Maternal, Child Health and Neonatal Nursing Commons^™

The Role Of Nurses' Knowledge Of Postpartum Complications And Its Effects On Maternal Mortality Rates In The United States: An Integrative Literature Review, Elizabeth Reid

Grace Peterson Nursing Research Colloquium

Background:The maternal mortality rate for the United States of America still remains the highest of all developed countries with 20.7 deaths per 100,000 live births with the CDC estimating that 60% of all of the deaths were preventable.

Objectives: The purpose of this integrative literature review was to identify the common causes of maternal mortality and nurses’ knowledge of these issues and how they apply this knowledge to care for and provide discharge education to patients.

Methods: This integrative literature review was conducted with the key words “maternal mortality, maternal morbidity, postpartum, nurse’s education, complications, quality of care, discharge …

“Code Labor”: An Evidence Based And Interdisciplinary Approach To Managing Women Experiencing Precipitous Labor Outside Of The Labor And Delivery Unit, Rachel Wooten, Rachel Smedley

Research, Publications & Creative Work

Local Problem: Precipitous deliveries can incite adverse obstetrical events and poor outcomes. In one rural northern Alabama hospital, 75-100 babies are delivered monthly with an average of two precipitous deliveries occurring monthly.

Objective: The intent of the work was to address a cohort of obstetrical (OB) and emergency department (ED) nurses’ knowledge gaps regarding the care of women experiencing precipitous labor outside of the labor and delivery (L&D) unit. DESIGN A quasi-experimental design aimed at quality improvement at the healthcare system’s level was developed. A non-probability, quota sampling method was used to gather data.

Participants: Fifty-seven ED and OB RNs …

Comprehensive Staff Education And Implementation Of A Checklist Tool To Increase Staff Adherence To Pitocin Titration Protocols, Tara N. Cassell

Electronic Theses and Dissertations

This quality improvement project was designed to increase staff adherence to an existing Pitocin titration protocol used in a labor and delivery unit at a community hospital. In the current U.S. health care climate, safe patient care is paramount and the Institute for Safe Medication Practices identified Pitocin as a high-alert medication. Evidence-based practice recommends the use of a titration protocol to guide proper use of Pitocin. Prior research has shown improvements in patient outcomes when facilities implement Pitocin titration protocols, with staff adherence key to the successful implementation of evidence-based titration protocols, which may be improved with the use …

Presenting The Good Mother: Experiences Of Canadian Adolescent Mothers Living In Rural Communities, Karen A. Campbell, Corinne Hart

The Qualitative Report

Adolescent mothers and their children are at risk for suboptimal health outcomes making adolescent motherhood a public health concern. However, the experiences of rural-living adolescent mothers are not well understood. Using Lieblich, Tuval-Mahiach, and Zilber’s (1998) narrative methodology approach, the experiential accounts of three rural-living adolescent mothers was explored. Reflecting Goffman’s (1959) presentation of self, the findings of this study revealed how adolescent mothers attempted to construct and present their notion of being a good mother, while coping with complicating rural factors. The need to present as a good mother, the lack of anonymity associated with rural living, and geographical …

Increasing Nursing Competence And Confidence During Obstetric Emergencies Through Simulation: A Quality Improvement Project, Tram Wallen

Dissertations

Problem: This quality improvement project aimed to improve the knowledge and confidence of the mother/baby nursing staff during postpartum hemorrhages through in situ simulation. PPH is a leading cause of maternal death. Hospitals across the U.S. lack a standard approach to managing obstetric emergencies; the complications of childbirth are often identified too late. Multidisciplinary simulation-based team training has been associated with improved outcomes in obstetrics.

Methods: A convenience sample of 26 registered nurses (RNs) that care for postpartum patients attended a one-hour instructor-led presentation followed by in situ simulations of postpartum hemorrhage. A knowledge assessment and confidence survey were administered …

Depression Screening In Antepartum Females, Michelle Burk

Dissertations

Problem: Perinatal mood disorders, including depression, affects one in five pregnant or postpartum females. The American College of Obstetricians and Gynecologists (ACOG) and the US Preventative Task Force (USPTF) recommended screening for depression at least once during the antepartum and postpartum periods. The purpose of this quality improvement initiative was to introduce depression screening using the patient health questionnaire (PHQ) in antepartum women in a Midwestern private OB-GYN practice.

