Empowering Maternal Resilience: A Prenatal Education Program For Mothers And Their Chosen Support Persons For Postpartum Depression, Jennifer Medina

Nursing | Senior Theses

Previous research studies have demonstrated the positive impact education and social support has on reducing the risk of postpartum depression (PPD) when used separately. However, there exists a clear gap in understanding the combined effects of integrating both education and social support during the prenatal period on PPD. This longitudinal quasi-experimental study aims to evaluate the impact of an in-person prenatal PPD prevention program for the birthing person, requiring the presence of a support person on the reduction of PPD. Participants and their chosen support persons will receive information on PPD, including risk factors, signs and symptoms, preventative measures, and …

Doula Support For Hispanic Women, Marilyn Cervantes-Munoz, Daisy Arango-Hernandez

Nursing | Senior Theses

Purpose

This quantitative study will seek to provide valuable insight into the needs and preferences of Hispanic women during labor with the potential benefit of doula support in minimizing their pain.

Methods

A quasi-experimental design study will be conducted, randomizing a convenient sample into two groups consisting of one experimental and one control group, with the objective of evaluating the efficacy of doula presence as a source for pain management in Hispanic women. One hundred Hispanic women will be recruited under the following criteria: 18 years or older, a single fetus pregnancy, gestational age 37 weeks and above, and no …

Furry Friends & Brighter Futures: Enhancing The Life Skills Of Toddlers With Autism Through Animal Assisted Therapy, Abigail Rosales Tolentino

Nursing | Senior Theses

Autism Spectrum Disorder (ASD) encompasses a broad spectrum of challenges that impact social interaction, communication, and behavior. While Applied Behavior Analysis (ABA) stands as a common therapeutic approach, there is a growing recognition of the need for personalized interventions. Animal Assisted Therapy (AAT) emerges as a promising avenue for enhancing social interactions. This study focuses on the utilization of dogs in AAT for toddlers aged 12 to 36 months with confirmed ASD diagnoses. The experimental group will undergo a combined intervention involving standard ABA therapy alongside weekly AAT sessions, whereas the control group will receive standard ABA therapy alone. Pre- …

Breastfeeding Support In Your Pocket: Evaluating The Impact Of A Mobile App On Maternal Success, Maygan Brandt

Nursing | Senior Theses

Background: Breastfeeding has well-known benefits for both the nursing infant and the birthing parent. It bolsters the newborn immune system, and reduces the risk of future health conditions in both parties. Due to these advantages, several health organizations internationally recommend exclusive breastfeeding until 6 months of age. However, only a fraction of infants in the United States meet this goal each year. Improved rates and duration of exclusive breastfeeding will lead to better long-term health outcomes for patients. The use of smartphone applications for breastfeeding education and support has not been thoroughly researched. Objective: This thesis explores the feasibility of …

Post-Discharge Malaria Chemoprevention In Children Admitted With Severe Anaemia In Malaria-Endemic Settings In Africa: A Systematic Review And Individual Patient Data Meta-Analysis Of Randomised Controlled Trials, Kamija Phiri, Carole Khairallah, Titus Kwambai, Kalifa Bojang, Aggrey Dhabangi, Robert Opoka, Richard Idro, Kasia Stepniewska, Michael Boele Van Hensbroek, Chandy C John

Paediatrics and Child Health, East Africa

Background: Severe anaemia is associated with high in-hospital mortality among young children. In malaria-endemic areas, surviving children also have an increased risk of mortality or readmission after hospital discharge. We conducted a systematic review and individual patient data meta-analysis to determine the efficacy of monthly post-discharge malaria chemoprevention in children recovering from severe anaemia.

Methods: This analysis was conducted according to PRISMA-IPD guidelines. We searched multiple databases on Aug 28, 2023, without date or language restrictions, for randomised controlled trials comparing monthly post-discharge malaria chemoprevention with placebo or standard of care among children (aged <15 years) admitted with severe anaemia in malaria-endemic Africa. Trials using daily or weekly malaria prophylaxis were not eligible. The investigators from all eligible trials shared pseudonymised datasets, which were standardised and merged for analysis. The primary outcome was all-cause mortality during the intervention period. Analyses were performed in the modified intention-to-treat population, including all randomly assigned participants who contributed to the endpoint. Fixed-effects two-stage meta-analysis of risk ratios (RRs) was used to generate pooled effect estimates for mortality. Recurrent time-to-event data (readmissions or clinic visits) were analysed using one-stage mixed-effects Prentice-Williams-Peterson total-time models to obtain hazard ratios (HRs). This study is registered with PROSPERO, CRD42022308791.

Findings: Our search identified 91 articles, …

Implementation Of A Community Health Worker (Chw) Training Program To Improve Birth Outcomes, Emiko Maruri

Doctor of Nursing Practice (DNP) Projects

Background

Those who have been affected by any adverse childhood experience (ACE) have an increased likelihood of poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.

Problem

Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. Further evidence supports those affected by 2 or more ACEs have poor birth outcomes.

