Maternal, Child Health and Neonatal Nursing Commons^™

Invasive Haemophilus Influenza Type B In An Infant During The Covid-19 Pandemic: The Return Of Diseases We Hoped Never To See Again…, Christy Tabarani, Stephen A Fletcher, Gloria P Heresi, Susan H Wootton

Faculty, Staff and Student Publications

No abstract provided.

Implementing A Robust Process Improvement Program In The Neonatal Intensive Care Unit To Reduce Harm, Klaus G Nether, Eric J Thomas, Amir Khan, Madelene J Ottosen, Lauren Yager

Faculty, Staff and Student Publications

INTRODUCTION: Preventable harm continues to occur with critically ill neonates despite efforts by hospital neonatal intensive care units (NICUs) to improve processes and reduce harm. Attaining significant and sustainable improvements will require training including leadership support, mentoring, and patient family engagement to improve care processes. This paper describes the implementation of a robust process improvement (RPI) program in the NICU to reduce harm.

METHODS: Leaders, staff, and parents were trained in RPI concepts and tools. Multidisciplinary teams including parent members applied the training and received regular mentorship for their improvement initiatives.

RESULTS: Participants (N = 67) completed pretraining and post-training …

Nicu Experiences Of Adoptive Parents & Desired Preparation, Catherine J. Howe

Graduate Theses/Dissertations

Parents who have newborns admitted into the Neonatal Intensive Care Unit (NICU) have multiple experiences and emotions. Additional social and emotional layers are experienced by adoptive couples when the infant they wish to adopt needs specialized care. This research study was completed to find out what adoptive parents experience in the NICU and what preparation would have been helpful. The method included semi-structured, open-ended interviews with seven couples who adopted a newborn at a Midwestern adoption agency within the past three years and had a NICU experience. The results described adoptive couples’ experiences on the unit, bonding and attachment, fears …

Defining The Epidemiology Of Safety Risks In Neonatal Intensive Care Unit Patients Requiring Surgery, Daniel J France, Jason Slagle, Emma Schremp, Sarah Moroz, L Dupree Hatch, Peter Grubb, Timothy J Vogus, Matthew S Shotwell, Amanda Lorinc, Christoph U Lehmann, Jamie Robinson, Marlee Crankshaw, Maria Sullivan, Timothy A Newman, Tamara Wallace, Matthew B Weinger, Martin L Blakely

Faculty, Staff and Student Publications

OBJECTIVE: The aim of the study was to determine the incidence, type, severity, preventability, and contributing factors of nonroutine events (NREs)-events perceived by care providers or skilled observers as a deviations from optimal care based on the clinical situation-in the perioperative (i.e., preoperative, operative, and postoperative) care of surgical neonates in the neonatal intensive care unit and operating room.

METHODS: A prospective observational study of noncardiac surgical neonates, who received preoperative and postoperative neonatal intensive care unit care, was conducted at an urban academic children's hospital between November 1, 2016, and March 31, 2018. One hundred twenty-nine surgical cases in …

Initial Laparotomy Versus Peritoneal Drainage In Extremely Low Birthweight Infants With Surgical Necrotizing Enterocolitis Or Isolated Intestinal Perforation: A Multicenter Randomized Clinical Trial, Martin L Blakely, Jon E Tyson, Kevin P Lally, Susan R Hintz, Barry Eggleston, David K Stevenson, Gail E Besner, Abhik Das, Robin K Ohls, William E Truog, Leif D Nelin, Brenda B Poindexter, Claudia Pedroza, Michele C Walsh, Barbara J Stoll, Rachel Geller, Kathleen A Kennedy, Reed A Dimmitt, Waldemar A Carlo, C Michael Cotten, Abbot R Laptook, Krisa P Van Meurs, Kara L Calkins, Gregory M Sokol, Pablo J Sanchez, Myra H Wyckoff, Ravi M Patel, Ivan D Frantz, Seetha Shankaran, Carl T D'Angio, Bradley A Yoder, Edward F Bell, Kristi L Watterberg, Colin A Martin, Carroll M Harmon, Henry Rice, Arlet G Kurkchubasche, Karl Sylvester, James C Y Dunn, Troy A Markel, Diana L Diesen, Amina M Bhatia, Alan Flake, Walter J Chwals, Rebeccah Brown, Kathryn D Bass, Shawn D St Peter, Christina M Shanti, Walter Pegoli, David Skarda, Joel Shilyansky, David G Lemon, Ricardo A Mosquera, Myriam Peralta-Carcelen, Ricki F Goldstein, Betty R Vohr, Isabell B Purdy, Abbey C Hines, Nathalie L Maitre, Roy J Heyne, Sara B Demauro, Elisabeth C Mcgowan, Kimberly Yolton, Howard W Kilbride, Girija Natarajan, Kelley Yost, Sarah Winter, Tarah T Colaizy, Matthew M Laughon, Satyanarayana Lakshminrusimha, Rosemary D Higgins, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Neonatal Research Network

Faculty, Staff and Student Publications

OBJECTIVE: The aim of this study was to determine which initial surgical treatment results in the lowest rate of death or neurodevelopmental impairment (NDI) in premature infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP).

