Maternal, Child Health and Neonatal Nursing Commons^™

Neonatal Toxic Stress And Long-Term Neurodevelopment In Premature Infants, Rachelle Sey

Dissertations

Background: Evidence suggests the presence of complex biologic connections between the social environment, neurologic development, and long-term health. Premature infants spend many months in the Neonatal Intensive Care Unit (NICU) often separated from their parent(s). Decrease in the age of viability threshold allows extremely preterm infants to benefit from lifesaving therapies; however, they are frequently exposed to significant stressors that increase their risk for adverse neurodevelopmental outcomes.

Purpose: The purpose of this study is to examine the relationship among socio-demographic factors, exposure to stressors in the NICU environment, stress modifiers/buffers, neonatal morbidities at discharge, and 1. 2-year neurodevelopmental outcomes and …

Maternal Provision Of Mother's Milk And Birth Trauma In The Neonatal Intensive Care Unit: A Grounded Theory Analysis, Emma West, Samrawit Kelkay

20th Annual Celebration of Undergraduate Research and Creative Activity (2021)

Less than half of very low birth weight (VLBW, < 1500 grams) infants are discharged from the neonatal intensive care unit (NICU) receiving mother’s own milk (MOM), despite its demonstrated importance. Nevertheless, few studies have explored the impact of maternal perceived trauma (MPT) on infant feeding outcomes. The purpose of this study is to describe MPT among mothers of hospitalized VLBW infants and examine infant feeding outcomes with MPT. This analysis is derived from a grounded theory study exploring the maternal provision of milk among a convenience sample of mothers with VLBW infants at a Midwest NICU. This study utilized semi-structured interviews and content analysis to identify common themes (n=30). Data were analyzed using Dedoose, web-based data management and analytical software. A preliminary analysis identified trauma as a prominent theme. Trauma was defined as a mother’s perceived inability to process an experience at the time of the event, a lack of understanding during the time of an event, and the rapid decline of either maternal or infant health. The occurrence of MPT (n=865) was reported most frequently in women described as Black (46%), multipara (57%), married (75%), and ages > 30 (57%). The MPT frequency was greater with cesarean (54%) and hypertensive (71%) births. The MPT frequency with MOM was 63%, but only 23% with exclusive MOM at discharge. This study’s limitations include using a single hospital location and only English-speaking mothers, making the results less generalizable. Additionally, the interviewer’s Latina racial identity may have led to a sense of kinship with some mothers. A better understanding of MPT and those at risk for MPT will allow providers the opportunity to identify interventions to increase MOM feedings at discharge proactively.

Impact Of Group Prenatal Care On Health Outcomes For Women Of Color In The United States: A Systematic Literature Review, Morgan Brockington, Emily Bauer, Julie Kameisha

Thinking Matters Symposium

Women of color in the United States experience disproportionately higher rates of adverse pregnancy-related outcomes, both in the prenatal and postpartum period. Group prenatal care (GPC) has been gaining popularity in recent years and has demonstrated improved health outcomes. The aim of this systematic literature review was to examine and summarize the impact of group prenatal care on health outcomes for women of color in the United States. Using a systematic approach and PRISMA guidelines, two electronic databases—CINAHL and PubMed—were used to search the literature. Quantitative research studies that were published in peer-reviewed journals between 2010 and 2020, written in …

Black Maternal Mortality In The United States, Grace Phelps

Honors College Theses

Black maternal mortality is a looming issue in the United States as the rate of Black maternal deaths is 3-4 times higher than the average rate for White women. Research establishes that this is a multifaceted issue of care quality, preexisting health, biases and racism, and structural inequalities. This study aims to discuss the statistics, contributing factors, and possible solutions to the issue of Black maternal mortality. Specifically, this study aims to educate nursing students on the matter and test the implications an educational session has on knowledge about Black maternal mortality and how health care professionals can be part …

Postpartum Support: Application Of A Local Peer Support, Community Care Model, Stephanie E. Ward

