Maternal, Child Health and Neonatal Nursing Commons^™

Managing Ambiguity: Nurses Caring For The Mother Of A Stillborn Baby, Natasha J. Nurse

Dissertations, Theses, and Capstone Projects

Abstract

Purpose: The aim of this study was to describe and conceptualize the experiences and processes involved when labor and delivery nurses provide care to women experiencing a stillbirth.

Background: The care of a woman experiencing a stillbirth is an important topic that requires attention, however, there is a paucity of literature on the specifics of a nurse’s experience as she or he cares for a grieving mother. These experiences may shed light on gaps in care that may exist as well as gaps in the resources, education and support needed to appropriately prepare nurses for providing care …

Structural Stress And Otherness: How Do They Influence Psychological Stress?, Christine Dewilde

Theses and Dissertations

Background: The Theory of Cultural Distress offers a framework for understanding the potential outcomes in patients who do not receive care that incorporates their cultural beliefs (DeWilde & Burton, 2017).This study represents initial steps in researching the theory byexploring the layering of stressors that place the patient at risk for Cultural Distress. Methods: Utilized aCross-sectional descriptive correlational analysis of intersecting identities (Structural Stressors), ethnicity-related stressors (Otherness) and ethnic-identity (Otherness) to develop understanding of the potential effects of these variables on psychological stress. Independent variables included intersecting identities, perceived ethnic discrimination, concern for stereotype confirmation, own group conformity pressure, and …

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin …

Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman

Electronic Theses and Dissertations

With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive …

Why American Parents Circumcise Their Sons: An Integrative Review Of Literature, Lacy Lauber

Grace Peterson Nursing Research Colloquium

Background: Since medical evidence supports both pros and cons of routine neonatal male circumcision, expectant and new parents are left to make the decision to circumcise their sons on their own. There is limited research as to why American parents choose to circumcise their newborn sons.

Objectives: The purpose of this integrative literature review is to identify the reasons behind parental decision making in neonatal male circumcision in the United States. Understanding motivating factors in parental decision-making can highlight areas of prenatal education for expectant parents.

Method: An integrative literature review was conducted utilizing these online databases: PubMed, The Cumulative …

Postpartum Depression And Childbirth Education: An Integrative Literature Review, Marialicia J. Kunkel

Grace Peterson Nursing Research Colloquium

Background: Postpartum Depression (PPD) is a mood disorder that affects approximately 15% of women. Preventative methods are key to reducing the prevalence of PPD, and childbirth educators are in a unique position to disseminate information to new parents.

Objective: The purpose of this literature to review was to investigate what PPD information is currently being incorporated in Childbirth education curriculum. The goal of this literature review was to establish whether new parents were being educated on PPD prior to giving birth and if that helped raise levels of awareness.

Methods: Articles were found using Cumulative Index of Nursing and Allied …

A Delphi Study: Guidelines For Researchers Working With Teenage Mothers, Alison M. Chamberlain

Nursing Theses and Dissertations

Problem: It is difficult to get teenage mothers to participate in studies, yet some researchers have been successful. Researchers who understand the barriers to conducting studies with a vulnerable population and are guided in ways to overcome these barriers, will experience greater success when doing studies with this group. Improved study methods can lead to larger numbers of teenage mothers who participate in studies. Researchers who follow developmentally appropriate guidelines are more likely to conduct and replicate studies with this population. Access is essential to advance the science related to care for teenage mothers who are at risk for many …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Implementing An Evidence-Based Education Program For Labor And Delivery Nurses In A Community Hospital Setting, Sara E. Humphrey

Graduate Theses, Dissertations, and Capstones

Many factors contribute to the success of an organization. The nursing workforce is the guiding strength behind the delivery of safe patient care resulting in quality outcomes. Preparing the nursing staff to deliver safe care begins with the introduction of evidence based practice as a viable partner to clinical expertise and knowledge. Implementing an evidence based education program is a critical step in the process of integrating evidence into clinical practice. This paper focuses on the implementation of an evidence based education program or Labor and Delivery nurses in a community hospital setting. Evidence based education can promote competency development, …

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Scholarly and Creative Works Conference (2015 - 2021)

