Maternal, Child Health and Neonatal Nursing Commons^™

Determinants Of Uptake Of Breast Cancer Screening Among Women Of Reproductive Age In Makueni County, Lola Ndirangu

MSc in Advanced Practice Nursing

Background: Breast cancer is the most diagnosed cancer in all women worldwide, with women in low and middle-income countries dying of the disease in disproportionate numbers because of late diagnosis and access to screening services. Sub-Saharan Africa is an under-researched area, and the level of screening uptake in Kenya, especially in rural and semi-arid areas, including Makueni County, is low. This research assessed the factors that determine the reproductive age women's screening uptake of breast cancer in Makueni County.

Methodology: The cross-sectional design was analytical and was conducted in Makueni County Referral Hospital, where 301 randomly chosen women …

Eat, Sleep, Console Care For Infants With Neonatal Abstinence Syndrome: A Multisite Evaluation, Amanda Fout

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: Opioid use in pregnancy continues to rise, leading to increasing cases of neonatal abstinence syndrome (NAS). Traditional management with the Finnegan Neonatal Abstinence Scoring System (FNASS) often results in pharmacologic treatment, prolonged hospitalizations, and higher costs. Inconsistent FNASS scoring at the hospital system contributed to unnecessary NICU admissions and variable outcomes. Eat, Sleep, Console (ESC) was introduced as an alternative approach, but its effectiveness had not been formally evaluated.

Aim of the Project: The aim of the quality improvement initiative was to evaluate the effectiveness of the ESC model in improving outcomes for infants with NAS across three hospitals …

Ready Or Not? An Autoethnography Of A Midwife’S Preparedness And Readiness Journey, Kristen Graham

The Qualitative Report

This emotive autoethnography explores my experiences working as an Australian midwife in low- and middle-income countries, which led to a Doctor of Philosophy journey exploring primary care midwives' preparedness and readiness in rural and remote communities in this context. I use the midwifery tradition of storytelling to explore personal experiences of preparedness and readiness as a way towards researcher reflexivity, understanding and meaning. Emerging themes of preparation for practice, resource limitations, heartache, and emotional resilience offer insights to inform midwifery education, research, and practice.

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Nurses’ Knowledge About Assisted Reproductive Methods And Their Awareness About It In Potential Immune-Related Outcomes Of Conceived Children, Salma Abd-Elatty Moawed, Abdallah Ahmed Said

Nursing

Abstract A rising worldwide health concern, infertility is impacted by a number of environmental and lifestyle factors. With cutting-edge methods like intrauterine insemination, intracytoplasmic sperm injection, and in vitro fertilization, assisted reproductive technology gives infertile couples hope. Because they provide clinical care, education, and emotional support before, during, and after assisted reproductive technology procedures, nurses are essential to its success. The purpose of this study is to assess nurses’ knowledge and awareness about assisted reproductive methods and the immune outcomes among the resulting children. A structured interview questionnaire will be used to gather data from 130 nurses as part of …

Enhancing Patient Outcomes: Developing A Comprehensive Database For Tracking Post- Dural Puncture Headache Incidence And Contributing Factors, Meredith B. Auge, Brittany Bogonovich

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Post-dural puncture headache (PDPH) is a debilitating complication following labor analgesia, often resulting from unintentional dural puncture (UDP). While national incidence is approximately 1.5%, institutional rates may vary due to provider experience, documentation practices, and patient factors. This Doctor of Nurse Anesthesia Practice (DNAP) quality improvement project aimed to improve identification and monitoring of UDP and PDPH through a revised tracking tool, retrospective review of 2024 data, and planning for an electronic registry. A multidisciplinary team of anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs), Student Registered Nurse Anesthetists (SRNAs), and IT and quality specialists revised an existing tracking tool to better …

"Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project", Amber M. Woodring, Samantha Kalkstein

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project, Samantha Kalkstein, Amber Woodring

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Socio-Cultural Correlates Of Breastfeeding Behavior Among Latina Mothers And Its Implications For Child Health, Liliana Davalos, Brisa Rodriguez Alcantar, Marissa Martinez, Christopher Johansen

Social and Behavioral Health Faculty Research

Background: Latina mothers in the United States report lower rates of breastfeeding initiation and exclusivity than their non-Hispanic counterparts. Lower rates of breastfeeding in infancy may lead to a higher rate of excess weight in childhood and adverse health conditions. Breastfeeding disparities in Latina women have been previously correlated with socio-cultural factors such as acculturation, education, income, nativity, and marital status. This study examines whether socio-cultural factors are associated with breastfeeding behaviors in Latina mothers in Nevada. Methods: Participants were Latina mothers [n = 214] over 18 years of age, with a child 2–5 years old. A logistic regression was …

