Maternal, Child Health and Neonatal Nursing Commons^™

Podium Presentation: Identifying Barriers To Quality Mother-Infant Interactions In The Nicu Through Naturalistic Systematic Observations, Christine Neugebauer, Miranda Cox, Melissa Deckert, Ann M. Mastergeorge

2022 Providence Nurse Research Conference

No abstract provided.

Podium Presentation: Continuous Labor Epidural Placement Trends Among Parturients: An Evidence-Based Practice Project, Aleksandr A. Lyakhov, Teresa Bigand, Amanda Affleck, Kenn Daratha, Kris Daratha

2022 Providence Nurse Research Conference

Background:

Childbirth is very painful, and unmanaged pain may reduce patient satisfaction or lead to other complications. Evidence indicates that pain severity is lower among parturient women administered analgesia via a continuous labor epidural (CLE) and that maternal request is sufficient indication for CLE placement to manage labor pain. In some cases, a medical induction of labor may be scheduled, offering an opportunity for proactive pain management from hospital staff. Yet, trends on timing of CLE placement among parturient women with scheduled labor induction versus spontaneous labor in hospitals in Eastern Washington at one health system are unclear.

Purpose:

The …

The Development Of Maternal Medication Assisted Treatment Learning Modules, Katie Nadalsky, Rebecca Penders

2022 Providence Nurse Research Conference

No abstract provided.

Prescribed Pediatric Extended Care: A Program Evaluation On The Impact To Families Of Children With Medical Complexities., Jody Rogers

Graduate Theses, Dissertations, and Capstones

This is a paper about the impact of Prescribed Pediatric Extended Care (PPEC) on families of children with medical complexities.

Factors Associated With Utilization Of Quality Antenatal Care: Asecondary Data Analysis Of Rwandan Demographic Health Survey 2020, Quraish Sserwanja, Lilian Nuwabaine, Ghislaine Gatasi, Julius N. Wandabwa, Milton W. Musaba

School of Nursing & Midwifery, East Africa

Background

Over the last decade, progress in reducing maternal mortality in Rwanda has been slow, from 210 deaths per 100,000 live births in 2015 to 203 deaths per 100,000 live births in 2020. Access to quality antenatal care (ANC) can substantially reduce maternal and newborn mortality. Several studies have investigated factors that influence the use of ANC, but information on its quality is limited. Therefore, this study aimed to identify the determinants of quality antenatal care among pregnant women in Rwanda using a nationally representative sample.

Methods

We analyzed secondary data of 6,302 women aged 15–49 years who had given …

Spatial Variations In Family Planning Demand To Limit Childbearing And The Demand Satisfed With Modern Methods In Sub-Saharan Africa, Babayemi O. Olakunde, Jennifer R. Pharr, Daniel A. Adeyinka, Lung-Chang Chien, Rebecca D. Benfield, Francisco S. Sy

Environmental & Global Health Faculty Research

Background: There is an increasing demand for family planning to limit childbearing in sub-Saharan Africa (SSA). However, limited studies have quantified the spatial variations. This study examined: (i) the spatial patterns in the demand for family planning to limit childbearing and satisfied with modern methods, and (ii) the correlates of the demand for family planning to limit childbearing satisfied with modern methods in SSA.

Methods: This study analyzed secondary data on 306,080 married/in-union women obtained from Demographic Health Surveys conducted between 2010 and 2019 in 33 sub-Saharan African countries. We conducted exploratory spatial data analysis, with countries as the unit …

Intimate Partner Violence Disclosure And Associated Factors Among Pregnant Women Attending A City Hospital In South-Western Uganda: A Cross-Sectional Study, Eve Katushabe, John Baptist Asiimwe, Vincent Batwala

School of Nursing & Midwifery, East Africa

Background: Intimate partner violence (IPV) during pregnancy is a public health problem in Uganda that negatively impacts maternal and newborn health outcomes. However, IPVdisclosure and associated factors among pregnant women have remained poorly documented in southwestern Uganda. Therefore, this study determined IPV disclosure and associated factors among pregnant women attending a large City hospital.

Methods: In a cross-sectional design, 283 women attending Mbarara City Hospital Antenatal care (ANC) clinic were consecutively recruited into the study. Data was collected using a semi-structured questionnaire. This was administered by the research team and the exercise took over a month. That is; from 7th …

Remifentanil Patient Controlled Analgesia Use In Laboring Women: A Feasibility And Acceptability Study, Joshua Carr

Dissertations

Background/Purpose: Interest in remifentanil patient controlled analgesia (RPCA) as a treatment for labor pain has increased due to its unique pharmacodynamics and effectiveness on pain control among parturients. Despite its promise, RPCA remains infrequently used in the US. The purpose of this study was to 1) examine the implementation and acceptability of a new RPCA protocol in the labor and delivery ward of a mid-sized hospital, and 2) identify the attitudes and beliefs of healthcare workers in a real-world clinical setting.

