Maternal, Child Health and Neonatal Nursing Commons^™

Creating Consistency: Standardizing Gestational Diabetes Group Visit Framework In High-Risk Obstetric Care, Danielle Pack

Master's Projects and Capstones

Objective: Gestational diabetes mellitus (GDM) requires timely and consistent education to promote effective self-management and improve maternal and fetal outcomes. Baseline observations at a Santa Clara County high-risk obstetric clinic identified variation in educational materials, educator delivery, referral processes, and workflows between English- and Spanish-language GDM group visits. A review of the literature supported standardized diabetes education and group prenatal care as strategies to improve consistency, efficiency, and patient access. Aim: This quality improvement project aimed to develop and implement a standardized GDM group visit framework for nurse practitioners, registered dietitians, and scheduling staff, with the goal of increasing compliance …

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

Doctor of Nursing Practice Final Project Abstract

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

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

Methodology: A ten-week intervention period utilized …

Preliminary Insights From Hospital Records: Disseminated Intravascular Coagulation In Pregnancy And Postpartum In A Tertiary Care Hospital In Karnataka, Mitchelle Shilpa Lewis Ms, Judith Angelitta Noronha Dr

Manipal Journal of Nursing and Health Sciences

Introduction- During pregnancy and labor, women undergo changes in their bodies, and are at risk for various complications during this period of life. Disseminated intravascular coagulation (DIC)during pregnancy is a debilitating, life-threatening condition that impacts the health of women.

Purpose- This study aimed to identify the incidence ,factors predisposing women to DIC and the treatment modalities used for women during pregnancy and postpartum to manage DIC

Materials and Methods- A retrospective cohort study was conducted to identify incidence, symptoms, laboratory findings, treatment, and maternal outcomes for the last five years. Records of the patients diagnosed with DIC during pregnancy and …

Development And Implementation Of An Ob/L&D Sbar Framework To Enhance Communication Between Obstetric Nurses And Anesthesia Providers: A Quality Improvement Initiative, Jenna E. Bigam, Laina J. Uzarski

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Effective communication between obstetric (OB) nurses and anesthesia providers is critical to ensure patient safety during epidural placements in labor and delivery (L&D) settings. At a large teaching hospital, communication gaps were identified when OB nurses requested anesthesia for epidural placements without consistently providing vital patient information. The lack of structured communication can result in important details being overlooked, which may lead to delays in care and potential patient harm. To address this, the SBAR (Situation, Background, Assessment, Recommendation) communication framework was implemented to standardize and improve information exchange. This Doctorate of Nurse Anesthesia Practice (DNAP) project aimed to enhance …

Intermittent Auscultation Vs Electronic Fetal Monitoring In Laboring Patients, Nichole Plummer, Jennifer Kellerman

Nurse Residency

In healthy laboring women, how does the use of Intermittent auscultation, compared to continuous monitoring, affect fetal and maternal outcomes?

Paramedic Training, Experience, And Confidence With Out-Of-Hospital Childbirth (Oohb) In Australia, Michella G. Hill, Belinda Flanagan, Brennen Mills, Sara Hansen, Luke Hopper

Research outputs 2022 to 2026

Background: Out-of-hospital births (OOHBs) are rare representing ∼0.05% of prehospital callouts. OOHBs are at increased risk of complications including life-threatening conditions such as postpartum haemorrhage and neonate resuscitation. This research investigated Australian paramedics perceptions of’ training, experience, and confidence with OOHBs. Methods: Semi-structured qualitative interviews were undertaken in late 2021 via online conference or face-to-face. Sessions were audio-recorded and transcribed. Data was analysed and coded into over-arching themes using thematic analysis. Results: Fourteen participants were interviewed from military, industrial, and jurisdictional ambulance services. Nine participants were female, and experience ranged from 1.5 to 20 years. Six Australian states were represented, …

Reducing Postpartum Hemorrhage Rates At Maine Medical Center, Meaghan Smith, Colette Dumais, Tracey E. Mcmillan, Carrie Comeau, Mandy Wallace, Jenelle Boulanger, Jodi-Lynne Vaughn, Kelly Ouellette, Natalia Johnson, Suneela Nayak, Rebecca Brookes

Operations Transformation

In the United States, approximately 700 women die each year from pregnancy related deaths and the most frequent cause of preventable maternal mortality is obstetric hemorrhage. The postpartum hemorrhage (PPH) rate at Maine Medical Center (MMC) is three times the national average. At our facility we care for the most complex patients in the State and we must decrease our rate to accurately reflect our expertise, knowledge and skills.