Theses and Graduate Projects

The postpartum period is one of the most influential developmental stages of a women’s life and represents a time of heightened risk for mental health decline. Perinatal mood and anxiety disorders have been implicated as a key influence of negative parenting experiences, poor newborn psychological outcomes, delayed newborn development, and inadequately adaptive family development behaviors. Integrating established resiliency components against mental illness, such as social support, into a postpartum care model can benefit postpartum women and secondarily positively impact the aforementioned outcomes. A community care model highlighting social support for postpartum mothers was integrated into a rural Minnesota region and …

Timing Of Therapeutic Hypothermia & Short-Term Infant Outcomes, Brooke Rakes

Dissertations

Background: Hypoxic-ischemic encephalopathy (HIE) can result in devastating long-term neurological morbidity and/or death. Current evidence recommends initiating Therapeutic Hypothermia (TH), as early as possible, however, research specifically describing TH timing in relation to short-term infant outcomes is limited with mixed results.

Purpose: Examine TH timing (TH initiation time & time to target temperature) on short-term outcomes (neonatal seizure; brain injury) of infants >35weeks, with suspected HIE, born at a large urban women’s medical center.

Methodology: Retrospective, cross-sectional, correlational design examining data extracted from electronic health record from November 1, 2012- March 31, 2020. Descriptive and inferential statistics were performed.

Results …

Assessment Of Postpartum Nurses' Knowledge And Teaching Habits Of Maternal Morbidity And Mortality, Mikayla Dodson

DNP Projects

The postpartum period is a joyous time of mother-infant bonding, but it can also be a risky time for women. Despite the education that is provided to postpartum women after birth, many women are still questioning whether or not the signs and symptoms they are experiencing are sufficiently alarming to alert a health care provider. Any delay in seeking care can contribute to poor health outcomes and even maternal mortality. Registered nurses oftentimes provide the bulk of discharge education to postpartum patients. When their knowledge or confidence levels regarding specific topics are low, this can negatively impact the education they …

Intrapartum Guidelines For Nurse Midwives, Tanya Owens

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Intrapartum Guidelines for Nurse-Midwives

Abstract

Intrapartum clinical practice guidelines for certified nurse-midwives (CNMs) can improve quality of care and patient outcomes. Such improvements, however, often relate to the level of rigor in guideline development to assure quality and utilize the most recent and best evidence. This quality improvement project, introduced in three phases, aims to align existing clinical practice guidelines with national clinical practice guidelines and standards of care for certified nurse-midwives providing care in an intrapartum hospital setting. Phase One of this project will review existing clinical practice guidelines for midwifery care, accomplished by appraising 28 intrapartum guidelines. Phase …

Understanding The Emotional And Treatment Impact Of Recurrent Miscarriages For Women Living In Rural Medically Under-Served Areas, Whitney Dickerson

Doctor of Nursing Practice Scholarly Project

Purpose: The main purpose of this study was to identify woman’s feelings, support system, and their grieving process after repeating miscarriages. It was also used to identify any medications or treatments sought for miscarriages and pregnancies.

Design: A qualitative study was completed using a series of interviews performed in the rural area of Southeast Kansas regarding miscarriage history and the women’s experiences. Locating women to interview was done through social media, women were chosen who had a series of three or more miscarriages. The study examined access to fertility care in rural communities and the impact of access on …

Assisting Nursing Students In Their Development Of Empathy: A Guide To Fostering Requisite Skills For The Art Of Empathetic Communication, Susan Mee

Open Educational Resources

This 7-week lesson plan is designed for use in clinical nursing courses. It is designed specifically for use by Nursing faculty teaching in the absence of state required patient facing clinical opportunity due to COVID restrictions. The lesson plan describes pedagogical techniques and provides video and education OER resources designed to help support the development of empathetic communication skills over 7 weeks. Refection and video debriefing techniques will be employed. Role play will culminate in the group presentation project of a brief video modeling effective therapeutic empathetic communication.

2021 Nursing Annual Report, System Of Texas Children's Health

2021

No abstract provided.