Type 1 Diabetes Mellitus accounts for approximately 5% of the diabetic population (CDC, 2015). Numerous complications must be avoided when a diabetic is insulin dependent. Women who are diabetic who are planning to conceive a family have special considerations. Little research has been focused into how to best manage Type 1 diabetics during pregnancy. Since Type 1 diabetes is predominantly diagnosed between birth and 30 years of age, many Type 1 diabetics have potential to become pregnant without knowing how to best manage their diabetes. Poor glycemic control in diabetics has been related to miscarriages, stillbirths, malformations, and macrosomia (Lapolla, …

The Relationship Between Promoting Self-Efficacy And Informed Decision-Making In Pregnant Nulliparous Women And Method Of Delivery, Crystal Hunter

Scholarly and Creative Works Conference (2015 - 2021)

This presentation will cover the relationship between the concepts of decreased self-efficacy in pregnant women’s abilities to deliver their babies vaginally, fear of the pain and duration of labor process, and the acceptance of medical intervention without sufficient intrapartum education surrounding delivery methods. These interrelated variables impede the concept of informed choice. The current state of the problem surrounds women with low self-efficacy who are predicted to have negative childbirth experiences such as, consenting to an astronomically high rate of cesarean sections. The focus for nursing is that low-risk, healthy women who elect cesarean sections without the knowledge that permanent …

The Benefits Of Breastfeeding, Annagrace E. Anderson

Senior Honors Theses

Breast milk is the gold standard for infant nutrition. In the past, infant formula was promoted as equal or superior to breast milk. However, research has shown that breastfeeding is the superior form of infant nutrition except in rare circumstances. Breast milk provides for all of a newborn’s caloric needs and has the correct balance of nutrients to promote proper development. In addition, breast milk provides protection against illnesses, supports an infant’s immune system, and promotes life-long health for the newborn. Mothers also experience personal benefits by breastfeeding such as decreased cancer risks, bonding with their babies, and faster postpartum …

Infection Control In Labor And Delivery Room, Learning From The Small Hospital Based Project, Savera Aziz Ali, Sumera Aziz Ali

School of Nursing & Midwifery

Background: It has been estimated that around 36% of the neonatal deaths occur due to infection in the lower and middle income countries. Infection control is a more substantial area of concern, particularly in Labor and delivery room. Multiple factors can cause infection in the labor room, therefore it is important to assess various factors of maternal and neonatal infection. Hence we explored multiple factors through this project and developed the action plan to address those factors effectively.
Methods: During our Leadership and Management course, we conducted a project in Labor room pertaining to a prevalent issue. The whole process …

Adult Qdts, Chinese, Marianne E. Weiss, Binghua Wang

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Honoring Motherhood: The Meaning Of Childbirth For Tongan Women, Shelly J. Reed, Lynn Clark Callister, 'Ana Kavaefiafi, Cheryl A. Corbett, Debra Edmunds

Faculty Publications

Purpose: The purpose of this ethnographic study was to describe the meaning of childbirth for Tongan women.

Study Design and Methods: In this qualitative descriptive study, 38 Tongan women, 18 from Tonga and 20 from the United States, who had given birth in the past year were invited to share their perceptions of childbirth. Themes were generated collaboratively by the research team.

Findings: The overarching theme was honoring motherhood; other themes include using strength to facilitate an unmedicated vaginal birth, describing the spiritual dimensions of birth, adhering to cultural practices associated with childbearing, and the influence of the concept of …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

Rural Nebraska Women's Explanatory Models Of Postpartum Depressive Symptomatology, Elizabeth Mollard

Theses & Dissertations

The purpose of this study was to construct the explanatory models of postpartum depressive symptomatology (PPDS) from the perspective of rural Nebraska women and to compare these models with the medical model of PPDS. A sample of 20 rural Nebraska women were interviewed in a one-on-one qualitative descriptive telephone interview using questions based on Kleinman’s (1980) explanatory model of illness. This study used feminist pragmatism as a guiding philosophical paradigm. Qualitative data were analyzed using content analysis, and results were compared and contrasted with the medical model of PPDS, which included the onset, symptoms, and duration listed in the DSM-5 …

Doulas Could Improve Foreign-Born Women’S Perinatal And Postpartum Satisfaction And Increase Health Providers’ Cultural Competency In A Multicultural Urban Area Of The United States., Crystal Kazik

Sustainability and Social Justice

Doulas act as a cultural bridge between clients and providers through the support, advocacy, and education they provide. Unfortunately, migrant women may be at a disadvantage for accessing and benefiting from their services due to a variety of socioeconomic and cultural factors including predisposed ideas of care and structure based on experiences in native countries, language barriers, lower health literacy, and a lack of awareness and understanding from hospital/clinic staff.

