Maternal, Child Health and Neonatal Nursing Commons^™

Education And Enhanced Support To Improve Breastfeeding Success: A Quality Improvement Project In A Rural Community, Amberlyn Kay Gentry

Doctor of Nursing Practice Projects

Abstract

Problem Description: Breastfeeding continuation rates fall below the Healthy People 2020 goal of 60.6% for any breastfeeding at six months postpartum. In Navajo County, Arizona the breastfeeding rate for WIC participants was 36.9%. Breastfeeding provides health benefits to babies and women and decreased health care costs. A quality improvement project was developed and implemented with a pilot group of participants in a rural Northeastern Arizona community.

Interventions: After a thorough literature review, four interventions were selected. These included: development of a community health coalition, prenatal breastfeeding education, administration of a new baby tea event, and extended support …

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 …

A Transcultural Perspective On Nonpharmacological Treatment Of Postpartum Depression: A Systematic Review, Amanda W. Leyva

Honors Undergraduate Theses

Despite PPD’s global extent, scarce research that addresses culturally competent alternative interventions exists. The purposes of this thesis were to 1) analyze the existing literature on non-pharmacological treatment of PPD in the US and across selected cultures; 2) determine the effectiveness of cross-cultural non-pharmaceutical therapy; and 3) examine and suggest ways health care providers can integrate non-pharmacologic interventions into PPD treatment in the US. The systematic electronic search comprised the databases Cumulative Index to Nursing and Allied Health Literature, Medline, PsycINFO and SAGE Research Methods. Searches were limited to English language, peer reviewed, and research articles between 2007 and 2017. …

Exploring What It Is Like To Be An Undocumented Alien In Seek Of Healthcare, Eliany C. Torrez Pon

Honors Undergraduate Theses

Currently, there are about 11.8 million undocumented aliens in the United States who are not eligible for public insurance or any type of private coverage obtained through the American Health Care Act of 2017. This creates barriers to healthcare for this large population and has negative implications for the healthcare system. Despite the availability of clinics and low-cost healthcare, this group tends to underuse resources or seek healthcare for emergencies only which leads to increased cost totaling approximately $1.1 billion a year. The goal of this qualitative study is to better understand what it is like to be an undocumented …

The Effects Of Recorded Maternal Sound On Preterm Neonates: A Systematic Literature Review, Angela Aloisantoni

Honors Undergraduate Theses

A fetus hears and responds to maternal sounds as early as 26 weeks' gestation. When born prematurely, a neonate may face health challenges due to overall organ immaturity and hospitalization in the Neonatal Intensive Care Unit, where developmentally important maternal sounds are replaced with routine hospital noise. A potential intervention that can provide meaningful auditory stimulation these neonates lack is implementation of maternal sound interventions. These interventions replicate the intrauterine auditory environment by playing recorded maternal speech and heart sounds in the incubator. A literature review was completed to identify effects on neurodevelopmental, nutritional, and physiological measurements this intervention may …

Surrogacy: Pathway To Parenthood, Rachel A. Joseph, Alexandria M. Rafanello, Cassidy J. Morris, Kerry F. Fleming

Nursing Faculty Publications

Assistive reproductive technology has progressed significantly over the past few decades. In spite of the advances, people may still resort to a surrogate for bearing and birthing a baby. Surrogacy, though an altruistic act, has been commercialized in the past few years, leading to emergence of several ethico-legal concerns. Nurses care for the surrogates, the infants, and the intended parents through their journey with sensitivity, advocacy, compassion, and confidentiality. This article intends to explore the implications of surrogacy to individuals, families, nations, and health care.

