Maternal, Child Health and Neonatal Nursing Commons^™

Screening, Brief Intervention, And Referral To Treatment For Pregnant Women, Rebekah Feeney

Dissertations

Abstract

Background: In the United States, 10-20% of pregnant women reported using drugs during pregnancy. Current recommendations are to screen for drug use in all patients and provide a brief intervention and referral to treatment. The purpose of this quality improvement project was to evaluate the impact of implementing a standardized screening, brief intervention, and referral to treatment (SBIRT) protocol for first-trimester pregnant patients who are seen in the obstetrical department.

Methods: The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) screening tool was administered to first-trimester pregnant women, 13-45 years of age, seen in the obstetrical department from …

Challenges And Barriers Faced By Healthcare Workers In Implementing Strategies To Reduce Teenage Pregnancy In Iligan City, Elise Janella A. Denila, Jydel Anne P. Dalangin, Wynne Nicole P. Englatiera, Dave William E. Almonia, Ian C. Abordo, Donna Belle P. Sumugat Rn, Man, Raymond M. Salvador

Pacific Journal of Health

Aims: To investigate nursing strategies and their perceived barriers in reducing teenage pregnancy among barangays in Iligan City with high incidence of teenage pregnancy.

Study Design: This study uses qualitative, exploratory research design. This design is ideal for delving into complex issues and understanding phenomena in their real-world context.

Place and Duration of the Study: Iligan City Philippines, between September 2023 and May 2024

Methods: This study includes 6 healthcare workers experienced in handling teenage pregnancy and 25 teenagers who have experienced it. Participants were selected using purposive sampling to ensure they had relevant experiences. Data was collected through face-to-face, …

Postpartum Depression Screening In The Neonatal Intensive Care Unit At A Tertiary Pediatric Hospital, Abbie Bates

Doctor of Nursing Practice Final Manuscripts

POSTPARTUM DEPRESSION SCREENING IN THE NEONATAL INTENSIVE CARE UNIT AT A TERTIARY PEDICTRIC HOSPITAL

By

Abbie Kim Bates

Razel Bacuetes Milo, PH.D. DNP., FNP-C

Background: Postpartum depression (PPD) is a treatable mood disorder with an onset at 1-3 months after childbirth. In the United States, PPD occurs at a rate of 1 in 8 women and as high as 1 in 5 women in parts of the country. In unique populations such as the neonatal intensive care unit (NICU), PPD rates can be as high as 40%. The treatment rate for PPD is 50% with a sizable percentage of …

Treating Mothers With Postpartum Depression While In The Nicu, Arrie Belnap, Mary Jan Greer, Aimee Doughty

Summer 2024 OTD Capstone Symposium

The presentation is about an educational program developed to educate mothers with or at risk for postpartum depression (PPD) while their baby is in the neonatal intensive care unit (NICU). Mothers learned about the nature of PPD, occupations to implement to decrease symptoms of PPD, and occupations that they can participate in to care for their NICU babies. The evaluations, interventions, and outcomes of the program are discussed.

Natural Remedy Use During Pregnancy, Labor, And Breastfeeding, Christine Lyford

The Kabod

Honors Petition submitted to NURS 306: Pharmacology.

Improving The Diagnosis And Treatment Of Obstetric Sepsis, Edwije Joseph

Master's Projects and Capstones

Problem: Maternal mortality affects women during four phases of obstetrics, including triage, antepartum, labor & delivery, and postpartum. In the U.S., sepsis is the third leading cause of maternal death. Inconsistent screening practices and delays in recognizing symptoms can occur in any phase. These factors were identified as root causes in a northern California community hospital with 600 monthly deliveries.