Barriers To Healthy Births At Nigerian Hospitals, Caroline Johnston

Senior Theses

Maternal mortality is a problem everywhere, but it is especially dangerous in Nigeria where the average woman experiences pregnancy six times during her lifetime (Population Reference Bureau, 2001). Many researchers focus on the medical complications associated with labor, such as hemorrhage, eclampsia, or infection. Although these birth complications are the direct sources of maternal death, it is also important to recognize how maternal mortality is a multifaceted issue influenced by local cultural groups, religions, politics, poverty level and the absence of basic infrastructures. Although maternal mortality is interconnected with social and geographical elements, my paper concentrates on Nigerian hospitals and …

Improving Nurses’ Provision Of Neuroprotective Care In The Nicu: A Quality Improvement Project, Tammi Reeves-Messner

Doctoral Projects

Infants born prematurely (less than 37 weeks’ gestation) require specialized medical and nursing care to survive. Most of these babies require some form of respiratory, cardiovascular, thermal, and nutritional support as their bodies are not yet physiologically mature enough to handle these basic functions on their own. These supports include basic care such as diaper changes and feeding as well as life-saving interventions which include ventilation, intravenous nutrition, thermal regulation, and vasoactive medications. Depending on their gestational age or their diagnoses, they may require higher levels of support, such as nitric oxide gas delivered via a ventilator (Lai et al, …

The Effect Of Breastfeeding Education In African American Women On Initiation And Duration Of Breastfeeding, Shalawn F. Harris

Electronic Theses and Dissertations

Abstract

This Doctor of Nursing Practice scholarly project aimed to evaluate the effectiveness of breastfeeding education in African American women on the initiation and duration of breastfeeding. Studies demonstrated that breastfeeding education by providers and a breastfeeding support network positively influenced breastfeeding initiation and continuation in African American women. Breastfeeding education containing information on the decreased risk of breast cancer in African American women may be an even greater motivator for breastfeeding. Participants for this project were African American women, ages 18–50, in their last trimester of pregnancy. The project was approved to be implemented at an urban clinic in …

Using Quality Improvement (Qi)-Focused Evaluation To Redesign Direct Home- And Community-Based Services During The Covid-19 Public Health Emergency:, Marcia Moriarta, Anthony Cahill, Heidi Fredine

Developmental Disabilities Network Journal

Like many UCEDDs in the Developmental Disabilities (DD) network, the Center for Development and Disability at the University of New Mexico offers direct service programs in home and community settings. Before the start of the COVID-19 pandemic, services were delivered in-person to about 1,000 families across the state including clients with intellectual or developmental disabilities and/or from at-risk communities. In March 2020, due to the spread of COVID-19, a public health emergency was declared in New Mexico and home and community services were stopped throughout the state. This meant direct service programs at the Center had to turn to telehealth …

Evidence-Based Practice: Delaying Infant Bathing, Gabrielle Wadle, Grace Frankland

Scholars Week

A hospital's policy regarding infant bathing is currently not congruent with best nursing practice. The hospital’s current policy is to bathe an infant once they are stable and their rectal temperature is at or above 98.6 °F. Although the infant may become stable within the first 24-hours of birth, the World Health Organization recommends that, “Bathing should be delayed until 24 hours after birth.” (2013, p. 4). Research has been completed to support delaying infant bathing until 24 hours post-delivery, suggesting potential modifications to current policy.

Research Recruitment: A Case Study On Women With Substance Use Disorder, Kristy J. Cook Phd, Rn, Ibclc, Kim L. Larson Phd, Mph, Rn, Fnap

The Qualitative Report

Women with substance use disorder may evade research participation because of individual and societal factors. Limited information exists on recruitment of women with substance use disorder. The purpose of this study was to delineate recruitment challenges among women with substance use disorder and identify successful recruitment strategies. An exploratory case study was used to examine recruitment of women with substance use disorder. This case study was informed by a pilot study in 2017-2018, where data were generated from 25 direct observations and three key informants from a drug rehabilitation treatment agency. Analysis took an explanation-building approach, which incorporated chronological field …

Exploration Of The Cultural Beliefs, Values And Practices Of African American Women Regarding Postpartum Depression: A Mini-Focused Ethnography, Stephanie Jacobs

Graduate Student Research Symposium

The purpose of this study was to understand the cultural beliefs, values, and practices of African American women regarding postpartum depression. Postpartum depression (PPD) is the most prevalent perinatal mental health illness in women and affects approximately 10 to 20% of all women in the United States. African American women have a disproportionately higher prevalence of postpartum depression (35-67%) and experience it differently. The research question was: What are the cultural care beliefs, values and practices of African American women regarding postpartum depression? This mini-focused ethnography was the method used for this study. It included semi-structured interviews of four African …