Context

For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice (USF DNP) students and Community Health Workers (CHWs) of the Central …

Improving Intimate Partner Violence Screening In A Women’S Health Practice Through Implementation Of An Evidence-Based Screening Tool, Jasmine Weber

Doctor of Nursing Practice Projects: College of Nursing

The purpose of this quality improvement project was to implement intimate partner violence screening in an outpatient women’s health clinic with no prior screening process in place. Current recommendations are to screen all reproductive age women for intimate partner violence 6 . During a three-month period 170 patients out of 260 eligible patients were screened using the HARK screening tool, 7 of those patients screened positive and were offered referrals to social work. While universal IPV screening was not achieved, a screening rate of 64% is a remarkable improvement from an apparent absence of screening prior to project implementation.

Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn

Master's Projects and Capstones

This quality improvement project aims to improve nurse education about Lovenox prophylaxis to reduce the risk of pulmonary emboli – post-discharge – amongst high-risk postpartum women who underwent vaginal and cesarean deliveries on the family baby unit. This project took place in a Family Baby/Postpartum Unit at Hospital SC. This unit has a total of 25 beds with an increased prevalence of pulmonary embolism following cesarean delivery. Nurses were given anonymous pre- and post-survey questionnaires and provided educational sessions with distributed handouts. A unit needs assessment was conducted using the 5 P’s. Out of the 72 nurses on the staff …

Dodge The Fall: A Newborn Fall Prevention Initiative, Lenora Thompson

Master's Projects and Capstones

Problem: This newborn fall prevention initiative was developed in response to an increase in the number of newborn falls at a Bay Area hospital on the postpartum unit. This hospital had gone six years without a newborn fall but by September of 2023 had three falls on the postpartum unit.

Context: The setting for this newborn fall prevention initiative is an urban, NICU level III Bay Area hospital that provides high-risk obstetric care. This Bay Area hospital has 247 licensed patient beds; 10 beds make up the postpartum unit and 11 beds make up the antepartum unit which serve as …

Improving Education On Preeclampsia With Non-Severe Features And Frequency Of Assessment Among Nurses In The Maternal-Child Postpartum Unit, Alyssa J. Willsher

Master's Projects and Capstones

Problem: This Quality Improvement (QI) project aims to improve preeclampsia education among nurses and reduce the frequency of preeclampsia assessments among patients(without severe features) (SF) in the Mother-Baby postpartum unit at Hospital A. Nurses often stated that patients are unable to have uninterrupted rest periods with frequent assessments, which research shows is necessary for reducing patient blood pressure.

Context: The QI project is implemented in a 25-bed postpartum unit that cares for women and their newborns in the postpartum period. The unit’s nurse educator and nurse manager requested that the visiting University of San Francisco research group focus on simplifying …

Mentoring Nurses After Specialty Training Or Orientation In Labor And Delivery, Benjamin Jlopleh Worji

Master's Projects and Capstones

Mentoring Nurses After Specialty Training or Orientation in Labor and Delivery

Abstract

Background: The setting for this project was a northern California hospital-based healthcare system referred to as “Hospital KV.” Hospital KV is a non-profit, integrated hospital that operates to improve the community’s health. Hospital KV’s maternal child health (MCH) department comprises a labor and delivery(L&D) unit, a mother and baby unit (MBU), also referred to as a postpartum unit, and an intermediate nursery (IMN).

Problem: The hospital KV MCH department faced the challenge of a nursing shortage. The nursing shortage was associated with substantial challenges to Hospital KV, its …

Give Love With Lovenox: Reducing Pulmonary Embolism Risk In The Postpartum Unit Through Lovenox Prophylaxis Nursing Education, Guadalupe Sierra Arroyo

Master's Projects and Capstones

Problem: This quality improvement project aims to improve nurse education on Lovenox prophylaxis to reduce pulmonary embolism occurrence post-discharge amongst high-risk postpartum women who underwent vaginal/cesarean deliveries and to increase patient medication compliance in the Family Baby Unit (FBU) at Hospital X.

Context: The quality improvement project occurred on the Family Baby Unit (FBU) at Hospital X. This 25-bed unit has recently had an increased rate of pulmonary embolisms post-discharge due to poor Lovenox medication adherence amongst patients and lack of education among nurses.

Intervention: Data was collected in the microsystem. This data was collected through questionnaires to assess nurses' …

Dodge The Fall: A Newborn Fall Prevention Initiative, Linda Nguyen

Master's Projects and Capstones

Problem: In the past year, three separate newborn fall incidents occurred on the postpartum unit at Hospital X. This project aims to increase nurse-to-patient education on newborn fall prevention, thereby reducing the number of newborn falls on the unit.

Context: This quality improvement project was implemented on the postpartum unit at a hospital located in San Francisco County. At this hospital, the postpartum unit consists of 10 beds in postpartum and 11 beds in antepartum. Currently, there is no standardized method used by registered nurses to prevent newborn falls.