Context: Two maternal sepsis cases cost $90,000 annually. A standardized pathway was initiated nationally in October 2023 through the California Maternal Quality Care Collaborative (CMQCC). One regional hospital system initiated a quality improvement project over 5 months within a community …

Supporting Nursing Care Transition For Late Preterm Infants From Nicu To The Level 1 Nursery, Megan R. Deans

DNP Projects

Late preterm births are increasing each year due to increasing rates of IVF, multiple births, and advancing maternal age (Visruthan et al., 2015). This group has been traditionally cared for in the NICU, but facilities may consider transitioning this care to the level 1 nursery due to the relative physiologic stability of this population (Visruthan et al., 2015). The transition, without appropriate planning, creates a potential for inconsistencies in caring for the diverse needs of 35.0-35.6 week late preterm infants (LPIs), including variations in education provided to parents and care of the LPI (Visruthan et al., 2015). This project aimed …

Global Management Of Serious Bacterial Infections In Young Infants Aged 0 To 59 Days: An Overview Of Systematic Reviews, Karen M. Edmond, Georgia R. Whisson, Derek C. Swe, Natalie A. Strobel

Research outputs 2022 to 2026

BACKGROUND: To inform World Health Organization guidelines for the management of serious bacterial infection (SBI) (suspected or confirmed sepsis, pneumonia, or meningitis) in infants aged 0–59 days. OBJECTIVE: To conduct an “overview of systematic reviews” to: (1) understand which systematic reviews have examined diagnosis and management of SBI in infants aged 0–59 days in the last 5 years; and (2) assess if the reviews examined PICOs (population, intervention, comparator, outcomes) and regimens currently being recommended in low and middle income countries (LMICs) by the World Health Organization. DATA SOURCES: MEDLINE; Embase; Cochrane Library; Epistemonikos; PROSPERO. STUDY SELECTION: Systematic reviews of …

Integration Of Depression And Anxiety Screening Among Uninsured And Underinsured Patients In A Mobile Nurse-Led Clinic, Samantha Hamm

DNP Projects

This quality improvement project sought to increase screening rates and referrals for pregnant and postpartum depression/ anxiety using the Edinburgh Postnatal Depression Scale (EPDS) and increase the rate of mental health referrals as a result of that screening in an underserved population /community health mobile clinic. Maternal mental health is a key public health concern. In the most recent community health needs assessment (2022-2025) in one Midwestern rural community, priority needs were identified with the top priority of building families with access to culturally competent healthcare, including access to mental health services (Central MN Alliance, 2022). Under-reporting anxiety and depression …

Knowledge And Attitudes Toward Baby-Led Weaning In Primary Care, Taylor Schreiner

DNP Projects

Objective

Adequate nutrition is critical for an infant’s growth and development. Around the age of six months, most infants can begin the process of being introduced to table foods. The debate is about what method is safest for the infant, spoon-led feeding or baby-led weaning (BLW).

Methods

This project explored the beliefs, attitudes, and knowledge of both parents of infants and primary care providers (PCP) on baby-led weaning. Data were obtained through the use of pre-and post-surveys following the implementation of specific education for parents and PCPs.

Results

The findings from parents who participated would suggest that most parents who …

Obstetric Education For Critical Care Nurses, Anna Forberg

DNP Projects

Background The purpose of this study was to educate ICU nurses on the care of obstetric women in critical care through the use of a toolkit with intentions to increase knowledge and confidence.

Method The toolkit was created via the platform WordPress™ and topics were chosen based on the most common admission diagnoses found during the literature review. Data were collected via forms manager and voluntary participation among ICU nursing staff was obtained.

Results Mean scores from the pretest to the post-test showed improvement from 7.08 to 8.50 and the minimum and maximum scores increased from pretest to post-test supporting …

Implementation Of Skin-To-Skin Immediately Post C-Section: A Pilot Study, Miah Vernor

Dissertations

Skin-to-skin contact during the golden hour is a practice that has numerous health benefits following the delivery of a newborn. These benefits include a healthy transition to extrauterine state, initiation of breastfeeding, thermoregulation, and more. However, the mode of delivery affects how often this practice is done. Parents who deliver vaginally are routinely offered the opportunity to perform skin-to-skin immediately after delivery whereas birth parents who deliver by cesarean section are not always offered this same benefit due to various reasons. A quality improvement project was conducted on an 18-bed labor and delivery unit at a Midwest hospital. This project …

Implementation Of Skin-To-Skin Contact Immediately Post Cesarean Birth: A Quality Improvement Project, Sophia Cooke

Dissertations

Problem: Skin-to-skin contact implemented within the first hour of a newborn’s life improves health outcomes for both mother and infant. One of these health outcomes includes exclusive breastfeeding. The purpose of this quality improve project was to implement an infant securement device within the operating room after cesarean section births to decrease the time to initiate skin-to-skin contact and increase exclusive breastmilk feeding rates at discharge.