Exploring Parent Perception Of Adverse Childhood Experiences Screening In Pediatric Primary Care: A Clinical Inquiry Project, Kathryn Stevens

The Eleanor Mann School of Nursing DNP Capstone Projects

This manuscript explores the incidence and implications of Adverse Childhood Experiences (ACEs) and outlines a project assessing parental perception of their own ACEs screening during their child’s wellness visit. ACEs are adversarial events occurring during childhood, which may be chronic or singular. Abuse, neglect, and household dysfunction result in negative outcomes, including compromised neurological development and cognitive behaviors, developmental delays, poor lifestyle choices, and reduced mental and physical health. Additionally, a growing body of literature supports the impaired parenting skills in those with a history of ACEs. This can perpetuate intergenerational trauma, deprived opportunities, and poor familial health. Despite the …

Connected Care: The Relationship Between Infant-Caregiver Interaction & Preterm Infant Development, Amelia G. Williams

University Honors Theses

This thesis encompasses how families and healthcare workers alike can uplift preterm infants’ development in the Neonatal Intensive Care Unit. The use of positive facial expressions, skin-to-skin contact, verbalizing with the infant, quality time, and focused attention are explored to promote the preterm infant’s positive development. Additionally, this thesis includes research on optimizing the transition from hospital to home for both parents and infants.

This thesis aims to gather information that caregivers can easily reference and put into action with preterm infants. At the end of each body paragraph, the reader can promptly locate summarizing bullet points of how caregivers …

The Effect Of Barometric Pressure, Temperature, And Precipitation On Preterm Labor In Expecting Women In South Carolina, Allison K. Fletcher

Journal of the South Carolina Academy of Science

Each year, approximately 9.9% of infants in the United States are born prematurely at less than 37 weeks of gestation with unidentified causes. From 2014 to 2016, the total preterm birth rate rose 3%, and late preterm birth rates rose almost 4%. One source of preterm labor that has been examined in recent years is its potential correlation with meteorological phenomena, including barometric pressure, temperature, and precipitation. In September of 2019, birth data recording 322 deliveries from two South Carolina hospitals was collected along with weather data on the given dates. The changes in temperature, barometric pressure, and precipitation for …

Evaluating The Impact Of Volunteer And Facility Provided Doula Support In The Intrapartum Period On Maternal, Neonatal, And Psychosocial Outcomes In The Hospital Setting, Kayla Puent, Keirsta Marie Ragels

All Electronic Theses and Dissertations

Background/Purpose: The unacceptably high maternal mortality rate in the United States has demanded a call to action for evaluation and implementation of efforts to improve both maternal and neonatal outcomes. Low-resource and low-socioeconomic populations are at a higher risk of experiencing adverse birth outcomes. Doulas have continuously been recognized as key tools in improving outcomes, but not all birthing persons have access to them. The positive impact of continuous labor support in improving outcomes is recognized by the American College of Obstetricians, American College of Nurse-Midwives, the Society for Maternal-Fetal Medicine, and the March of Dimes. The purpose of this …

Improving Nursing Practice For Perinatal Mood Disorders, Tonya May

Master of Science in Nursing Theses and Projects

Perinatal mood disorder can affect mothers in the antepartum and post-partum phase of pregnancy. Nurses need to be educated on the risk factors, signs, screening tools, and management methods to provide excellent patient care. The purpose of this project was to implement education used to improve nursing practice for patients that experience perinatal mood disorders. Early recognition and management is essential for patient care. Patients that experience perinatal mood disorder do not always report symptoms. This is often out of fear their ability to care for the child or children at home will be questioned if signs of perinatal mood …

Implementation Of Obstetric Enhanced Recovery After Surgery (Ob Eras) Protocol: Prenatally Through Transition To Community, Emily Corbett