Intervention: The requirement for mothers to sign the Pledge Form for …

Improving Preeclampsia Education And Assessment Frequency Among Nurses And Patients With Non-Severe Features In A Postpartum Unit, Monica Heredia

Master's Projects and Capstones

Problem: This Quality Improvement project aimed to improve preeclampsia education among Registered Nurses (RNs) and simplify the preeclampsia assessment frequency for patients with non-severe features in the Mother-Baby Postpartum Unit at Hospital Y.

Context: The Quality Improvement project occurred in a 25-bed Mother-Baby Postpartum unit at Hospital Y. The nurse educators at Hospital Y requested that University of San Francisco (USF) nursing students focus on increasing preeclampsia education among nurses and reducing the nursing assessment frequency.

Interventions: Collect quantitative data through observation and hand anonymous questionnaires to the registered nurses and clinical nurse leaders (CNLs) to determine …

Kangaroo Care And Improved Physiological Status In Preterm Infants, Kira Harkonen

Wisdom & Compassion: The LUSON Journal

Preterm births continue to cause long-term sequelae for infants worldwide. Interventions in the neonatal intensive care unit (NICU) that promote better outcomes can make an impact on preterm infants’ futures. The purpose of this review was to determine if kangaroo care has positive physiological effects on preterm infants in the NICU. Practice changes to enhance kangaroo care in the NICU include reducing barriers such as medical complexity and staff misconceptions as well as facilitating increased parental presence. The review of the literature found evidence to support the positive outcomes that kangaroo care has on neonates’ growth, vital signs, stress outcomes, …

Continuity Of Care In The Post-Partum Period, Ashley Quezada

MSN Capstone Projects

Maternal mortality rates in the United States have been a growing concern over the past decade, with rates continuing to climb as recent studies have been published. The total maternal mortality rate in the United States in 2018 was 17.4 and has increased to 32.9 as of 2021, while other developed countries continue to decline (Hoyert, 2023). The maternal mortality rate is the number of deaths per 100,000 live births. More than 50% of pregnancy-related deaths in the United States occur after delivery, in the post-partum period (Melillo, 2020). The purpose of this report is to not only bring light …

Implementation Of Standardized Contraceptive Education To Improve Larc Initiation In Postpartum Individuals, Gracie E Clayton, Melissa M. Hessock, Amanda Flood

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Approximately 50% of pregnancies in the United States are unintended, leading to negative health, psychosocial, and financial outcomes. Supported methods for preventing unintended pregnancies are promoting education and access to highly effective contraceptive methods, including long-acting reversible contraceptives (LARCs). Studies demonstrate counselor knowledge and bias contribute to underutilization of LARCs, highlighting the need for standardized education.

LOCAL PROBLEM: The setting for this practice improvement project was a rural obstetrical unit in Tennessee where there was no standardized postpartum contraceptive education. Rates of contraceptive use at postpartum discharge were low. The purpose of this project was to implement …

Sleep Hygiene Interventions For Hospitalized Pediatric Patients, Courtland E. Kunz, Marian Malone

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

ABSTRACT

BACKGROUND: Adequate sleep is found to improve overall physical and mental health. Unfortunately, hospitalized children receive significantly less sleep than what is recommended by the National Sleep Foundation.

LOCAL PROBLEM: Patient and family feedback at the project site demonstrated inadequate sleep and a noisy hospital environment. The objective of this EBP project is to improve sleep for the hospitalized pediatric patient.

METHODS: The Johns Hopkins Evidence Based Practice Model for Nurses and Healthcare Providers was used as the framework for this project. The PROMIS Sleep Disturbance 4a questionnaire was the tool used to measure pediatric patients’ …

Effect Of Doula Care Education On Cesarean Section Rates: A Benchmark Study, Elena Rubio-Mcdonald

MSN Capstone Projects

A cesarean section (CS) is a vital maternal care intervention when necessary; however, the surgical procedure places childbearing women at direct risk for infection, hemorrhage, thromboembolism, injury to bladder or bowel, post-surgical pain, and complications from anesthesia. The risk of mortality associated with CS is four to five times more likely compared to vaginal delivery. Severe nursing shortages, high patient volumes, and patients with complex pregnancy related health concerns create barriers to the provision of continuous labor support (CLS) by labor and delivery (L&D) nurses. Partnering with certified doulas and implementing the CLS methods they employ may promote spontaneous vaginal …

Certified Midwives: An Exploration Of Their Impact On Maternal Health Outcomes – A Comprehensive Literature Review, Heather Hollister

Capstone Experience

Maternal health outcomes in the United States have been consistently worse than other high-income countries, with a disproportionate impact on women of color. Midwives have long played an important role in maternal health worldwide. The literature review examines the evidence for midwives as key contributors to improving maternal health outcomes. The paper reviews the existing literature on midwifery, including the impact on maternal health, labor and delivery outcomes, and patient satisfaction. Electronic searches were conducted through Cochrane Library, CINAHL, Medline and Embase. Articles were screened according to inclusion and exclusion criteria including that they must be a randomized study; participants …