Theoretical/Conceptual Framework: The holistic nature of Comfort Theory can account for the proposed mechanisms contributing to the …

Stop The Bleed And Seize Control: The Use Of Simulation And Video Modules In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage, Yvonne Oliva

Master's Projects and Capstones

Problem: This quality improvement project aims at Hospital X meeting the new Joint Commission (JC) provisional deadline through the implementation of simulation training and video development as a way of educating emergency department (ED) staff in recognizing and treating preeclampsia (PreE) and postpartum hemorrhage (PPH).

Context: This quality improvement project utilizes evidence-based practice, California Maternal Quality Care Collaborative (CMQCC) toolkits, and JC standards to educate ED staff on worsening cases of maternal morbidity and mortality nationwide. Research shows that early recognition and prevention of maternal hemorrhage and preeclamptic emergencies has the highest probability of decreasing maternal complications in the ED. …

Stop The Bleed And Seize Control: The Use Of Simulation In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage: A Quality Improvement Project, Raquel Andreina Torres

Master's Projects and Capstones

A quality improvement (QI) initiative was geared to assess and prepare Emergency Department (ED) nurses and clinical staff preparedness of pre-eclampsia and postpartum hemorrhage (PPH). The Non-Profit Hospital, with two different Emergency Room locations, currently does not have a Labor and Delivery (L&D) unit at one of their campuses. Additionally, there is no current policy or procedure set in place for the treatment of preeclamptic or postpartum women in the emergency room. As a direct result of The Joint Commission (TJC) standards and a very short timeline, a group of University of San Francisco Clinical Nurse Leader (CNL) graduate students …

Counting Every Drop: Preventing Maternal Mortality With Quantifying Blood Loss Through Triton Scale, Summer Le

Master's Projects and Capstones

Postpartum (PP) hemorrhage is one of the leading causes of maternal mortality (AWHONN, 2021). In each of the past three years, the percentage of PP hemorrhage has increased at Hospital X. The PP unit at Hospital X performs around 4,500 total deliveries each year. While the standard of care for PP blood loss is to specifically measure blood in milliliters as Quantifying Blood Loss (QBL) for Labor and Delivery (L&D), it is not yet the standard of care in the 24 hours postpartum after delivery (ACOG, 2019). This quality improvement project involved educating nurses about measuring blood loss – specifically …

Save Lives And Sanitize: Prevention Of Surgical Site Infections Post-Cesarean Section Through Increased Hand Hygiene Compliance, Lindsay N. Nance

Master's Projects and Capstones

Problem: Surgical site infections (SSIs) occur in 3-15% of cesarean sections, making SSIs one of the most common hospital-acquired infections (HAIs). Surgical site infections (SSIs) have increased within a Labor & Delivery (L&D) unit in a large California teaching hospital for the past three years, affecting reimbursement and creating a range of adverse outcomes for patients. Performance of consistent and thorough hand hygiene practices is key to preventing infection, yet the unit’s hand hygiene compliance of 66.7% is well below the facility’s target goal of 90%. Based on recommendations from the organization’s Infection Prevention & Control (IPC) specialist, the …

Stop The Bleed And Seize Control: Educating Emergency Department Staff On Maternal Hypertension And Hemorrhage, Mayra A. Portillo-Guerra

Master's Projects and Capstones

Problem: A Not-for-Profit Hospital accredited by the Joint Commission was fined for not having a current policy or procedure set in place for the treatment of obstetric emergencies. This quality improvement project implemented a simulation and a training video to prepare Emergency Department (ED) nurses and clinical staff for the awareness of preeclampsia and postpartum hemorrhage (PPH).