Methods: An observational, descriptive, cohort design utilizing a retrospective record review was used to evaluate for PHQ depression screening. A convenience sample of antepartum patients at/or around 36-weeks gestation was studied. …

Improving Maternal Outcomes Through Labetalol Algorithm Utilization For Hypertensive Disorders Of Pregnancy, Hailee B. Taylor

Dissertations

Hypertensive disorders of pregnancy can have negative effects on both mothers and neonates and are a major contributor to the increasing morbidity and mortality affecting women pregnant women in the United States. Treatment algorithms are available for treatment of hypertensive disorders of pregnancy when treatment criteria are met. With proper use of these algorithms, healthcare personnel can decrease the mortality and morbidity rates, which will increase patient safety and decrease healthcare spending. This research project focused on implementing The American College of Obstetricians and Gynecologists’ (ACOG) Labetalol treatment algorithm to treat patients diagnosed with severe preeclampsia. Prior to implementation, data …

Formula And Milk Food Insecurity Amongst Infants And Children In Wic Families, Kristen Hench

Grace Peterson Nursing Research Colloquium

No abstract provided.

The Effects Of Rape Trauma And Ptsd On The Childbirth Process, Helena Kevorkian

Grace Peterson Nursing Research Colloquium

Abstract

Background: Sexual trauma, including rape and childhood sexual abuse, takes a toll on the survivor emotionally and physically. With the invasive procedures, physical exposure and feelings of loss of control related to childbirth, the survivor may become triggered and become retraumatized. Through an integrative literature review, the effects of rape trauma and PTSD on the childbirth process were identified.

Objective: The purpose of this integrative literature review was to determine the effects of rape trauma and PTSD on the childbirth process. Through determining the effects, a greater understanding will be gained on how to best approach a situation with …

Exploring Parental Wishes And Personhood In The Grey Zones Of Neonatal Resuscitation, Alison Lindsay

Honors Projects

The intense societal debate churning around the moral status of fetuses includes topics such as qualifications for personhood, the role of the autonomous decisions of a fetus’ mother, and the obligations of society to protect fetuses. This paper analyzes extending this discussion to newborns in five sections. The first section presents a literature review of responses to a philosophical paper about the respective interests of parents and fetuses and newborns, elaborating on aspects of personhood and parental decision-making. The second section presents a literature review of medical and nursing discussion around resuscitation for extremely premature newborns, focusing on similar evaluations …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Ibuprofen Does Not Increase Blood Pressure In Preeclampsia, Sofia Costas, Sherry Hutton, Cindy Kenyon

Books, Presentations, Posters, Etc.

Objective: The aim of this IRB approved study was to evaluate the impact of ibuprofen on Mean Arterial Pressure (MAP) in the immediate postpartum period of women with preeclampsia.

Design: A retrospective chart audit of 633 preeclampsia patients who had treated severe hypertension (BP > 160/105) during their hospital stay.

Setting: Metropolitan Level 3 facility in Portland OR.

Patients/Participants: 169 patients met criteria; received magnesium sulfate postpartum and had severe hypertension postpartum. 60 were randomly selected, 30 received ibuprofen, 30 did not.

Methods: Baseline was obtained at 2 hours postpartum. Each patients MAP for each 24 hour interval were …

Understanding The Impact Of A Perinatal Mood And Anxiety Disorders Phone Support Line, Diana Nguyen, Semira Semino-Asaro

Doctor of Nursing Practice Final Manuscripts

Postpartum depression affects one in every seven women and anxiety is estimated to range from 13-21% in new mothers. Risk factors include prior diagnosis of depression, family history of depression, having medical complications during childbirth including a premature baby and a lack of social, emotional support. The purpose of this evidence-based practice project was to increase the amount of data gathered by a local perinatal support organization by analyzing the callers’ demographics through phoneline surveys and use the information to expand resources and access to care for mothers with perinatal mood and anxiety disorders (PMADs). The project was guided by …

Telephone Follow Up For Obstetrical Triage, Ann Grimshaw

Doctor of Nursing Practice Final Manuscripts

TELEPHONE FOLLOW UP FOR OBSTETRICAL TRIAGE VISITS

Ann Grimshaw, RN, MSN, CNS

Clinical Nurse Specialist

Doctorate of Nursing Practice, Student

University of San Diego, School of Nursing

San Diego, CA

Purpose: To reduce a patient’s knowledge deficit related to plan of care after an unscheduled obstetric triage through follow up phone calls.

