Maternal and Child Health Commons^™

Annual Hepatitis C Screening Qi: A Scoping Review, Sadiat Omowunmi Adebiyi Bsn, Rn, Sakinah Shaw Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Sharon Little Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.

Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles …

Infant Car Seat Safety Education And Confidence Measure For Maternal-Child Nursing Students, Mariah A. Arnett

Honors College Theses

Studies have shown that nursing students experience a greater-than-normal amount of anxiety and decreased clinical confidence when in settings involving infants and children, which is said to have a negative impact on the learning experience (Lassche, 2013; Moscaritolo, 2009). Patient education is a vital aspect of nursing, but one that the student nurse may not feel comfortable taking part in, either because of their lack of nursing experience or because of a lack of experience with infants and infant safety (Potter, 2020; Lassche, 2013). This project attempts to assess for a change in clinical confidence after providing a subject specific …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

Impact Of Social Determinants Of Health On Adherence To Urinary Tract Infection Treatment Recommendations: A Scoping Review, Charles W. Stewart Cpnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: Pediatric health is significantly affected by social determinants of health. Screening for and addressing social determinants of health helps to decrease negative effect on health outcomes. The purpose of this project is to determine if there is an association between addressing or not addressing social determinants of health by the healthcare provider and parents’ adherence to treatment recommendations in children with urinary tract infections.

Methods: Between October 2020 and November 2021, a literature review was performed to obtain data from studies regarding urinary tract infections, social determinants of health and adherence to treatment recommendations. The University of Tennessee Health …

Impact Of Ante- And Postnatal Depression Screening In Women With Hiv: A Scoping Review, Kimberly M. Grider Bsn, Rn, Pmh-Bc, Bao Chau Le Bsn, Rn, Blessing Okon Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Maternal depression has been identified as a strong predictor of poor prenatal care. Among pregnant women living with Human Immunodeficiency Virus (HIV), mental health-related factors such as depression could potentially undermine effective antiretroviral therapy (ART) adherence, increase mortality, and cause poor HIV viral suppression consequently impacting vertical transmission of HIV. This scoping review aims to identify existing knowledge regarding the impact of ante- and postnatal depression screening in women with HIV and to adduce the necessity for effective screening.

Methods A literature search was performed for studies with primary outcomes of depression screening within the context of ante- or …

Improving Postpartum Hypertension Discharge Education: A Pilot Project, Kathryn Barth

Dissertations

Problem: Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal morbidity, mortality, and postpartum readmission. Several evidence-based algorithms and protocols have been implemented in the inpatient setting to treat severe blood pressure and prevent complications. However, there remains an opportunity to improve the postpartum care transition and discharge education for patients with these conditions in an attempt to decrease 30-day postpartum hypertension readmissions.

Methods: This pilot project utilized a descriptive design and took place on a postpartum unit at a Midwest metropolitan high-risk obstetrical teaching hospital. Interventions included patient-specific discharge education, distribution of a home blood pressure …

The Relationship Of Child Health And Parenting Stress To Child Neurocognitive Development, Nancy Alise Farrell

Theses and Dissertations (ETD)

Problem. Although the United States rates high in economic resources, the neurocognitive development (NCD) of children falls behind many other developed nations. Levels of parenting stress may be linked to sociodemographic factors such as the high incidence of poverty in children or health disparities in children, which in turn may affect NCD in children. Using the data from an observational, longitudinal cohort study of a diverse population could provide information related to parenting stress, child health, and related factors to guide and support interventions with families and policies to improve child NCD. Aims. The overall aim of this study was …

Examining Newcomer Women’S Experiences With Perinatal Care In Ontario, Canada: An Application Of Carspecken’S Critical Ethnographic Method, Jessica Pimienta, Oona St-Amant, Sepali Guruge, Corinne Hart, Cristina Catallo

The Qualitative Report

This article provides a practical description of Carspecken’s (1996) five-stage critical ethnographic approach entitled “Critical Qualitative Research (CQR).” Situated epistemologically and ontologically in the critical paradigm, this article is an exploration of critical ethnography as an important methodology for shedding light on the discursive culture of perinatal care for newcomer women during the three-month health insurance waiting period in Ontario, Canada. We argue that Carspecken’s approach to critical ethnography is especially instrumental in illuminating the social structures that contribute to health inequities.