SUMMARY BACKGROUND DATA: The impact of initial laparotomy versus peritoneal drainage for NEC or IP on the rate of death or NDI in extremely low birth weight infants is unknown.

METHODS: We conducted the largest feasible randomized trial in 20 US centers, comparing initial laparotomy versus peritoneal drainage. The primary outcome was a composite of death or NDI at 18 to 22 months corrected …

Tiny Tusk Internship: The Relationship Between Duration Of Breastfeeding And The Development Of Attention-Deficit / Hyperactivity Disorder, Mckenna Gribble

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that remains highly prevalent in the youth community, yet its cause cannot be definitively placed. With the idea that this condition is primarily targeting children, the problem and possible solution may lie in infancy. The purpose of this literature review was to integrate evidence from studies published from 2015 to 2021 on the relationships between duration of breastfeeding during infancy and the development of ADHD. The results of this review supported the hypothesis that a longer duration of breastfeeding has a protective effect on childhood development and reduces the risk of developing ADHD …

Tiny Tusks Internship: Does Breastfeeding Education In An Undergraduate Nursing Program Affect Student Knowledge And Attitudes Concerning Breastfeeding?, Grace Murphy

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks provides honors nursing students enrolled in the Eleanor Mann School of Nursing at the University of Arkansas an opportunity to support mothers in the community by providing breastfeeding services, education, and assistance at public Razorback sporting events. Interns provide this support by setting up designated lactation spaces at sporting events, such as gymnastics meets, football, and basketball games, for mothers to breastfeed or pump. In this thesis, I reflect on my internship experience and provide a review of literature. Since the aim of Tiny Tusks is to provide breastfeeding education and support to mothers in the community, the …

Tiny Tusks Breastfeeding And Infant Support Internship, Anna Elizabeth Ray

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks Breastfeeding and Infant Support is a program at the University of Arkansas that provides a clean, private area for mother’s to nurse, pump, and change their infant’s diaper at Razorback home athletic events. The Tiny Tusks area is utilized at multiple athletic events including football games, men’s basketball games, and women’s gymnastics meets. Mothers are supplied comfortable rocking chairs, clean changing tables, heaters or fans depending on the weather, bottled water, and informational handouts about a wide array of breastfeeding topics. Along with supporting mothers, the mission of Tiny Tusks is to normalize breastfeeding in public areas and …

Tiny Tusks Internship: Barriers To Breastfeeding, Cameron Watson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks Breastfeeding and Infant Support Internship allows students to gain insight on breastfeeding practices through volunteering at University of Arkansas sporting events. Therefore, I chose to review prevalent barriers to breastfeeding that mothers in the United States face. These mothers were at least one of these: Hispanic, Marshallese, African American, disabled, employed, a veteran, living in a rural area, or a woman of the general American population. This topic is relevant because of the many benefits that breastfeeding provides for both the baby and the mother.

The Effects Of Postpartum Depression On Children's Social Development, Delaney Besse, Margaret Williams, Danielle Spencer, Brooke Walters

Williams Honors College, Honors Research Projects

The increased incidence of postpartum depression has had significant effects on children’s social development. The purpose of this systematic review is to bring attention to the growing problem in such a vulnerable population. In addition, it was designed to shed light on the lack of research in this area of healthcare. The methods used to conduct the study include various peer reviewed, scholarly and evidenced based articles from databases such as Academic Search Complete, PsycNet, and Pubmed. Each article has been critically evaluated based on the following guidelines: a population group of children under the age of four, specifically maternal …

Fathers’ Experiences Of Feeding Their Extremely Preterm Infants In Family-Centred Neonatal Intensive Care: A Qualitative Study, Evalotte Mörelius, Sofia Brogren, Sandra Andersson, Siw Alehagen

Research outputs 2014 to 2021

Background:

Extremely preterm infants need advanced intensive care for survival and are usually not discharged before they reach the time of expected birth. In a family-centred neonatal intensive care unit both parents are involved at all levels of care including the feeding process. However, studies focusing on fathers in this situation are scarce. The purpose of this study was to explore the experiences of feeding extremely preterm infants in a neonatal intensive care unit from fathers’ perspectives.