A strategic multifaceted approach utilizing doulas, such as Boston Medical Center’s collaborative and culturally competent model, may greatly improve foreign-born women’s experience and satisfaction with healthcare when pregnant and giving …

Effective Interventions To Reduce The Increase In Elective Cesarean Sections In Low Risk Women, Kimberly Kelsey, Crystal Hunter, Brianna-Kirsten Tan, Sara Shea, Heather Holland, Sasha Riley, Mary Uy, Tenzin Tsomo, Fasha Ruys-Solorzano, Dolma Tso

Student Research Posters

According to the Annals of Family Medicine, the amount of babies born via cesarean section has increased from 4.5% in 1965 to 26.1% in 2002 and nearly 40% of all cesarean sections are repeats. After an extensive literature review, results showed that patients need to be educated about the risks and benefits of vaginal delivery and cesarean delivery. It was also found that there needs to be policy changes to decrease the amount of cesarean sections done and increase the labor and delivery support without using interventions. Further study should be focused on morbidity and mortality very low birth weight …

Training Traditional Birth Attendants In Sub-Saharan Africa, Lindsey J. Smith

Senior Honors Theses

Even after many adjustments, recommended practice regarding traditional birth attendants (TBAs) and their contribution to lowering the maternal mortality rate (MMR) continues to be disputed among various stakeholders. Sub-Saharan Africa continues to see high maternal mortality rates, despite various attempts by the World Health Organization (WHO) and others at utilizing the formal health care system (Prata, et al., 2011). Considering all factors and variables behind the reason for this problem in Sub-Saharan African, it is reasonable to conclude that training traditional birth attendants (TBAs) in evidence-based practice, in conjunction with developing longer-term strategies, is an appropriate approach for the short …

The Effect Of Alternative Labor Positions Versus The Lithotomy Position On Birthing Outcomes: An Integrative Literature Review, Kelsey Gaffka

Honors Undergraduate Theses

Traditionally, the lithotomy position is the most commonly used birthing position in western cultures. The purpose of this literature review was to examine the differences in maternal and neonatal outcomes when alternative labor positions are used. Implications for future use of alternative labor positions were explored. Peer reviewed, English-language research articles published from 2009 to 2015 were included for synthesis. Study results revealed that the lithotomy position is linked to multiple negative maternal outcomes. Birthing in a water pool or in a lateral position has been linked to more optimal maternal and neonatal outcomes compared to other positions. Health care …

Educated Birth: Beliefs Vs. Outcomes, Lauren Presley

Human Nutrition and Hospitality Management Undergraduate Honors Theses

“Our infant mortality rate is a national embarrassment.”¹ The words seem shocking and harsh across the headline of a 2014 Washington Post article. The thought of America not only not being the best at something, but falling upsettingly behind, is a foreign concept to many who view America as a nation inferior to none. However, the statistics on infant mortality rate tell the stark truth that of 26 “wealthy” countries, the U.S. ranks last, with a sobering 6.1 deaths per 1,000 live infant births.²

Part of the Healthy People 2020 Objectives is to reduce the rate of infant …

Common Factors In Unplanned Cesarean Section, Lauren C. Compton

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Obstetrical delivery by cesarean section is a prevalent form of delivery. Whether clinically indicated or by maternal request, cesarean delivery rates in the United States have risen to account for over a third of all deliveries. Cesarean section procedures are often clinically indicated and occur because of fetal factors, but they can also be elected by maternal request. The aims of this study are to analyze the frequency of the factors in the study questions that are associated with unplanned cesarean section procedures and to compare the frequency of these factors per cesarean section with the time of day the …