Effects Of Integrating Family Planning With Maternal, Newborn, And Child Health Services On Uptake Of Voluntary Modern Contraceptive Methods In Rural Pakistan: Protocol For A Quasi-Experimental Study, Zahid Memon, Sophie Reale, Wardah Ahmed, Rachael Spencer, Talib Hussain Lashari, Zulfiqar Ahmed Bhutta, Hora Soltani

Centre of Excellence in Women and Child Health

Background: The uptake of modern contraceptive methods (MCMs) remains low, with 25% of women reporting their use in Pakistan. The overarching interventions covering service delivery platforms at facility and community levels necessitate the integration of family planning (FP) with maternal, newborn, and child health (MNCH) services.
Objective: The main aim of this study is to evaluate the impact of an integrated FP-MNCH service delivery model to increase coverage of MCMs in rural Pakistan. Moreover, we aim to measure the level of effectiveness of interventions regarding the uptake of MCMs.
Methods: A quasi-experimental, sequential, mixed methods study design with pre- and …

Factors Associated With Home Delivery In Rural Sindh, Pakistan: Results From The Global Network Birth Registry, Afreen Sadia, Shafaq Mahmood, Farnaz Naqvi, Seemab Naqvi, Zahid Soomro, Sarah Saleem

Community Health Sciences

Background: According to global estimates for 2017, nearly 295,000 maternal deaths occurred worldwide. Thus, approximately 810 women die every day due to pregnancy-related complications. This burden of maternal deaths in LMICs is primarily due to poor healthcare service utilization, as indicated by relatively low rates of institutional deliveries and skilled-birth attendance (SBA). We conducted this study with an aim to assess the factors associated with home delivery and its subsequent effect on the pregnancy outcome in rural Sindh, Pakistan.
Methods: Data for this study were taken from The Global Network's Maternal Newborn Health Registry (MNHR), which is a prospective, population-based …

Rural Pregnant Women’S Experiences With Substance Use Disorder: A Qualitative Study, Cami Weber

Dissertations

Rural pregnant women with substance use disorder (SUD) are an understudied vulnerable population that often experiences poor pregnancy outcomes (Higgins et al., 2019; Jumah, 2016; Kramlich et al., 2018; Shaw et al., 2015). Despite the high prevalence and high burden associated with SUD, rural women are less likely than non-pregnant women to seek addiction treatment and complete an outpatient treatment program during pregnancy (Shaw et al., 2015). This study aimed to give voice to rural Missouri women with SUD. The research questions explored the life experiences and motivations for seeking treatment using a qualitative, descriptive research design with grounded theory …

Exploring Digital Health Interventions For Pregnant Women At High Risk For Pre-Eclampsia And Eclampsia In Low-Income And-Middle-Income Countries: A Scoping Review, Anam Shahil Feroz, Noreen Afzal, Emily Seto

Community Health Sciences

Objective: To explore digital health interventions that have been used to support pregnant women at high risk for pre-eclampsia/eclampsia (HRPE/E) in low-income and middle-income countries (LMICs).
Design: Scoping review.
Data source: EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched between 1 January 2000 and 20 October 2020.
Eligibility criteria: The review included original research studies that were published in English, involved pregnant women at HRPE/E and implemented digital health interventions for PE/E in LMICs.
Data extraction and synthesis: Two reviewers independently completed the data extraction for each of the 19 final …

Do Empowered Women Receive Better Quality Antenatal Care In Pakistan? An Analysis Of Demographic And Health Survey Data, Muhammad Asim, Waqas Hameed, Sarah Saleem

Community Health Sciences

Introduction: Quality antenatal care is a window of opportunity for improving maternal and neonatal outcomes. Numerous studies have shown a positive effect of women empowerment on improved coverage of maternal and reproductive health services, including antenatal care (ANC). However, there is scarce evidence on the association between women's empowerment and improved ANC services both in terms of coverage and quality. Addressing this gap, this paper examines the relationship between multi-dimensional measures of women empowerment on utilization of quality ANC (service coverage and consultation) in Pakistan.
Methods: We used Pakistan Demographic and Health Survey 2017-18 (PDHS) data which comprises of 6,602 …

Prenatal Perception Of Wic Breastfeeding Recommendation Predicts Breastfeeding Outcomes In Infant's First Year, Joanne Guthrie, Qi Zhang, Kelin Li, Kathryn Wouk, Rajan Lamichhane

Community & Environmental Health Faculty Publications

Objectives

Promoting breastfeeding (BF) is a priority of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Prior research found that pregnant mothers who believed WIC recommends BF only (versus BF and formula equally OK) were more likely to initiate BF and continue through 1 month postpartum. We examine whether such mothers are more likely to continue to exclusively BF through 5 months and BF at all through the infant's first year. Methods

Data are from the WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a longitudinal study that includes 2,649 mothers who completed prenatal interviews. Four BF …

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 …

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown

Theses & Dissertations

African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. …

Reducing The Postpartum Readmission Rate With Standardized Discharge Teaching, Darlene Day-Herzog

Master's Projects and Capstones

Problem: Hospital readmission rates are one of the quality metrics that matter for hospital reimbursements. In a large Northern California healthcare system, the postpartum readmission rate is often above the national average.