Methods:

The study adopts a qualitative inductive method, reported according to the COREQ checklist. Seven fathers of extremely preterm infants (gestational age 24–27 …

An Altitude Adjustment: Implementing A Clinical Practice Guideline In The Newborn Nursery At Moderate Altitude, Leeann Blaskowsky

Student Scholarly Projects

Practice Problem: All infants undergo many changes at birth, but for some, the transition from intrauterine to extrauterine life presents more of a challenge, especially at altitude. Despite continuing research, neonatal prescribing guidelines for oxygen therapy remain ambiguous.

PICOT: For term and late preterm infants requiring oxygen beyond transition, does a clinical practice guideline compared to practice without a guideline, provide consistent, evidence-based care, support the mother-infant dyad, and impact nursing perceptions over a six-week pilot period?

Evidence: Birth at moderate altitude presents the newly born with less oxygen than those delivered at sea level. Several studies …

The Cortico-Limbo-Thalamo-Cortical Circuits: An Update To The Original Papez Circuit Of The Human Limbic System, Jochen Profit, Paul J Sharek, Xin Cui, Courtney C Nisbet, Eric J Thomas, Daniel S Tawfik, Henry C Lee, David Draper, J Bryan Sexton

Faculty, Staff and Student Publications

OBJECTIVES: Key validated clinical metrics are being used individually and in aggregate (Baby-MONITOR) to monitor the performance of neonatal intensive care units (NICUs). The degree to which perceptions of key components of safety culture, safety climate, and teamwork are related to aspects of NICU quality of care is poorly understood. The objective of this study was to test whether NICU performance on key clinical metrics correlates with caregiver perceptions of safety culture.

STUDY DESIGN: Cross-sectional study of 6253 very low-birth-weight infants in 44 NICUs. We measured clinical quality via the Baby-MONITOR and its nine risk-adjusted and standardized subcomponents (antenatal corticosteroids, …

Accuracy Of Rn Visual Quantification Of Emesis Volumes In The Neonatal Intensive Care Unit, Stephen Stoever

Seton Hall University DNP Final Projects

An important component of nursing assessment of feeding tolerance in the neonatal intensive care unit (NICU) for both low-risk and high-risk babies, is the quantification of emesis volumes. While some nurses attempt to weigh the items saturated in emesis in order to quantify volume loss (QEV), there is no or limited consistency in this practice across nurses in this unit. Rather, volumes are “best-guessed” or estimated (EEV) and reported to the practitioner for decision-making. Often feed advances are paused or limited due to perceived feeding intolerance connected to emesis events in neonates.

For this project, 158 NICU nurses at a …

Family-Centered Care In The Neonatal Intensive Care Unit, Madison Winter

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Family-centered care can be useful in any clinical scenario, but more so in the Neonatal Intensive Care Unit (NICU). Having a preterm infant admitted into the NICU is not an ideal situation, and can cause high levels of apprehension for the parents. “Stress experienced by parents whose infant is hospitalized in the NICU is strongly correlated with anxiety, fatigue, depression, and sleep disruption” (Busse et al., 2013). [excerpt]

Tiny Tusks: Breastfeeding And Infant Support Internship Review, Blair Wilhelm

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks: Breastfeeding and Infant Support is a tent and lactation room at University of Arkansas athletic events such as men's basketball and football games that allows moms that are breastfeeding a comfortable and private area. Tiny Tusks aims to empower and educate moms about the benefits of breastfeeding and decrease the stigma behind it. The tent offers comfortable chairs, a changing table, arts and crafts for younger kids and educational pamphlets and brochures. Tiny Tusks is run by certified lactation consultants, BSN honors students and Eleanor Mann School of Nursing faculty. Participants were asked to fill out a survey …

Decreasing Hospitalization In Infants, William Hang

MSN Capstone Projects

Infants are the most vulnerable population at risk for serious diseases. Respiratory syncytial virus (RSV) is a disease that can be detrimental in infants because of their immature lungs and immune system. Palivizumab, a humanized monoclonal antibody medication, given every 28-30 days has been shown to reduces RSV symptoms and decrease rates of hospitalization by 15%. By reducing the rate of hospital stay, it will also reduce cost.