Methods: This study utilized a descriptive, observational design and was guided by the Plan-Do-Study-Act framework. A pre-test, post-test design was utilized to compared retrospective and prospective data. The retrospective data was collected to assess …

Evaluation Of The Grief Of Mothers Affected By Perinatal And Traumatic Loss, Landry Crabtree

Dissertations

Problem: The experience of a perinatal loss can be traumatic for mothers, and complicated grief reactions are common for those who have experienced a perinatal loss. An increase in perinatal loss resources is needed in the United States. The purpose of this program evaluation was to assess outcomes of a pilot perinatal loss support program on the grief of women who have experienced a perinatal loss.

Methods: This project was an evaluation of a perinatal loss support program that employed evidence-based strategies in both individual and group therapy sessions. A retrospective design was used, and data on perinatal …

Implementation Of Postnatal Depression Screening: A Pilot Study, Mollie Gulino

Dissertations

Abstract

Background: Postpartum depression (PPD) is a prevalent problem among women during their childbearing years, affecting approximately 1 in 7 women. Alarmingly, about 50% of PPD cases go undiagnosed and untreated, contributing to poor maternal outcomes, including suicide, which is a leading cause of maternal mortality in the United States.

Issue: Despite its prevalence and severe consequences, PPD often goes unrecognized due to inconsistent screening practices. Current guidelines vary by organization and lack consistent, evidence-based criteria.

Objective: This pilot program aimed to implement universal PPD screening with a validated tool at the six-week postpartum follow-up visit. The goal was to …

Implementation Of The Edinburgh Postpartum Depression Screening Tool For Postpartum Depression In A Midwest Primary Care Clinic, Makenzie Garrison

Dissertations

Problem: Postpartum depression is a prevalent health concern in postpartum women. Screening practices to identify postpartum depression are inconsistent. The purpose of this quality initiative is to determine if the implementation of the Edinburgh Postpartum Depression Screening Tool (EPDS) to screen for postpartum depression in the primary care setting increases the detection of postpartum depression in postpartum women from delivery to one year postpartum.

Methods: This quality improvement project utilizes a descriptive, observational design. A retrospective medical record review was utilized as well as a 12-week data collection period. Retrospective medical record reviews were conducted to assess the rate of …

Implementation Of Quantitative Blood Loss Following Cesarean Section Birth, Layna Victoria Schultz

Dissertations

Problems: Postpartum hemorrhage (PPH) is a significant problem due to potential harm and is a main contributor to maternal morbidity (ACOG, 2019). According to ACOG, of maternal deaths in the United States, 11% are caused by PPH and 54-93% of the deaths related to PPH could be prevented (ACOG, 2019). When institutions adopt quantitative blood loss (QBL) protocols for improved accuracy in blood measurement, PPH can be identified sooner, allowing for earlier intervention. Inaccurate estimation of obstetric blood loss by health care providers is a primary cause of delayed staff response to PPH (ACOG, 2019).

Methods: This quality improvement (QI) …

Disparities In Birth Outcomes Within The U.S. White Population: Prevalence Of Low Birth Weight Among Immigrant Mothers From The Middle East And North Africa, Leila Moustafa, Patricia Mcgaughey, Tod G. Hamilton

School of Nursing Faculty Scholarship and Creative Works

Immigration from the Middle East and North Africa (MENA) has diversified the U.S. non-Hispanic White population. Analyzing health disparities within this group is a complex task due to data limitations across most federal and state data collection systems. This study investigates disparities in the risk of giving birth to a low-birth-weight infant among foreign-born non-Hispanic White MENA and non-MENA mothers and by MENA mothers’ nationality. This population-based study uses Restricted-Use Detail Natality Data from 2016 to 2019 accessed through the National Center for Health Statistics and provided by the Centers for Disease Control and Prevention. The study examines the …