The Rates Of Mothers Who Continually Breastfeed After Implemented Breastfeeding Teaching, Katherine L. Moore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Many mothers are unaware of the benefits of breastfeeding. This lack of knowledge leads to an inability to weigh the advantages and disadvantages of the potential source of nutrition their infant will receive during his or her first months of life. Many mothers never even attempt to breastfeed their infant. Even among the mothers who do initially choose to breastfeed, the majority deviate to other forms of feeding early in the postpartum period. Despite the fact that most major medical organizations encourage exclusive breastfeeding through the first six months of an infant’s life, the CDC report for 2013 claims the …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

Perinatal Health Education Intervention For Adolescent And Young Adult Pregnant Homeless Women Living In Transitional Housing, And Best Practice Teaching Intervention Program For Staff Responsible For Care Of The Mother-Baby Dyad, Colleen Carrington

Seton Hall University DNP Final Projects

Purpose: A population at great risk is pregnant homeless adolescents and young adult women. Research shows that about 20% of homeless young women become pregnant (Bender, & Thompson, 2007). These pregnant young women are at an increased risk for low birth weight infants and a high infant mortality due to inadequate health care, poor dietary habits, and a knowledge deficit related to maintaining good health during pregnancy and to care of the infant and growing child. A transitional shelter may offer many psychosocial services to assist the women in becoming independent; however, a significant gap exists regarding the medical …

Heath Care Providers’ Perceptions Of The Reproductive Challenges And Experiences Among Asian Indian Women Living In Silicon Valley, Olga Alexandra Libova

Doctoral Projects

Objective: To identify common reproductive challenges among Asian Indian (AI) women living in Silicon Valley as perceived by healthcare providers (HCP). Design: A 71-item investigator-developed survey Setting: The survey was available on-line to all HCPs in California Santa Clara county, 75% of respondents were affiliated with El Camino Hospital Mountain View. Participants: Convenience sample of 78 respondents: 34% mother-baby nurses, 24% labor-delivery nurses, 21% OB/GYNs, 7% CNMs, 14% other HCP; 89% female; 55% Caucasian, 24% Asian. Methods: Likert-type scales comparing prevalence of certain reproductive challenges among AI women and women from other race-ethnic groups and openended questions regarding HCPs’ experience …

Maine's Breastfeeding Gap: How Initiation And Duration Differ By Socioeconomic Status, Zoe Miller

Thinking Matters Symposium Archive

The preventive health benefits of breastfeeding for both mothers and children are widely recognized. Leading health authorities recommend exclusive breastfeeding for the first six months of life.

Though breastfeeding rates in the United States have been increasing for the past decade, significant disparities continue across race and socioeconomic status.

Ouch, That Hurts: Childbirth-Related Pain Management And The Inappropriate Replacement Of Traditional Obstetrical Knowledge In Kumaon, Uttarakhand, India, Sabrina Zionts

Independent Study Project (ISP) Collection

Throughout India, obstetrical knowledge and practice has been developed and passed down by generations of women. In many Indian societies, traditional birth attendants, or dais, remain the gatekeepers of childbirth-related knowledge. Yet with the push towards institutional delivery, traditional knowledge and practices are being increasingly replaced with modern and Western ones. While the trend of hospital deliveries has yielded positive health outcomes, its socio-cultural consequences remain unclear. Situated in Uttarakhand’s Kumaon Himalayas, this study employs a bio-social framework and begins to reveal these consequences. Using labor pain management as an entry point, this study argues that the push towards institutional …

Implementation Of Interprofessional Education And Physician Order Set Improves Compliance With Early Recognition And Treatment Of Maternal Sepsis, Lori Susan Olvera

Doctoral Projects

Septic shock is rare in pregnancy; however, sepsis remains an important contributor to maternal mortality. The perinatal patient can appear deceptively well before rapidly deteriorating to septic shock. There is a need for protocols regarding early recognition and management of maternal sepsis. The Surviving Sepsis Campaign developed guidelines to provide guidance for the clinician caring for patients with severe sepsis or septic shock. The purpose of this doctoral project was to evaluate compliance with early goal directed therapy before, during, and following the implementation of a standardized physician order set and interprofessional education for nurses and physicians in the perinatal …