Context: This quality improvement project was implemented in two different Emergency Room locations for this Not-for-Profit Hospital. One of the campuses does not have a Labor and Delivery (L&D) unit while the other one does. The overarching goal is to increase awareness of …

Stop The Bleed And Seize Control: The Use Of Simulation And Video Modules In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage, Jared Maxwell Talsky

Master's Projects and Capstones

In order to address shortcomings of the health care system within the United States surrounding the early recognition and response to preeclampsia (PreE) and postpartum hemorrhage (PPH) emergencies The Joint Commission (TJC) revised the accreditation requirements regarding implementing yearly maternal hypertension and hemorrhage simulation scenarios in emergency departments. A Quality improvement team of Clinical Nurse Leader (CNL) students at University of San Francisco, working alongside the emergency department and labor and delivery department nurse educators assisted a dual hospital system in the Bay Area of California to develop and implement training materials and simulations for the hospital system’s Emergency Department …

Every Milliliter Matters: Quantitative Blood Loss In Postpartum, Iana Vatsenko

Master's Projects and Capstones

Postpartum hemorrhage remains a leading cause of maternal mortality in the United States. Postpartum hemorrhage occurs when mothers are bleeding excessively, have uterine atony, or the placenta has failed to come out completely. Research has shown that quantitative methods of blood loss estimation revealed a higher incidence of PPH than visual estimation. That is why using quantitative methods on time is essential for diagnosing PPH. Quantification of blood loss should be replaced by estimated blood loss since it is more accurate. The project's main focus was implementing quantification of blood loss and using the Triton Scale, a smart system to …

Utilizing Training And Educational Materials To Increase Hand Hygiene Compliance Of Healthcare Providers Participating In Cesarean Sections, Christopher Natividad

Master's Projects and Capstones

Surgical site infections (SSIs) are one of the most common complications of Cesarean section (C-section) procedures. The incidence of SSIs after C-section procedures at Hospital X has increased in each of the past three years. The Labor and Delivery (L&D) unit at Hospital X performs approximately 4,500 C-sections each year. Observation of these procedures illustrated a lack of adhesion to hand hygiene policies and protocols. This quality improvement project involved informing staff members of the poor hand hygiene compliance rates, and re-educating them regarding proper hand hygiene behavior using flyers, emails, and addressing them at shift change. Data collection focused …

Every Milliliter Matters: A Quality Improvement Initiative For Postpartum Quantified Blood Loss, Amy O. Quinones

Master's Projects and Capstones

Problem: The microsystem for maternal-child healthcare in 2020 had 5.9% of deliveries progress to a postpartum hemorrhage. In 2021, the percentage of deliveries that progressed to a postpartum hemorrhage increased to 12.3%. The nearly two-fold increase in postpartum hemorrhage occurrence led to the creation of the Quality Improvement (QI) initiative to identify postpartum hemorrhage at an earlier stage. The QI initiative aims to extend the quantitative blood loss (QBL) measurement beyond labor and delivery, and support identification of postpartum hemorrhage in the postpartum period.

Context: The microsystem that this quality improvement project occurred on were three postpartum units in a …

A Two-Step Approach To Increase Breastfeeding Adherence In Mothers With Preterm Infants, Jessica J. Glinski

Evidence-Based Practice Project Reports

Breastfeeding provides multiple benefits for mothers and infants. An overwhelming amount of evidence indicates that breastmilk optimizes infant growth and develops the immune system (Yu et al., 2018). Apart from the health benefits for infants, the immediate effects of breastfeeding for mothers include a decreased risk for hemorrhage, stress, and postpartum depression (Flemming, 2021). A mother’s psychological state impacts lactation success, mainly by affecting milk ejection (Dabas et al., 2019). Despite evidence suggesting that relaxation techniques are beneficial for all human beings, it is one of the least commonly used approaches for postpartum mothers (Joseph et al., 2019). The PICOT …

Perceptions Of Perinatal Nurses Caring For Perceived Stigmatized Patients During The Covid-19 Pandemic In Perinatal Settings: A Qualitative Study, Deborah Tucker

Dissertations

Perinatal nursing consists of caring for women before, during, and shortly after the birth experience, providing a unique opportunity for nurses to care for women and families in a fundamental moment of life (Simpson et al., 2020). This qualitative descriptive study design allows for straight descriptions of phenomena to evaluate perceptions of nurses caring for perceived stigmatized patients in the perinatal setting during the SARS-CoV-2 (COVID-19) pandemic. As research gaps were identified, the following research questions were developed and used to guide this study:

1. What are the perceptions of caring in perinatal nurses who deliver care to perceived stigmatized …

Maternal Distress In The Neonatal Intensive Care Unit, Morgan A. Staver

Theses & Dissertations

Maternal distress in the NICU is a common and potentially harmful phenomenon for mothers with a sick infant. The overall purpose of this dissertation was to describe maternal distress and to examine maternal distress among mothers who have infants greater than or equal to 34 weeks of gestation at birth in the NICU. This was accomplished by first conducting a concept analysis of maternal distress in the NICU. Next, an integrative review of the literature was done to assess maternal distress and associated variables in response to infant hospitalization in the NICU. Finally, a mixed methods study was done to …