Skin-To-Skin Contact At Birth For Very Preterm Infants And Symptoms Of Depression And Anxiety In Parents During The First Year – A Secondary Outcome Of A Randomized Clinical Trial, Siri Lilliesköld, Karoline Lode-Kolz, Björn Westrup, Nils Bergman, Kimmo Sorjonen, Ulrika Ådén, Evalotte Mörelius, Siren Rettedal, Wibke Jonas

Research outputs 2022 to 2026

Background: Mental health issues are common in parents to preterm infants. In the neonatal intensive care unit (NICU), skin-to-skin contact (SSC) as an avenue for parent-infant closeness may improve parental mental health. Few studies exist regarding its benefits when initiated immediately postbirth. The aim was to determine the effect of SSC for very preterm infants at birth on parents' mental health, by assessing symptoms of depression and anxiety within the first year. Methods: The Immediate Parent-Infant Skin-to-Skin Study was a randomized clinical trial conducted 2018–2021 at three NICUs in Sweden and Norway. Very preterm infants (28–33 weeks of gestation) were …

Temporal Patterns Of Ectopic Pregnancy: Using The Electronic Health Record To Illuminate A Dark Corner In Women's Health, Kirsten Hepburn

Theses & Dissertations

Ectopic pregnancy remains a significant contributor to pregnancy-related morbidity and mortality, yet little is known about whether its occurrence follows discernible temporal patters that could inform prediction and prevention efforts. This dissertation aimed to explore the temporal characteristics of ectopic pregnancy through three interrelated projects: development of a new theoretical framework, a scoping review of the literature on ectopic pregnancy temporal patterns, and an empirical study using electronic health records data from a ten-year period at a single academic medical center. The Nursing Genomic and epigenomic, Environment, and Microbiome (N-GEM) situation-specific theoretical framework was introduced as a novel nursing theory …

Improving Effective Assistant Nurse Manager Communication In Obstetrics, Julie Marie Glover

Master's Projects and Capstones

Abstract

Problem: This quality improvement project addresses inconsistent leadership communication among Assistant Nurse Managers (ANMs) in the Obstetrics (OB) department of a hospital in Northern California. ANM and staff concerns around shift handoff, huddles, and leadership responsiveness have created confusion and hindered team coordination. The project aims to improve communication effectiveness scores among OB ANMs from 50% to 75% by July 11, 2025.

Context: The project was conducted in the Maternal-Child-Health (MCH) unit of a hospital in Northern California, specifically targeting communication practices among OB ANMs. Concerns around communication practices were voiced by both ANM leadership and frontline staff, signaling …

Reducing Nulliparous, Term, Singleton, Vertex Cesarean Birth Rate, Roseanna Juarez

Master's Projects and Capstones

Abstract

Problem: Cesarean birth rates for nulliparous, term, singleton, vertex (NTSV) pregnancies in the United States continue to exceed the Healthy People 2030 goal of 23.6%, resulting in preventable maternal and neonatal complications and higher healthcare costs.

Context: This quality improvement (QI) initiative was conducted in a high-acuity labor and delivery unit in California’s Central Valley, an area characterized by maternal health disparities, high rates of comorbidities, and limited access to prenatal care. The goal was to reduce the NTSV cesarean rate to 18.0% by July 31, 2025.

Interventions: Guided by Kotter’s 8-Step Change Theory and the Plan-Do-Study-Act (PDSA) framework, …

Enhancing Adherence To Oxytocin Administration Guidelines To Reduce Postpartum Hemorrhage Rates In A Labor And Delivery Unit, Maya Denny

Master's Projects and Capstones

Abstract

Background: Postpartum hemorrhage (PPH) remains a critical challenge in maternal care. It shows a 13% PPH incidence rate in a high-risk labor and delivery unit in a northern California medical center, exceeding the national benchmark of 5%–10% based on 2021 ACOG data from 150 patient records.

Problem: There is inconsistent adherence to oxytocin administration guidelines, with only 60% of 100 audited charts documenting fetal and uterine activity, contributing to the elevated rate. The team is looking for a target rate of 90%.

Intervention: This involves implementing a checklist, providing training for 25 clinicians, and conducting two 30-minute simulation scenarios …

Establishment Of Neonatal Sepsis Predictors Utilizing Non-Invasive Monitoring Techniques, Dalton Janssen

Dissertations

Neonatal sepsis remains one of the leading causes of global neonatal mortality. Reactionary approaches for diagnosis and treatment have dominated the tactics in addressing neonatal sepsis but clinical intuition is an untapped resource that could lead to earlier prediction of sepsis onset. Nurses and other staff with specialized training and experience who have served as routine caregivers for a specific patient are able to identify when the patient’s status is altered. This clinical intuition may be substantiated by referencing specific patient trends in non-invasive measures over time. This retrospective, exploratory study examined whether variation in non-invasive monitoring variables could serve …

The Lived Experiences Of Fathers With Postpartum Depression: A Qualitative Study, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Background:

Although parents may joyfully anticipate the birth of a child, it's impossible for them to know ahead of time just how profoundly their lives will change. Postpartum depression (PPD) can result. While there is a substantial body of research regarding maternal PPD, paternal PPD has received far less attention and is neither adequately understood nor diagnosed. This is exacerbated by outdated but persistent sociocultural masculinity norms and the stigmas around mental health issues.