Prenatal Yoga In Pregnancy, Ashleigh Clingenpeel

Senior Honors Theses

Prenatal yoga has emerged as an advisable, beneficial, and supportive addition to birth preparation. Many studies have linked participation in prenatal yoga with both maternal and infant benefits. Physical benefits for the mother include decreased labor time, decreased labor pain, and improved comfort during pregnancy. Significant emotional and mental effects have also been correlated, such as lowered rates of depression and anxiety, increased self-efficacy in labor, and easier transitions into the postpartum period. Finally, prenatal yoga has demonstrated benefits to the neonate, with a greater number of vaginal deliveries, which are less traumatic for the infant, an increase in gestational …

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Silvia Chiang, Carmen Contreras, Ganmaa Davaasambuu, Wafaie W Fawzi, Molly F Franke, Jerome T Galea, Daniel Garcia-Ferrer, Maria Gil-Fortuño, Barbará Gomila-Sard, Amita Gupta, Nikhil Gupte, Rabia Hussain, Jesus Iborra-Millet, Najeeha T Iqbal, Jose Vicente Juan-Cerdán, Aarti Kinikar, Leonid Lecca, Vidya Mave, Noemi Meseguer-Ferrer, Grace Montepiedra, Ferdinand M Mugusi, Olumuyiwa A Owolabi, Julie Parsonnet, Freddy Roach-Poblete, Maria Angeles Romeu-García, Stephen A Spector, Christopher R Sudfeld, Mark W Tenforde, Toyin O Togun, Rosa Yataco, Zibiao Zhang, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.

METHODS AND FINDINGS: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Risk For Maternal Infant Bonding Reduction In High Risk Deliveries And The Recovery Phases, Amanda M. Karimi, Corie Vanarsdale Msn

Anna Vaughn School of Nursing Undergraduate Work

Bonding is one of the first developmental tasks for infants and is imperative for successful growth. The bonding phase begins in the periods immediately following birth. Complications that inhibit bonding postpartum may delay this process. Breastfeeding barriers, maternal substance abuse, and poor maternal mental health are among the contributing factors to delayed bonding. The purpose of this research study was to answer the question, “What best practiced nursing interventions assist mothers to promote bonding with the newborn after high risk deliveries?” This research review included a sample size of 10 articles which provided a variety of interventions to promote bonding …

Outcomes Of Implementation Of An Evidence-Based Enteral Feeding Protocol In Neonates Weighing Less Than 1800g At Birth, Rebecca Edwards

MaineHealth Maine Medical Center

Background:

Several studies have demonstrated that the implementation of standardized enteral feeding guidelines can lead to positive outcomes in the neonatal intensive care unit (NICU), including improved nutrition, decreased need for parenteral nutrition (PN), central lines and decreased costs. Furthermore, implementation of standard feeding regimens have significantly reduced the incidence of necrotizing enterocolitis (NEC), a devastating gastrointestinal emergency in neonates. It has been reported that NEC has an iatrogenic component related to variations in feeding practices. While the exact mechanism of the reduced risk of NEC and implementation of feeding protocols is unclear, standard feeding regimens likely improve consistency in …

Exome Sequencing Identifies Gene Variants And Networks Associated With Extreme Respiratory Outcomes Following Preterm Birth, Aaron Hamvas, Rui Feng, Yingtao Bi, Fan Wang, Soumyaroop Bhattacharya, Jared Mereness, Madhurima Kaushal, C Michael Cotten, Philip L Ballard, Thomas J Mariani

Faculty, Staff and Student Publications

BACKGROUND: Previous studies have identified genetic variants associated with bronchopulmonary dysplasia (BPD) in extremely preterm infants. However, findings with genome-wide significance have been rare, and not replicated. We hypothesized that whole exome sequencing (WES) of premature subjects with extremely divergent phenotypic outcomes could facilitate the identification of genetic variants or gene networks contributing disease risk.

RESULTS: The Prematurity and Respiratory Outcomes Program (PROP) recruited a cohort of > 765 extremely preterm infants for the identification of markers of respiratory morbidity. We completed WES on 146 PROP subjects (85 affected, 61 unaffected) representing extreme phenotypes of early respiratory morbidity. We tested for …

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 …

Reducing The Risk Of Hypothermia In Neonatal Infants, Monika Klett-Dunbar

Master's Projects and Capstones

Abstract

Global Aim: To improve infant thermoregulation within the first 24 hours of life of the high risk preterm and very low birth weight (VLBW) infant population in the NICU, thereby reducing rates of morbidity and mortality due to complications influenced by infant hypothermia. Project Aim: To reduce the rate of hypothermia at one hour and the first 24 hours of life in the target population of preterm neonates weighing less than 1500 grams with a gestational age less than 32 weeks from 9.5% to < 5% through the consistent use of a specific bundle of interventions applied in the labor and delivery setting, by December 2017. The aim of the current initiative is also to build on the success of the pilot program launched in 2015 by adding to the preliminary bundle of initiatives, and sustaining hard-won achievements by reinforcing education measures to the nursing and medical teams involved in the infant delivery and NICU admission process. Background: Hypothermia is a major factor in morbidity and mortality of low-birth-weight premature infants, …

