Interventions Co-Designed By Healthcare Providers And Clients For Improving Therapeutic Relationships In Maternal And Child Healthcare: A Pilot Study Using Human Centered Design In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background

Research shows that poor provider–client interactions in maternity and child health (MCH) continue to affect health outcomes, service uptake, continuity of care, and trust in formal healthcare systems.

Objective The study’s objective was to jointly create a prototype intervention package for enhancing nurse-client relationships using human centered design (HCD) approach.

Methods A five-step HCD methodology was used: (1) Community-driven discovery through qualitative descriptive research methods using 9 focus groups with nurses and clients and 12 key informant interviews with MCH administrators; (2) consultative ideation and co-creation meetings with 10 nurses, 10 clients, and 10 administrators to co-design a rough …

A Socioecological Description Of The Influencing Factors To Midwives’ Management Of Preeclampsia In A Ghanaian Tertiary Hospital, Isabella Garti, Michelle Gray, Angela Bromley, Benjamin Tan

Research outputs 2022 to 2026

Introduction: In low-resource settings, midwives are the first contact for women with preeclampsia and lead the coordination of care. Unfavourable preeclampsia outcomes create a burden for women, families, and the health system. It is therefore important to understand the unique context of midwives’ practice and the complex factors that influence the delivery of maternal healthcare. Aim: This qualitative study explored the perspectives of key stakeholders in a tertiary hospital in Ghana regarding the facilitators and barriers influencing midwives’ provision of preeclampsia care using a socioecological model. Methods: Semi-structured interviews were conducted with 42 participants comprising senior managers (n = 7) …

Bertumbuh Berkembang: Modul Pemberian Makan Bayi Dan Anak (Pmba), Hikmah Kurniasari

Pengembangan Profesional

Pemberian Makanan Bayi dan Anak (PMBA) yang optimal akan meningkatkan kesempatan hidup dan pertumbuhan anak; juga daya tangkap untuk menguasai keterampilan serta pengetahuan yang mereka perlukan sebelum memulai pendidikan di tahun-tahun awal sekolah. Tidak hanya bagi bayi dan anak, pemenuhan gizi yang baik juga amat penting bagi ibu hamil dan menyusui. Selain penjelasan lengkap seputar PMBA dan kesehatan ibu hamil/menyusui, modul ini juga menjelaskan kepercayaan lokal yang kepercayaan lokal yang terkadang menimbulkan misinformasi dan menghambat akses bagi ibu, bayi, dan anak untuk mendapatkan nutrisi yang dibutuhkan. Modul ini akan bermanfaat bagi kader layanan kesehatan (Posyandu) untuk menyampaikan informasi yang tepat …

Bertumbuh Berkembang: Aktivitas & Lembar Evaluasi—Modul Pemberian Makan Bayi Dan Anak (Pmba), Hikmah Kurniasari

Pengembangan Profesional

Bagian lampiran dari Modul PMBA ini berisikan ide aktivitas untuk dilakukan oleh kader Posyandu beserta orang tua/pengasuh anak, lembar evaluasi, serta refleksi modul untuk tiap-tiap bab. Lampiran ini juga dilengkapi dengan arahan untuk melakukan curah pendapat, diskusi kelompok, juga latihan kasus.

Seeking Patient-Centered Care Through Bedside Handoff In The Postpartum Unit, Evelyn Ndaki

Master's Projects and Capstones

Problem: Patient discontent with nurse compassion and attentiveness prompted the implementation of standardized bedside shift handoff (BSH) for nurses in the postpartum unit of a Northern California teaching hospital.

Context: Pandemic stressors led to nurse practices not reflecting patient-centered care. Bedside handoff offers an opportunity to improve patient-centered nurse behaviors.

Intervention: To standardize BSH, a modified SBAR (Situation, Background, Assessment, Recommendation) tool was implemented.

Measures: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) question on “Nurses kept you informed” was tracked, and nurse satisfaction with the handoff process was measured with a pre- and post-implementation survey.

Results: Final …

Implementation Of A Structured Hybrid Training Program To Improve Clinical Skills And Staff Confidence In The Care Of Maternal And Neonatal Patients In The Emergency Department: A Quality Improvement Project, Melissa Hewitt

Doctor of Nursing Practice (DNP) Manuscripts

Caring for a pregnant woman or compromised newborn is often a stressful situation for all healthcare workers regardless of their experience or expertise. This stress is only heightened when the patient presents to a unit that may not be comfortable with the situation such as the Emergency Department (ED). Often units such as the ED do not receive adequate training in caring for maternal and neonatal patients. The infrequency of patient interactions coupled with their lack of knowledge can leave staff with decreased levels of confidence. Various research articles recommend that hospitals provide interdisciplinary team training for high acuity low …

Examining School Nurses' Knowledge And Confidence Related To Their Intention To Screen For And Report Child Sexual Abuse: A Descriptive Cross-Sectional Study, Suzanne Ackers

Electronic Theses and Dissertations

Background: Child sexual abuse (CSA) in a preventable national public health problem that results in adverse health consequences. Research suggests many victims are currently attending school. Screening for early detection of health issues is integral to school nurse (SN) practice but there is little evidence that screening for CSA is occurring in schools despite recommendations that it should be. Lack of confidence and knowledge related to screening for suspected CSA contribute to a SN’s missed opportunity for early intervention.