Quiet Time On Family Maternity Center, Deanna Conley, Shelbie Clement

Articles, Abstracts, and Reports

Background: A stay at the hospital is full of interruptions from family visitors, lab draws, hearing screens, nurses and doctors, social workers, and environmental services. All these interruptions during the postpartum stay negatively affect parents and newborns by interrupting breastfeeding, sleep, and family bonding time. Evidence from AWHONN (Association of Women's Health Obstetric and Neonatal Nurses) research, in the articles referenced, demonstrates overwhelming support of Quiet Time in the Postpartum period. Quiet Time has been shown to improve exclusive breastfeeding rates, decrease emotional and physical exhaustion, enhance shared decision making and set realistic expectations, increase nurse satisfaction, decrease nursing stress …

Reducing Maternal Morbidity From Peripartum Hemorrhage In Cesarean Delivery, Jennie Lee

Dissertations

Background/Purpose: Maternal hemorrhage is the second highest cause of direct maternal death and the leading cause of morbidity and mortality in the United States. This public health crisis is highlighted by the economic burden of over $30.8 million annually in the United States. The greatest tragedy in the review of maternal mortality is that 84% of pregnancy-related deaths were determined preventable. Identifying trends of factors that predispose women to hemorrhage can mitigate rates of severe maternal morbidity and mortality. This study describes relationships among demographic factors (maternal age, race, and ethnicity), clinical and physiologic factors, which include coexisting medical conditions …

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Improving Adherence Rates To Postpartum Screening Of Diabetes In Women With Gestational Diabetes Mellitus: An Evidence-Based Project, Alicia Hernandez Punsalan

Doctor of Nursing Practice Final Manuscripts

Background: Women with a history of gestational diabetes mellitus are at increased risk of developing type 2 diabetes mellitus. Approximately 6%–10% of pregnancies in the United States are complicated by gestational diabetes mellitus, yet postpartum diabetes screening rates are low nationwide.

Purpose: This project focused on implementing a multi-modal reminder system to increase adherence to postpartum diabetes screening, or the 2-hour oral glucose tolerance test, for women with a history of gestational diabetes mellitus in the 4-12 weeks postpartum period.

Evidence-Based Practice Change: The multi-modal reminder system was comprised of an educational session for the staff reviewing current clinical guidelines …

Improved Pediatric Icu Mortality Prediction For Respiratory Diseases: Machine Learning And Data Subdivision Insights, Johayra Prithula, Muhammad E H Chowdhury, Muhammad Salman Khan, Khalid Al-Ansari, Susu M Zughaier, Khandaker Reajul Islam, Abdulrahman Alqahtani

Faculty, Staff and Student Publications

The growing concern of pediatric mortality demands heightened preparedness in clinical settings, especially within intensive care units (ICUs). As respiratory-related admissions account for a substantial portion of pediatric illnesses, there is a pressing need to predict ICU mortality in these cases. This study based on data from 1188 patients, addresses this imperative using machine learning techniques and investigating different class balancing methods for pediatric ICU mortality prediction. This study employs the publicly accessible "Paediatric Intensive Care database" to train, validate, and test a machine learning model for predicting pediatric patient mortality. Features were ranked using three machine learning feature selection …

Evaluation Of Breastfeeding Interventions To Improve Duration In Women At Risk For Breastfeeding Attrition, Anthonia Anukam

The Corinthian

Children that are optimally breastfed have the healthiest start in life. The World Health Organization and the CDC recommend that mothers optimally breastfeed. Benefits of breastfeeding to children include the receipt of antibodies, reduction of ear, respiratory, and gastrointestinal infections, decreased sudden infant death syndrome, allergies, diabetes, and childhood leukemia. Several research studies have reported a strong positive correlation between breastfeeding and reduced infant morbidity and mortality. Evidence illustrates that the health benefits from breastfeeding are dose-dependent, thus the longer the breastfeeding duration the greater the acquisition of the enumerated benefits. However, premature cessation of breastfeeding less than the WHO …

Standardizing Nurse Knowledge Exchange In The Peripartum Mesosystem, Gabrielle Ann Romena