The Influence Of Gender Bias On Male Nurses And Nursing Students In The Obstetric, Maternal, And Pediatric Nursing Profession., Julian Alvarez

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This literature review analyzes if gender bias influences the disproportionate number of male nurses and male nursing students in the pediatric, maternal, and obstetric nursing fields as compared to nursing as a whole. PubMed and CINAHL databases were utilized to find 15 research articles focused on the experiences of male nurses and male nursing students. These articles were compared amongst each other to find common themes of the male experience in the nursing fields of pediatrics, maternity, and obstetrics. The three common themes found were 1) Men tend to encounter situations where their professionalism will be monitored more closely when …

The Effects Of Doula Care On Birth Outcomes And Patient Satisfaction In The United States, Lynae Carlson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The visitor policies related to the COVID-19 pandemic limited doula care and called into question the importance of doulas in the birth process. While the Cochrane Systematic Review presents compelling evidence of the benefits of continuous birth support on outcomes ranging from shorter labors to higher 5-minute Apgar scores, there are gaps in literature that exclusively focus on continuous support from doulas. The literature review aims to determine both qualitative and quantitative outcomes of doula care on the mother and baby during the labor and post-partum periods, focusing on specific aggregates, such as adolescents, women with low incomes, and women …

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 …

Reducing Hypotension In Elective Cesarean Section Patients With Administration Of Ondansetron Prior To Spinal Anesthesia: A Retrospective Chart Analysis, Linsey Erin Phipps

Doctoral Projects

The birth of a child is one of the most memorable moments in a woman’s life, and many women undergo an elective cesarean section, requiring spinal anesthesia. At this time, the patient and the unborn child’s well-being become the anesthetist’s main focus. The ultimate goal of anesthesia providers is to provide the safest care to the patient. Spinal anesthesia has many benefits, but has a common side effect of hypotension, which can also result in nausea. Hypotension, dangerous to mother and child, is often treated with vasopressors, but can also cause nausea, which is treated by the administration of ondansetron. …

Efficacy Of Intravenous Ondansetron In Relieving Nausea/Vomiting And Pruritus Post Epidural Administered Opioids In The Obstetric Patient, Benjamin Stephen Butler

Doctoral Projects

One prominent side effect in the use of a neuraxial anesthesia is pruritus, with an incidence in the obstetric patient of 60-100% (Kumar & Singh, 2013). Another side effect of an epidural placement is nausea and vomiting. Nausea and vomiting occurs frequently during the progress of labor and is difficult to determine an incidence that is related to epidural opioid administration (Chestnut, Wong, Tsen, Ngan Kee, Beilin, & Mhyre, 2014). A review of literature was performed and established evidence that ondansetron is effective in reducing incidence of pruritus in intrathecal administered opioids for cesarean sections in the obstetric patient. No …

Interprofessional Roles Shoulder Dystocia: Maximizing Safety In Community Hospitals, Elizabeth Yznaga

Doctor of Nursing Practice (DNP) Projects

Prompted by evidence that clinical simulations improve patient safety, team simulations are emerging in hospital settings. Accrediting organizations such as the U.S. Joint Commission on Accreditation of Healthcare Organizations and the American College of Obstetricians and Gynecologists (Joint Commission, 2004, American College of Obstetricians and Gynecologists, 2002) have recommend simulation of obstetrical emergencies, including shoulder dystocia for hospital teams. National patient safety mandates for simulation training of critical events have not been available to small, rural hospitals because of lack of talent and equipment, creating a gap in resources. Other than demonstrations by manikin companies, this author has currently been …

Perception, Expression And Management Of The Pain Of Childbirth, Mary H. Christenson

Senior Honors Theses

In order to be a competent nurse on an American labor and delivery unit it is important to have an understanding of the pain of childbirth. This includes a thorough understanding of pain as a sensation and its manifestation during the birthing experience. An understanding of pain is useless, however, unless standardized pain assessment practices are used. The most accurate pain assessment is associated with a general understanding of cultural trends in pain perception and expression. Along with culture, other factors also influence how a woman senses and copes with the pain of labor. Anxiety is one of these influential …

Increasing Labor And Delivery Nurse Knowledge Of Triaging Non-Obstetrical Medical Emergencies In Pregnant Women Through The Use Of Simulation, Julie Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the effect simulation training has on an OB nurse's ability to correctly triage pregnant patients. Registered Nurses (RNs) working in OB triage must be able to correctly and expediently identify the care a pregnant patient needs. OB triage nurses are trained to recognize pregnancy related issues that commonly present during the months leading up to delivery. It is as important for these nurses to have the skills to realize when a pregnant patient is having a non-obstetrical health crisis. A group of OB triage RNs participated in simulation-training scenarios based on non- …

Comparison Of Primiparous Women's Expected And Experienced Pain In Labour, Shelagh Lawrence

Theses : Honours

Pain is a subjective phenomenon and is, in varying degrees, an inherent part of the childbirth experience. However, most Western societies view suffering as unacceptable and as such, regard analgesia as a necessity. Many women do not anticipate the intensity of pain experienced in childbirth and are, therefore, not ready to manage this amount of pain when it occurs. This prospective study compared the expected and experienced labour pain of 99 primiparous women, aged 17-40 years. The relationship between expected and experienced pain and acceptance of pregnancy; identification with the motherhood role; relationship with mother; relationship with husband/partner; preparation for …