Purpose:

This study sought to explore the lived experiences of new fathers with PPD in order to provide greater insight into their experiences.

Methods:

This qualitative …

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 …

Management Of Neonates In The Special Care Nursery And Its Impact On The Developing Gut Microbiota: A Comprehensive Clinical Review, Ravisha Srinivasjois, Shripada Rao, Gavin Pereira

Research outputs 2022 to 2026

The first few days following the birth are a vulnerable time for the neonate. Sick infants experience various interventions during their stay in the neonatal unit in order to stay alive and grow. Acquisition of gut microbes is critical for the short- and long-term health of the neonate. At a time when the gut microbiome is starting to take shape, crucial interventions directed at improving the growth, development and survival of the neonate impact its development. Events prior to and after the birth of the neonate, such as maternal conditions, antibiotic exposure, type of feeds, supplemental probiotics, and neonatal intensive …

Implementation Of An Evidence-Based Postpartum Depression Screening Tool In A Level Iv Neonatal Intensive Care Unit, Morgan A. Takacs

Dissertations

Problem: Postpartum depression (PPD) affects up to 40% of mothers with infants admitted to the Neonatal Intensive Care Unit (NICU), yet many remain undiagnosed due to the absence of standardized screening protocols. Early identification and referral to Perinatal Behavioral Health Services (PBHS) is critical to support maternal well-being and improve neonatal outcomes.

Methods: This evidence-based quality improvement project utilized a descriptive and correlational design to evaluate the impact of implementing the Patient Health Questionnaire-8 (PHQ-8) for PPD screening among mothers of infants born ≤ 32 weeks’ gestation in a Level IV NICU. A convenience sample of 29 mothers received the …

Implementation Of Quantitative Blood Loss To Detect Postpartum Hemorrhage After Vaginal Birth, Raven S. Simpson

Dissertations

Problem: In the U.S., postpartum hemorrhage (PPH) is attributed to maternal morbidity and mortality, resulting in long-lasting effects of extended recoveries, surgical interventions, birth-related trauma, interruptions in mother-infant bonding, or death. Performing estimated blood loss (EBL) measurement methods postpartum is subjective and often associated with over- and underestimations of blood volume. The delay in recognition interferes with timely, efficient, and appropriate interventions, yielding a PPH (≥1000ml).

Methods: A quality improvement (QI) project was initiated with a descriptive, pre-implementation/post-implementation focus on a high-risk Labor and Delivery unit to explore the effects of Quantitative Blood Loss (QBL) measurements on the identification of …

Implementation Of A Human Papillomavirus Vaccination Toolkit Postpartum, Emily R. Leone

Dissertations

Problem: Human papillomavirus (HPV) is the most common sexually acquired infection in the world (DeCherney et al., 2018). Even a single dose of the HPV vaccine can provide up to 97% protection against HPV 16 and 18, which are the strains that cause 70% of all cervical cancers (Barnabas et al., 2022). Missouri ranks 35th in the country for HPV vaccination (Office of Disease Prevention and Health Promotion, 2020).

Methods: This quality improvement project implemented an HPV toolkit consisting of: 1) staff nurse education in the form of a written presentation 2) patient and provider education in the form of …

Integrating Kangaroo Care Into Cesarean Delivery Practices: A Pathway To Enhanced Health Outcomes, Julia Swords

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: Cesarean deliveries often interrupt early mother-infant bonding, delaying the initiation of breastfeeding and limiting opportunities for skin-to-skin contact. Despite national guidelines promoting immediate postpartum contact, cesarean-born infants receive kangaroo care (KC) at significantly lower rates than those born vaginally. Prior to this project, only 2% of cesarean births at the project site received KC, highlighting a significant gap in care delivery.

Aim of the Project: The aim was to evaluate the feasibility and impact of implementing kangaroo care during cesarean deliveries in a community hospital to improve neonatal outcomes and adherence to evidence-based postpartum practices.

Review of the Evidence: …

2024 Nursing Annual Report, System Of Texas Children's Health

2024

No abstract provided.