Master's Projects and Capstones

Problem Handoff report is a significant source of medical error, as reported by the Joint Commission. As it stands, Hospital A’s peripartum mesosystem has no standardized policy regarding the Nurse Knowledge Exchange (NKE) process. Context Hospital A is an urban tertiary care medical center in San Francisco, with its peripartum mesosystem divided into two floors with a total of 35 dedicated beds. Intervention Stakeholder engagement, literature review, and mesosystem analysis identified potential barriers to bedside NKE. To address the identified causes, the project implemented a standardized handoff guide and staff education. Measures The outcome measured was comprehensiveness of NKE as …

Enhancing Peripartum Care Through Standardized Nurse Knowledge Exchange, Gabriela Ochoa

Master's Projects and Capstones

Problem Inconsistent handoff practices during patient transfers can cause mistakes and adverse outcomes. Hospital A's peripartum unit has no set policy for Nurse Knowledge Exchange (NKE) during transfers. This project will introduce a standard handoff guide to enhance communication and prevent harmful results after patient transfers.

Context The quality improvement project was conducted in a peripartum mesosystem within an urban hospital in Northern California. This specific area of the hospital comprised 21 postpartum rooms and nine laboring rooms.

Intervention The project involved a methodical strategy that encompassed engaging stakeholders, conducting a literature review, and analyzing data to pinpoint areas for …

Raising The Bar: Optimizing Peripartum Handoff Through Standardized Nurse Knowledge Exchange (Nke), Kimberly Martinez Rn

Master's Projects and Capstones

Problem Hospital X’s peripartum microsystem has no policy guiding the Nurse Knowledge Exchange (NKE) process. Variability in handoffs during patient transfers could lead to medical errors and adverse events. This quality improvement (QI) project aims to pilot a standardized handoff guide to improve nurse communication and avoid adverse patient outcomes following patient transfers. Context The setting for this QI project was a peripartum mesosystem at an urban hospital located in Northern California with 21 postpartum rooms and nine labor rooms. Intervention The project employed a systematic approach that involved engaging stakeholders, analyzing microsystems, reviewing literature, and analyzing data to identify …

Unlocking The Potential Of Peripartum Handoff: Standardizing Nurse Knowledge Exchange (Nke), Kiana Killian

Master's Projects and Capstones

Problem The absence of a structured and standardized handoff during patient transfers may result in the unintentional omission of patient information, medical errors and adverse events. No standardized bedside handoff process, referred to as Nurse Knowledge Exchange (NKE), was observed in Hospital A’s peripartum mesosystem during patient transfers from the Labor and Delivery (L&D) unit to the Postpartum unit. Context Hospital A is a medium-sized urban hospital located in Northern California. The peripartum mesosystem includes 21 postpartum rooms and nine laboring rooms. Intervention Through the recruitment of stakeholder engagement, review of literature supporting evidence-based practices, and a mesosystem assessment, a …

Parents And Health Care Teams Perceptions Of Communication In Neonatal Intensive Care Unit, Marjan Mardani, Haydeh Heidari

The Qualitative Report

Parents experience a lot of stress in the neonatal intensive care unit (NICU). Then effective communication between parents and members of the care team is an essential component of improving the quality of care. The present study was conducted by qualitative exploratory research method for explaining parents and health care teams' perceptions of communication in NICU. We selected 39 participants by purposive sampling. We collected data through in-depth semi-structured, face-to-face interviews. The transcripts were analysed using the conventional content analysis approach. Three themes were obtained by analyzing the data included, the nature of communication, the theme of factors affecting successful …

Implementation Of A Doula-Supported Postpartum Wellness Toolkit In A Black Community-Based Maternal Wellness Program, Janice Luethje, Leslie Torres

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to expand the areas of focus within a maternal wellness program at a Black community center and to evaluate the satisfaction levels of the doulas who utilized the material during postpartum home visits. The toolkit covers a range of postpartum topics in the areas of nutrition, exercise, sexual health, mindfulness, and social support as well as a postpartum mental health screening tool.

Design: This quality improvement project included three distinct phases: The pre-implementation phase, the implementation phase, and the post-implementation phase.

Setting: The project location was a Black community center in Lincoln, Nebraska. …