Master of Science in Nursing Theses and Projects

This project discusses the implementation of Obstetric Enhanced Recovery after surgery (ERAS) protocol for cesarean section patients scheduled or emergent. The goal of this project was to ensure the best possible outcomes from surgery for obstetric patients by decreasing surgical site infection rates in order to decrease maternal mortality rates. It provides protocols preoperatively, intraoperatively, and postoperatively for surgical procedures. Key steps take place in each phase of surgical care to impact patient outcomes. The protocol includes shorter NPO times, decreased surgical stress through multi-modal approaches for pain and nausea, early mobility, and reduces the length of stay. OB ERAS …

Reflections On Labor And Delivery Internship, Olivia Ozier

2021 Honors Symposium

Introduction
• This research was inspired by clinical experience as a nurse intern on a labor and delivery unit.
• Breastfeeding is extremely beneficial for the health of both mothers and babies. Despite this fact, not enough mothers are breastfeeding.

Purpose
The purpose of this literature review was to determine if the attitude and knowledge hospital staff has about breastfeeding influences how successful mothers are in initiating and continuing breastfeeding.

Nursing Student’S Expectancy-Value Regarding Sudden Infant Death Syndrome Knowledge Retention, Raquel Suba

Nursing | Student Research Posters

Sudden Infant Death Syndrome (SIDS) is a sudden and unexpected death within the first year of life, which is attributable to unexplained causes after autopsies and full case investigations are unable to resolve the reason for death. Annually in the United States, approximately 3,600 infants die unexpectedly and suddenly of Sudden Unexpected Infant Death (SUID) and in 2018, there were 1,300 infant deaths due to SIDS (CDC, 2018). Despite American Academy of Pediatrics (AAP) recommendations promoting the endorsement and modelling of SIDS risk-recommendations from birth, studies reveal that both nursing students and registered nurses have deficient knowledge in adequate SIDS …

Implementation Of A Pregnancy Intention Screening Question At A Federally Qualified Health Center, Diana Gue

Regis University Student Publications (comprehensive collection)

Objective: Process improvement project idea was examined due to the need to fulfill a requirement within a grant. One measure needed for the grant was a pregnancy intention screening question (PISQ) asked of women during their visits. There currently was no formal PISQ. The primary outcomes for this project are to measure effects of the addition of a PISQ on the provision of contraceptive counseling and/or contraceptive methods. Methods: The staff and providers were provided education of the workflow and documentation of the PISQ and the diagnosis codes for contraception counseling and methods. Data was collected three months prior to …

Racial Disparities Among Black Women In Maternal Health: A Literature Review, Tatiyana Rich

Honors Undergraduate Theses

African American women are at a higher risk of experiencing maternal health complications than women of other races. Determining the factors that contribute to the severity of their maternal health complications can help bring awareness and exposure to the disparities among black women in maternal health. The purpose of this study was to explore the various elements that contribute to the high pregnancy mortality ratio and infant mortality ratio in black women and black infants. The secondary purpose was to determine the relationship between stereotypes about African American women as healthcare consumers and the disproportionate percentage of black women experiencing …

Home-Based Interventions To Lower Neonatal Mortality Rates In Developing Countries, Josee Sarah Etienne

Honors Undergraduate Theses

Aim: To evaluate Home-based interventions to lower neonatal mortality rates in developing countries.

Background: A developing country is a country that is lacking in the services and facilities enjoyed by people in developed countries, such as personally owned automobiles and homes with indoor plumbing and water-carried sewage disposal systems. The difference in resources compared to developed regions, has been evident to the correlation of the increase neonatal mortality rates.

Method: An electronic, systematic review of four databases were used to retrieve 209 articles initially, later filtered to 42 articles utilized in this review. The following databases used are as listed: …

Facilitation Of Enviromental Factors To Reduce Sound Decibels In The Neonatal Intensive Care Unit: A Literature Review, Cassandra Hanlon

Honors Undergraduate Theses

This literature review investigates nursing interventions to reduce decibel levels in the neonatal intensive care unit (NICU). The secondary purpose of this review was to evaluate if the interventions to reduce noise in the NICU had different outcomes for normal weight premature infants and infants afflicted with neonatal abstinence syndrome. The data bases for completing this review were Google Scholar, the Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus), PubMed, and Elton B. Stephens Co. (EBSCO). The key search words included ‘NICU and decibels', ‘reducing decibels', ‘neonatal abstinence syndrome' ‘decibels', ‘preterm infants' and 'normal weight preterm infant*'. The …