Children’S Oxygen Administration Strategies Trial (Coast): A Randomised Controlled Trial Of High Flow Versus Oxygen Versus Control In African Children With Severe Pneumonia, Kathryn Maitland, Sarah Kiguli, Robert Opoka, Peter Olupot-Olupot, Charles Engoru, Patricia Njuguna, Victor Bandika, Ayub Mpoya, Andrew Bush, Thomas Williams

Paediatrics and Child Health, East Africa

Background: In Africa, the clinical syndrome of pneumonia remains the leading cause of morbidity and mortality in children in the post-neonatal period. This represents a significant burden on in-patient services. The targeted use of oxygen and simple, non-invasive methods of respiratory support may be a highly cost-effective means of improving outcome, but the optimal oxygen saturation threshold that results in benefit and the best strategy for delivery are yet to be tested in adequately powered randomised controlled trials. There is, however, an accumulating literature about the harms of oxygen therapy across a range of acute and emergency situations that …

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 Role Of Exercise For Postpartum Depression And Well-Being, Maria Gaz

All Graduate Theses, Dissertations, and Other Capstone Projects

Postpartum depression is a prevalent condition (American Psychological Association, 2018). Untreated postpartum depression can have serious consequences for the mother and baby (McCurdy, Boule, Sivak, & Davenport, 2017). Traditional treatment options may not be feasible. Exercise is an effective treatment for adults with depression (McCurdy et al., 2017). Less is known about treating postpartum depression with exercise. This review of the literature sought to understand in postpartum mothers, how a regimen of regular exercise, compared to no regular exercise, impacted the perception of wellbeing and/or postpartum depression scores. The Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus with …

Anxiety Reduction In Pregnancy Subsequent To Perinatal Loss, Jessica Lemker

All Graduate Theses, Dissertations, and Other Capstone Projects

Anxiety is common in pregnancies that occur after a miscarriage or perinatal loss and can lead to detrimental effects on the mother and fetus. The objective of this literature review is to examine whether caring-based nursing actions and anxiety-reducing interventions decrease the self-report of anxiety more than self-management alone. A literature search of four journal databases was conducted using related keywords which produced 429 studies for consideration. A total of 57 studies were reviewed for a match with the inclusion criteria. Nine studies were included in the review provided knowledge of anxiety in pregnancy after loss, discussed anxiety self-management techniques, …

Implementation Of Donor Human Milk In A Newborn Nursery: A Quality Improvement Initiative To Increase Exclusive Breast Milk Feeding, Emily Bombard

DNP Scholarly Projects

Background: At the site of this quality improvement project, exclusive breast milk feeding rates before discharge from a newborn nursery were behind benchmark goals. The aim of this project was to improve exclusive breast milk feeding rates by implementing a Pasteurized Donor Human Milk (PDHM) Program for breastfeeding newborns requiring medically indicated supplementation. The study site was a Level I newborn nursery of a 20-bed, labor, delivery, recovery, and postpartum unit within a 100-bed community hospital (i.e., the agency).

Methods: This retrospective pre-post cohort study used the Plan, Do, Study, Act (PDSA) framework for rapid cycle change to assess the …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Reproductive Autonomy: The Context Of Pregnancy Intention, A Global To Local Approach, Hartley C. Feld

Theses and Dissertations--Nursing

Globally, in low and middle-income countries 4 out of every 10 pregnancies is reported to be unintended. Having an unintended pregnancy increases the risk of maternal and infant morbidity and mortality, preterm birth, low birth weight, and decreases rates of breast-feeding. The United States (U.S.) consistently has some of the highest rates of preterm birth, infant and maternal mortality of all high-income countries and 45% of all pregnancies in the U.S. are reported to be unintended. The etiology of these outcomes and their relationship to pregnancy intention are complex and multifactorial, but we know this disproportionately effects women living in …

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …

The Effect Of Lactation Consultation On The Duration Of Breastfeeding In New Mothers: A Systematic Review, Jillian Leiter, Jennifer Naegeli, Lilyana Walkley

Williams Honors College, Honors Research Projects

In the United States, 3.978 million babies were born in the year 2015 (U.S. Department of Health & Human Services, 2016). Statistics show that less than 25% of newborns in the United States are breastfed for half of the recommended time by The American Academy of Pediatrics. There are many benefits to breastfeeding, but babies are not receiving these benefits. This systematic review identifies, reviews, and critically appraises the evidence regarding the effect of lactation consultation on duration of breastfeeding in new mothers. Literature was retrieved from CINAHL and Google Scholar. Each study was vetted based on criteria to fully …