Interventions To Reduce The Effects Of Nicu Noise In Preterm Neonates, Rebecca L. Manske

Honors Undergraduate Theses

Exposure to excessive noise during a neonates stay in the neonatal intensive care unit (NICU) can create both immediate and long term health problems such as, hearing loss, neurological deficits, and sleep pattern disturbances. The use of earmuffs or earplugs to decrease the neonate’s exposure to noise can create a more stable environment to facilitate improved growth and development. The purpose of this research was to examine the use of earmuffs or earplugs to reduce the impact of noise on neonates. A systematic review of literature was conducted using online databases including CINAHL, ERIC, Ebsco Host, Medline, and PsychINFO. The …

Opioid Abuse In Pregnancy: A Systematic Review, Emily Sebunia, Colleen Fearon

Williams Honors College, Honors Research Projects

Prenatal opioid abuse is a serious public health concern and linked with numerous health consequences for both mothers and children. Despite research describing negative outcomes of drug use during pregnancy, it is still a prevalent problem in the United States, with researchers finding that women are at highest risk for substance abuse during their reproductive years. Opioid abuse during pregnancy is common, including opioids such as hydrocodone, oxycodone, morphine, and heroin. Use of these drugs results in both short and long term side effects for the mother and child. Therefore, the prevalence of this problem should not be underestimated. …

Neonatal Mortality Within 24 Hours Of Birth In Six Low- And Lower-Middle-Income Countries., Abdullah H. Baqui, Dipak K. Mitra, Muhammad Imran Nisar, Fyezah Jehan, Muhammad Ilyas, Murtaza Ali, Imran Ahmed, Shabina Arif, Sajid B. Soofi, Sachiyo Yoshida

Department of Paediatrics and Child Health

Objective: To estimate neonatal mortality, particularly within 24 hours of birth, in six low- and lower-middle-income countries.

Methods: We analysed epidemiological data on a total of 149 570 live births collected between 2007 and 2013 in six prospective randomized trials and a cohort study from predominantly rural areas of Bangladesh, Ghana, India, Pakistan, the United Republic of Tanzania and Zambia. The neonatal mortality rate and mortality within 24 hours of birth were estimated for all countries and mortality within 6 hours was estimated for four countries with available data. The findings were compared with published model-based estimates of neonatal …

Nutritional Status And Tuberculosis Risk In Adult And Pediatric Household Contacts, Omowunmi Aibana, Xeno Acharya, Chuan-Chin Huang, Mercedes C Becerra, Jerome T Galea, Silvia S Chiang, Carmen Contreras, Roger Calderon, Rosa Yataco, Gustavo E Velásquez, Karen Tintaya, Judith Jimenez, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children.

METHODS AND FINDINGS: We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used …

Effects Of Multimodal Fever Education On Parents Of Febrile Children, Teresa S. Parkhouse

Evidence-Based Practice Project Reports

Insufficient knowledge regarding the physiology and appropriate management of fever in children often contributes to an increased parental anxiety, inappropriate antipyretic use, and overutilization of medical resources (Chang, Liu, & Huang, 2013; Crocetti, Moghbeli, & Serwint, 2001; Schmitt, 1980). Parental concerns regarding childhood fever can lead to an overuse of health care resources as febrile illness in children accounts for approximately 20% of emergency department visits, 30% of office visits, and over 50% of after-hour phone calls to private physicians (Zomorrodi & Attia, 2008). Research shows that multidimensional educational interventions are most effective in improving parental management of fever (Young …

The Effect Of An Educational Hunger Cues Intervention On Awareness In Mothers With Infants, Juliana F. Gill, Ellen A. Vierheller

Williams Honors College, Honors Research Projects

Stress to an infant can inhibit the ability to properly feed and gain the nutrients that are essential for efficient growth. Mothers who are unaware of early hunger cues from their infant have the potential to stress the infant if their early hunger cues are not attended to. The purpose of this study was to examine the effect of an educational hunger cues intervention on awareness in mothers with an infant. The following research question will be answered: Will new mothers who complete an educational intervention show increased awareness of hunger cues in their infants, in comparison to before the …