Context: The hospital designated as the main location for high-risk deliveries within a 30-mile radius has an Acute Care Obstetric postpartum population where twenty percent of the patients are at an increased risk for readmission.

Interventions: The project implemented the use of a standardized discharge teaching script and educational materials to be used by nursing staff throughout the patient’s hospital stay to see if multimodal standardization leads to …

Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada

Nursing | Senior Theses

The literature shows that Black women face many disparities in terms of health care access and the quality of care. These obstacles could negatively affect the health of the mother and their child. This paper includes a literature review and proposed research study. The objective of this research study is to identify the outcomes of Black women compared to White women and other women of color in terms of maternal health. A literature review is provided in order to identify how race affects the following factors: obstacles that limit access to healthcare, rates of obtaining prenatal care, postpartum outcomes and …

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 …

A Rollout Of A Blood Pressure Remote Patient Monitoring Program To Improve High-Risk Maternal Outcomes At A Pilot Clinic For Systemwide Expansion, Laura Geron

Seton Hall University Dissertations and Theses (ETDs)

An existing virtual care platform provides an innovative means of early recognition, identification, and intervention for women with elevated blood pressures during pregnancy, known as preeclampsia. A pilot program took place at a Northeastern prenatal care clinic where patients were identified as high-risk for preeclampsia, enrolled, educated by their providers, and equipped with Bluetooth-enabled blood pressure cuffs.

Through remote patient monitoring (RPM) technology, blood pressure readings could transmit from a patient’s residence to a portal accessible by their clinic provider at any time. This doctoral-level quality improvement project focuses on the identification of patients at high-risk for preeclampsia, their enrollment …

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

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 …

Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …

Global, Regional, And National Progress Towards Sustainable Development Goal 3.2 For Neonatal And Child Health: All-Cause And Cause-Specific Mortality Findings From The Global Burden Of Disease Study 2019, Katherine R. Paulson, Nicholas J. Kassebaum, Arianna Maever L. Amit, Veincent Christian F. Pepito, Gbd 2019 Under-5 Mortality Collaborators, 735 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include …

Factors Affecting Maternal-Care During Labour At Maternity Centres Of Karachi, Pakistan: Exploratory Study, Nirmal Shahzaib, Tazeen Saeed Ali, Nousheen Pradhan, Farina Abrejo, Shahnaz Shahid Ali, Amir Ali Samnani

School of Nursing & Midwifery

Globally 529,000 women die every year due to harmful consequences of childbirth. This study aimed to explore the barriers and facilitators that influence the provision of quality care during labour at maternity centres in Karachi, Pakistan. The qualitative exploratory study design was used to study such factors from public and private maternity health facilities of Karachi, Pakistan. A total of 12 in-depth interviews were conducted through purposive sampling by using validated semi-structured interview guide. Data was analysed using content analysis manually. Among major barriers, unhygienic environment, lack of basic equipment, supplies and medicine, unprofessional attitude of staff, physical infrastructre and …

Impact Of Simple Breastfeeding Initiatives Led By Nurses In A Primary Care Setting, Jessica Semin, Carolyn Hanus, Megan Scott, Amy Ford, Leeza Struwe

Doctor of Nursing Practice Projects: College of Nursing

Background: Breastfeeding is recognized by health experts as the preferred infant feeding method. Health professionals, especially nurses, play a vital role in influencing mothers’ infant feeding decisions. This quality improvement project designed, implemented, and evaluated by nurses explores how the implementation of three simple initiatives impacted healthcare staff’s attitudes, beliefs, and perceptions related to breastfeeding.

Materials and Methods: The project was led by three Doctor of Nursing Practice (DNP) students with guidance from their DNP prepared advisor. It took place in a primary care setting at a federally qualified health center. Prior to and after implementation, staff were …

Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …

Evaluation Of The Feasibility Of The Fast-M Maternal Sepsis Intervention In Pakistan: A Protocol, Sheikh Irfan Ahmed, Raheel Sikandar, Rubina Barolia, Bakhtawar M H. Khowaja, Kashif Ali Memon, James Cheshire, Catherine Dunlop, Arri Coomarasamy, Lumaan Sheikh, David Lissauer

Department of Obstetrics & Gynaecology

Background: Maternal sepsis is a life-threatening condition, defined by organ dysfunction caused by infection during pregnancy, childbirth, and the postpartum period. It is estimated to account for between one-tenth and half (4.7% to 13.7%) of all maternal deaths globally. An international stakeholder group, including the World Health Organization, developed a maternal sepsis management bundle called "FAST-M" for resource-limited settings through a synthesis of evidence and international consensus. The FAST-M treatment bundle consists of five components: Fluids, Antibiotics, Source identification and control, assessment of the need to Transport or Transfer to a higher level of care and ongoing Monitoring (of the …