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 …

Development Of A Nurse Practitioner Newborn Hospitalist Service, Kristi Gordon, Elizabeth Simpson, Sarah Forge, Eileen Almon

Posters

Background/Problem

•In 2012, our hospital expanded obstetrical services resulting in the delivery over 3700 infants per year.
•Approximately 35% of these infants had no relationship to a primary care physician with privileges at our hospital.
•These infants were either uninsured, Medicaid insured or privately insured but whose primary care physician did not have hospital privileges.
•Private Pediatricians “on call” were given these unassigned infants and were attempting to evaluate infants in the mornings, prior to seeing their scheduled office patients
•This resulted in an unmanageable daily census for them.
•This led to Pediatrician dissatisfaction, delayed medical evaluations of some infants, …

Redirecting Care, Directing Support: End Of Life Huddles In The Intensive Care Nursery, Tiffany Willis, Sandra Ganey

Posters

No abstract provided.

Breast Milk Supply Establishment For Mothers Of Nicu Infants: A Retrospective Chart Review Examining Milk Volume, Maternal Factors And Pump Type, Cynthia C. Jackson

Books, Presentations, Posters, Etc.

No abstract provided.

Antibiotic Prescribing For Treatment Of Acute Pediatric Illnesses By Advanced Practice Nurses, Deborah J. Whitehurst

DNP Projects

Antibiotic over-prescribing by physicians for the treatment of acute respiratory tract illnesses have been examined in a variety of settings. Different studies have examined nurse practitioner (NP) prescribing practices both in the United States and various international settings. There have been limited studies specifically examining antibiotic prescribing practices in the pediatric population. However, no studies were found which compared population specific NP groups. The purpose of this study was to understand differences in antibiotic prescribing practices among advanced practice pediatric providers.

The goal of this project was to describe and compare antibiotic prescribing practices of pediatric nurse practitioners (PNP) and …

Optimization Of Folic Acid Supplementation In The Prevention Of Neural Tube Defects, Shona Cawley, Daniel Mccartney, Jayne V. Woodside, Mary Rose Sweeney, Robert Mcdonnell, Anne M. Molloy, Michael J. Turner

Articles

Background We examined the relationship between timing and duration of folic acid (FA) supplementation in achieving red blood cell (RBC) folate levels in early pregnancy which are optimal (>906 nmol/l) for the prevention of neural tube defects (NTDs). Methods Clinical, FA supplementation and dietary folate details were computerized at the first antenatal visit. Maternal blood samples were analysed for RBC and serum folate. Results Of the 502 women, 98.2% (n = 493) reported taking FA. There was a positive correlation between duration of supplementation and both RBC folate (r = 0.43, P < 0.001) and serum folate (rho = 0.29, P < 0.001). The optimal RBC folate level was achieved in 80.4% (n = 46) of women who started FA 400 μg 4–8 weeks before their LMP compared with only 53.6% (n = 153) in women who started 4–8 weeks after their LMP (P < 0.001). Conclusions This study provides, for the first …

Ghanaian Parents’ Experiences Of Caring For Their Preterm Infants After Discharge From The Neonatal Unit - A Narrative Inquiry Study, Esther Abena Adama

Theses: Doctorates and Masters

The care of preterm infants is associated with stress. In the busy neonatal unit where highly skilled healthcare workers are always present, parents have reported being stressed when caring for their preterm infants in the neonatal unit. In Ghana, preterm birth is the highest cause of neonatal mortality with 70% of these morbidities and mortalities occurring in the community. Yet to date, no study in Ghana has explored how parents experience their care giving role after discharge from the neonatal unit into the community.

This study explored the experiences of caring for preterm infants in the neonatal unit and after …