Implementation Of One Key Question® Screening Tool To Increase Reproductive Life Planning At A Community Health Clinic, Laura D. Adams

Doctor of Nursing Practice Final Manuscripts

Introduction: This evidence-based practice project implemented and evaluated the One Key Question® (OKQ) screening tool to improve pregnancy intention screening and reproductive health counseling in primary care. The goal was to better identify reproductive health needs among women of reproductive age and enhance provider engagement in preconception and contraceptive counseling.

Background: Nearly half of all pregnancies in the U.S. are unintended, and many women do not receive timely reproductive health counseling. Despite national recommendations, pregnancy intention screening is often missed in primary care. Early identification of reproductive goals supports better outcomes through tailored education, contraception, or preconception care. OKQ is …

Barriers To Breastfeeding In The Workplace As A Nurse And Perceived Support, Juliette Parker

Honors College Theses

This paper explores a literature review of how women are expanding more into the workforce requiring them to balance the demands of both family and work. Attention was given to the importance of breastfeeding, and the current research involving lactation support for working lactating nurses. The goal of this paper was to assess a Southeast Georgia hospital for the barriers and perceived support for working lactating nurses. Based on the available literature investigating this topic, it was hypothesized that nurses would report a lack of resources and support for working lactating mothers. To investigate this, an anonymous survey was conducted …

Trauma-Informed Family-Centered Care Training For Neonatal Intensive Care Nurses, Sonja A. Alli-Casella

Doctor of Nursing Practice (DNP) Projects

Background The neonatal intensive care unit (NICU) is a high-stress environment that can cause or exacerbate emotional trauma for parents of critically ill infants. While NICU nurses are trained in neonatal care and basic family-centered principles, they often receive limited education on supporting adults in acute emotional distress, leaving them unprepared to manage dysregulated behaviors. Local Problem At a Level IV NICU in a Southern California pediatric hospital, nurses may underestimate their influence on parental stress levels due to a lack of formal training in supporting emotionally distressed adults. Methods A comprehensive literature review informed an evidence-based practice (EBP) initiative …

Intimate Partner Violence Prevention And Intervention At A Primary Care Clinic, Atticus Madrid

Master's Projects and Capstones

Abstract

Intimate partner violence (IPV) is a massive health concern in the Spanish-speaking community. There is a high rate IPV, worsening by factors such as language barriers, cultural stigma, and the constant fear of deportation. Resent data underscores the need for standardized IPV screening and trauma-informed care, thus supporting early recognition and intervention. The aim of this Quality Improvement (QI) project is to increase IPV detection rate by 25% from March 10, 2025, to April 15, 2025, in an San Francisco community clinic using an electronic tool called a HITS (Hurt, Insult, Threaten, Scream) and by trauma-informed staff training. Methods …

Strengthening The Birthing Bridge: Educating Labor And Delivery Nurses On Scope And Impact Of Volunteer Doulas, Catherine H. De La Torre

Master's Projects and Capstones

The objective of this quality improvement project was to address the lack of collaboration between the Labor and Delivery (L&D) nurses and the volunteer doulas on a L&D unit at a Bay Area hospital. There were reports of not understanding the role of the volunteer doula, which may have led to a lack of collaboration between both teams. The aim of this project was to improve the L&D nursing staff's understanding of the scope of practice of the volunteer doula to increase positive perception and collaboration between both professions by 25%, from 63% to 88%, following an educational intervention at …

The Nicu Nurse’S Aptitude In Teaching Neuroprotective Care To Caregivers Of Neonates, Lucy Bradley

Honors College Theses

Preterm neonates are at risk of developmental delays, behavioral problems, and mental health challenges. Neuroprotective care is essential to mitigate these risks, and nurses play a crucial role in educating caregivers on these practices. This study aims to investigate neonatal nurses' knowledge and confidence in teaching caregivers about neuroprotective care and to determine the extent to which caregivers implement these practices. A mixed-methods research design will be employed, using a survey to collect data from neonatal nurses who have at least one year of experience working in a NICU. The survey will assess nurses' understanding of neuroprotective care, their confidence …

Perceptions Of Perinatal Depression Among Immigrant Mothers: Screening Practices In Nurse Home Visitation, Silvia E. Arabia

Doctoral Projects

Screening for perinatal depression is a recommended strategy aimed at prevention and timely management of mood disruption in pregnancy and the postpartum (ACOG, 2024). Screening for perinatal depression is often integrated in evidence-based home visitation curriculums. The aim of this qualitative descriptive quality improvement project was to explore perceptions of perinatal depression among immigrant mothers engaged in nurse home visitation to identify barriers, if any, to disclosure and treatment of perinatal depression among a group at increased risk of developing perinatal depression (Gennaro, S., et al, 2016). Immigrant mothers residing in a large urban county in the San Francisco Bay …