Purpose: To describe SNs knowledge and self-efficacy associated with screening for and reporting CSA in school settings.

Methods: A descriptive cross-sectional …

Early Identification Of Postpartum Depression Symptoms During The Antenatal Period Through The Utilization Of The Edinburgh Postnatal Depression Scale, Cherie Didier

Doctor of Nursing Practice Projects

Postpartum depression (PPD) is a prevalent mental health disorder that negatively impacts maternal behavior and infant development. Despite a global incidence of around 12% (Ti & Curtis, 2019), current screening practices are inadequate. The American College of Obstetricians and Gynecologists (ACOG, 2018) recommends universal screening using the Edinburgh Postnatal Depression Scale (EPDS) at least once during pregnancy. However, the project site in an obstetrical clinic currently does not screen during pregnancy. This quantitative quality improvement project in a Memphis, TN, obstetrical clinic used systematic data collection of EPDS scores of pregnant women and analysis to investigate the effectiveness of implementing …

Transformational Leadership Training For Middle Management To Reduce Turnover And Improve Job Satisfaction, Andrea Huntsinger, Andrea Huntsinger

Master's Projects and Capstones

Reduce Turnover and Improve Job Satisfaction

Abstract

Background: The medical center’s Maternal Child Health Department comprises 10 labor and delivery beds, 22 postpartum beds, and a 16-bed Level II NICU. The unit is overseen by six ANMs, a manager, and a director. The unit comprises approximately 160 employees, most being bedside registered nurses (RNs). The hospital prioritizes achieving Magnet status, where nurse job satisfaction is prioritized. The concern is that the department’s culture is not aligning with Magnet guidelines due to a lack of leadership within the unit.

Problem: A review of the department’s ANM team showed an unstable turnover …

Implementation Of An Initiative To Standardize Abdominal Binder Use In Postoperative Cesarean Section Patients: A Program Evaluation., Sarah Cohron

Doctor of Nursing Practice Papers

A cesarean section is a major abdominal surgery with a unique recovery profile. The patient must recover from surgery while simultaneously coping with a major life event: the birth of a new baby. The utilization of pain management techniques with as few side effects as possible is paramount to ensure optimal maternal and newborn outcomes (Karlström et. al., 2007; Eisenach et. al., 2008). On an inpatient mother/baby unit at a high-risk urban hospital in Louisville, Kentucky approximately 66 babies are born via cesarean section every month (Mattingly, 2021). However, in the fall of 2021, it was discovered that there was …

Exploring The Influence Of Postnatal Depression On Neonatal Care Practices Among Mothers In Western Kenya: A Qualitative Study, Florence Achieng, Alloys K’Oloo, Hellen Barsosio, Simon Kariuki, Helen Nabwera

Obstetrics and Gynaecology, East Africa

Background: Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality.

Objectives: To explore how PND influences neonatal feeding and care practices among women in the early postnatal period in rural Western Kenya.

Design: A cross-sectional study.

Methods: Semi-structured interviews were conducted at 2-weeks postpartum among mothers of newborn infants identified <72 h old from the postnatal wards and clinics across five health facilities in Kisumu County of Western Kenya. They were all screened for features suggestive of postnatal depression using the Edinburgh Postnatal Depression Scale.

Results: Twenty-four mothers were interviewed, 13 of whom had features suggestive of PND. All mothers experienced health or socio-economic adversities in the perinatal period, including traumatic deliveries, financial constraints, and challenging relationships with partners/other family members. Feeding difficulties due to …

Exploring The Lived Experiences Of Dysphoric Milk Ejection Reflex During Postpartum Breastfeeding: A Phenomenological Study, Stephanie Herr, Jessica Devido, Richard Zoucha, Jill Demirci

Electronic Theses and Dissertations

This study sought to explore the lived experiences of Dysphoric Milk Ejection Reflex (D-MER) during postpartum breastfeeding. A phenomenological method based on Giorgi’s phenomenological underpinnings was used. The setting for this study was virtual interviews in a secure online platform. The sample consisted of 13 participants, self-identifying as experiencing D-MER. Semi-structured interviews, with thematic analysis of transcription were conducted. Four major themes were identified: 1) Breastfeeding concessions and toleration; 2) Something does not feel “normal”; 3) I remember a feeling like this before 4) This is real, and recognition is validating. Conclusions were that women of this study value the …

Encouraging Human Papillomavirus Vaccine Uptake: A Healthcare Improvement Project, Lauren E. Woll

Dissertations

Abstract

Problem: Human papillomaviruses are the causative agents of >95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease.

Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake.

Results: Following implementation, Gardasil9 first dose uptake increased …

Improving Postpartum Depression Screening Practices In The Postpartum Setting, Courtney Lynn Cole

Dissertations

Abstract

Problem: Postpartum Depression (PPD) is frequently undetected in women due to barriers that limit effective recognition and diagnosis. Depression screenings and treatment referrals improve outcomes in the immediate postpartum period. Follow-up methods for positive depression screens are often missed by postpartum care teams.

Methods: A descriptive, observational design was used for this quality improvement project. A formalized depression screening protocol was created to help guide nursing staff on a Postpartum Unit when detecting a positive depression screen. Convenience sampling was utilized and the sample included patients aged 18-45. Data collected throughout this quality improvement project included Edinburgh Postnatal Depression …

Design And Implementation Of A Community-Based Mother-To-Mother Peer Support Programme For The Follow-Up Of Low Birthweight Infants In Rural Western Kenya, Jemma Wright, Florence Achieng, Linda Tindi, Manasi Patil, Mwanamvua Boga, Mary Kimani, Hellen Barsosio, Dan Juma, Helen Nabwera, Laura Kiige

Obstetrics and Gynaecology, East Africa

Background: Globally, low birthweight (LBW) infants (

Methods: Key informant interviews were conducted with 10 mothers of neonates (infants days) from two rural communities in western Kenya. These data informed the identification of key characteristics required for mother-to-mother peer supporters (peer mothers) following up LBW infants post discharge. Forty potential peer mothers were invited to attend a 5-day training programme that focused on three main themes: supportive care using appropriate communication, identification of severe illness, and recommended care strategies for LBW infants. Sixteen peer mothers were mentored to conduct seven community follow-up visits to each mother-LBW infant pair with fifteen …

Implementation Of A Perinatal Depression Screening Protocol, Michele Fuller

Doctor of Nursing Practice Projects

Background: Perinatal depression (PD), leading to suicide, ranked as a high cause of maternal mortality and was found to affect one out of 7 women in 2018, according to the American College of Obstetrics and Gynecology (ACOG) (2018). PD screening at the start of pregnancy care aims to achieve early referral to behavioral health resources (ACOG, 2018).

Purpose: The purpose of the Doctor of Nursing Practice (DNP) project was to implement an evidenced-based PD screening protocol by presenting the Edinburgh Postpartum Depression Scale (EPDS) to each initial prenatal visit patient (IPV).

Methods: Qualitative pre-data was collected, followed by qualitative post-data …

Implementation Of A Postpartum Depression Screening Protocol, Samantha Abercrombie

Doctor of Nursing Practice Projects

Background: Postpartum depression (PPD) is a major depressive disorder that can occur after having a baby and anytime during the first year postpartum (Centers for Disease Control and Prevention [CDC], 2021). Symptoms of PPD may include anger, crying more than usual, withdrawing from family, inability to bond with the baby, feelings of anxiousness, or thoughts of the mother harming herself or the baby. PPD can yield many challenges and hinder daily living activities. Recent research by the CDC (2021) estimates that 1 in 8 women experience manifestations of PPD. Findings also suggest that 1 in 5 women were not …

Effectiveness Of Kaleidoscope On Pain And Behavioural Responses Among Children During Intravenous Cannulation- An Open-Label Randomised Controlled Study., Anju K S, Swapna K. Gopalan, Namitha P

Manipal Journal of Nursing and Health Sciences

Abstract

Introduction

Children experience significant pain and distress during paediatric procedures, especially during intravenous (IV) cannulation. Several non-pharmacological interventions are in use for this purpose. Many distraction techniques are suggested.

Methods

A randomised controlled trial was conducted among 60 children in the age group of 4-12 years undergoing first IV cannulation after admission to evaluate the effectiveness of kaleidoscope compared to standard treatment on pain and behaviour response. Through block randomisation, 30 children were allocated to each group. Standard tools were used to assess pain and behaviour response.

Results

Total 102 children were admitted to the paediatric ward during the …

Maternal Fetal Bonding In Three Trimesters Among Primigravida-A Comparative Study, Sasi Rekha

Manipal Journal of Nursing and Health Sciences

Introduction: Maternal Fetal Bonding is the term used to describe the relationship between the pregnant women and the fetus. A broad spectrum of Maternal Fetal Attachment (MFA) has been observed during pregnancy. The frequency and the intensity of MFA increases with advancing age particularly, after quickening at approximately 18 to 22 weeks of gestation. The aim of this study was to compare the maternal fetal bonding in three trimester. Methodology: Quantitative-evaluative research approach was selected. Non probability convenient sampling technique is used to collect 120 primigravida⁽⁴⁾. Rating scale was used to assess the maternal fetal bonding among primigravida …

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

Research outputs 2022 to 2026

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