Rationale and Background: Up to 75% women during their pregnancy will present to an unscheduled visit in obstetrical triage with questions about their own health and the health of their unborn newborn. The majority of these visits will result in discharge from obstetrical triage prior to delivery of …

Perinatal Mood And Anxiety Disorders, Stigma, And Social Support Among Postpartum Women, Ellen K. Fleischman

Dissertations

Purpose/Aims: The purpose of this descriptive, correlational, cross-sectional study was to examine the relationships among perinatal mood and anxiety disorder (PMAD) symptomatology, select demographics, stigma of mental illness, and social support, among inpatient postpartum women. Rationale: PMADs affect as many as 21% of childbearing women, yet these disorders are identified and treated less than half the time. There is a gap in the literature regarding the relationships among stigma, social support, and PMADs in postpartum women.

Conceptual Basis/Background: Despite recommendations from professional organizations, screening for PMADs is not consistently completed using a valid, reliable instrument. Stigma contributes to the low …

Music Therapy Assisted Childbirth In The United States: A Critical Literature Review, Sydney Mohr

Expressive Therapies Capstone Theses

Music therapy assisted childbirth is an approach of music therapy in which a licensed and credentialed professional utilizes music therapy interventions to address a variety of goals during childbirth. There is a lack of literature and missing knowledge on the topic, associated with an increased rate in traumatic birth cases, mothers with post-traumatic stress disorder, and postpartum anxiety and depression. The literature review provides a summary of the historical context of feminist theory and feminism, as well as brief descriptions of music therapy, guided imagery and music, and familiar music interventions. One of the primary goals of this type of …

Nursing Interventions That Address Barriers In The United States That Impact Neonatal Mortality, Victoria D. Sullivan, Ashton J. White

Anna Vaughn School of Nursing Undergraduate Work

In 2016, four out of every 1000 babies born in the US died within one month of age. This systematic research review explored nursing interventions that addressed barriers that impact neonatal mortality. The most significant barriers nurses faced in reducing and preventing NM were maternal access to healthcare and education during pregnancy, which can be influenced by maternal age, low socioeconomic status, lack of familial support, poor health literacy, and geographic location. The articles examined included nursing interventions that were evidence-based and addressed barriers relating to NM. Interventions promoting the reduction of NM included education of women’s health and prenatal …

Risk For Maternal Infant Bonding Reduction In High Risk Deliveries And The Recovery Phases, Amanda M. Karimi, Corie Vanarsdale Msn

Anna Vaughn School of Nursing Undergraduate Work

Bonding is one of the first developmental tasks for infants and is imperative for successful growth. The bonding phase begins in the periods immediately following birth. Complications that inhibit bonding postpartum may delay this process. Breastfeeding barriers, maternal substance abuse, and poor maternal mental health are among the contributing factors to delayed bonding. The purpose of this research study was to answer the question, “What best practiced nursing interventions assist mothers to promote bonding with the newborn after high risk deliveries?” This research review included a sample size of 10 articles which provided a variety of interventions to promote bonding …

Postpartum Depression Interventions, Maggie Brown, Corie Vanarsdale Msn

Anna Vaughn School of Nursing Undergraduate Work

PPD affects up to 19% of women worldwide. Possible behavioral changes include poor child outcomes, altered mother-infant bond, and even abuse of the child by the mother. The purpose of this systematic review is to synthesize current research to answer the question, what nursing interventions best treat postpartum depression affecting mothers of low SES in developed countries. The methodology included 10 articles in research of interventions related to sleep, exercise, and social support. Of these interventions in the discussion, exercise is the most effective. Peer support increases maternal mood and likelihood of seeking professional help. Volunteer support is effective if …

The Association Between Advanced Maternal Age And Short Interpregnancy Intervals On Preterm Labor, Hannah N. Burns, Kristi L. Duchanois

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Background: Preterm birth is the leading cause of neonatal and infant mortality and has become a major health concern due to the increasing rates of infant deaths in the United States (WHO, 2017). Studying maternal risk factors for preterm labor provides insight to this obscure condition and can assist in the identification of high risk women, as well as facilitate appropriate pregnancy planning. Purpose: Although research can be found on interpregnancy intervals and maternal age as independent risk factors for premature labor, gaps exist within the relation of these variables. This study was done to investigate whether there is …