impacting patient outcomes and health worker wellbeing. There are limited data and no cur‑ rent World Health Organization (WHO) standards for staftobaby ratios in neonatal units in low and middleincome countries (LMICs) to inform policy, planning, and investment.

Methods: In 65 neonatal units (36 in Malawi, 13 in Kenya, 7 in Tanzania, and 9 in Nigeria), a health facility assessment (HFA) for SSNC and governmentled quality improvement (QI) processes were implemented. Stafng data were col‑ lated from baseline HFA (Sept 2019–March 2021) …

Enhancing Patient Outcomes: Developing A Comprehensive Database For Tracking Post- Dural Puncture Headache Incidence And Contributing Factors, Meredith B. Auge, Brittany Bogonovich

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Post-dural puncture headache (PDPH) is a debilitating complication following labor analgesia, often resulting from unintentional dural puncture (UDP). While national incidence is approximately 1.5%, institutional rates may vary due to provider experience, documentation practices, and patient factors. This Doctor of Nurse Anesthesia Practice (DNAP) quality improvement project aimed to improve identification and monitoring of UDP and PDPH through a revised tracking tool, retrospective review of 2024 data, and planning for an electronic registry. A multidisciplinary team of anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs), Student Registered Nurse Anesthetists (SRNAs), and IT and quality specialists revised an existing tracking tool to better …