Maternal, Child Health and Neonatal Nursing Commons^™

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

The Eleanor Mann School of Nursing Undergraduate Honors Theses

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 a …

The Lived Experience Of African American First-Time Breastfeeding Mothers At A Baby Friendly Hospital, Catherine A. Hagerty

Dissertations, Theses, and Capstone Projects

The purpose of this research study was to explore the lived experiences of African-American first-time mothers at a hospital following the Baby Friendly Hospital Initiative (BFHI) guidelines to promote breastfeeding. Breastfeeding rates for African-American mothers are lower than other racial groups. BFHI institutions offer breastfeeding support through adaptation of a set of practices designed to promoted exclusive breastfeeding. Reflection on this experience allows discovery of approaches that help both nurses and patients. The study methodology used is qualitative phenomenology developed by van Maned (1990) with its’ philosophical origin in the work of Merleau-Ponty (2008). Participants were nine first-time mothers who …

An Integrative Review: Maternal Engagement In The Neonatal Intensive Care Unit And Health Outcomes For U.S.-Born Preterm Infants And Their Parents, Susanne Klawetter, Jennifer C. Greenfield, Stephanie Rachel Speer, Kyria Brown, Sunah S. Hwang

School of Social Work Faculty Publications and Presentations

Hospitals and perinatal organizations recognize the importance of family engagement in the neonatal intensive care unit (NICU). The Agency for Healthcare Research and Quality (AHRQ) defines family engagement as “A set of behaviors by patients, family members, and health professionals and a set of organizational policies and procedures that foster both the inclusion of patients and family members as active members of the health care team and collaborative partnerships with providers and provider organizations.” In-unit barriers and facilitators to enhance family engagement are well studied; however, less is known specifically about maternal engagement’s influence in the NICU on the health …

Outcomes Of Implementation Of An Evidence-Based Enteral Feeding Protocol In Neonates Weighing Less Than 1800g At Birth, Rebecca Edwards

MaineHealth Maine Medical Center

Background:

Several studies have demonstrated that the implementation of standardized enteral feeding guidelines can lead to positive outcomes in the neonatal intensive care unit (NICU), including improved nutrition, decreased need for parenteral nutrition (PN), central lines and decreased costs. Furthermore, implementation of standard feeding regimens have significantly reduced the incidence of necrotizing enterocolitis (NEC), a devastating gastrointestinal emergency in neonates. It has been reported that NEC has an iatrogenic component related to variations in feeding practices. While the exact mechanism of the reduced risk of NEC and implementation of feeding protocols is unclear, standard feeding regimens likely improve consistency in …

Pilot Study Of A Breastfeeding Support Training Program Designed Particularly For Infants With Common Congenital Anomalies And Defects, Gretchen Nelson Ezaki

Doctoral Projects

The American Academy of Pediatrics (American Academy of Pediatrics [AAP], 2018), the World Health Organization (World Health Organization [WHO)], 2018), and The March of Dimes (March of Dimes, 2016) recommend exclusive breastfeeding for the first six months of life. In 2014, 79% of women in the United States began breastfeeding their infants, but only 40.7% and 18.8% continued breastfeeding exclusively at three and six months respectively (Centers for Disease Control and Prevention, 2017). This doctoral project promotes breastfeeding by creating and testing simple teaching algorithms for training registered nurses to support breastfeeding, including for infants with trisomy 21, congenital heart …

Associations Of First Trimester Co-Use Of Tobacco And Cannabis With Prenatal Immune Response And Psychosocial Well-Being, Kristin Ashford, Amanda Fallin-Bennett, Andrea Mccubbin, Amanda T. Wiggins, Sheila Barnhart, Joshua A. Lile

Perinatal Research and Wellness Center Faculty Publications

PURPOSE: This study aims to describe the association of first trimester co-use of tobacco and cannabis with maternal immune response and psychosocial well-being, relative to tobacco use only.

METHODS: A preliminary midpoint analysis included 138 pregnant women with biologically verified tobacco use, 38 of whom (28%) also tested positive for recent cannabis use. Maternal perceived stress (Perceived Stress Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and serum immune markers (IL-1β, IL-2, IL-6, IL-8, IL-10, TNFα, CRP, MMP8), were collected, although cytokine data were only available for 122 women.

RESULTS: Participant average age was 29.1 years, approximately half had a high …

Malignant Hypothermia Preparedness For Labor And Delivery Nurses, Patricia Rabinowitz

Doctor of Nursing Practice Scholarly Projects

Malignant Hyperthe1mia (MH) is a rare, inherited disorder of skeletal muscle triggered by general anesthesia in susceptible individuals. Although MH can occur later in the anesthetic course as well as post-operatively, it most frequently occurs shortly after induction of general anesthesia. Operating roo1n (OR) nurses receive extensive training in MH crisis 1nanagement. On labor and delivery (L&D) units, neuraxial (spinal and epidural) blocks are the safest and 1nost co1nmonly used anesthetics during pregnancy. General anesthesia is utilized only when the life of the 1nother or infant is in jeopardy or when a neuraxial block is not possible. Under these circumstances, …

A Practical Understanding Of Preeclampsia For A Nurse In A Third World Setting, Anna Lovin

Senior Honors Theses

Preeclampsia is a disease of pregnancy that affects approximately 3-5% of women with child. It is one of the primary causes of mortality in mothers and babies across the globe. The exact cause, pathogenesis, or disease progression is unknown. Therefore, there is no definition of which patients are at risk for developing preeclampsia and what can work as a preventative measure. In high socioeconomic settings where there is good healthcare, standard treatment is established to manage the symptoms and decrease the progression of preeclampsia to eclampsia. However, in more rural, third-world settings of developing countries, caring for patients with preeclampsia …

Psychometric Development Of The Patient Engagement In Prenatal Care Scale, Phyllis M. Dyess-Nugent

Nursing Theses and Dissertations

The value of prenatal care in improving maternal and neonatal outcomes has been evident in research for many years, and yet in the U.S. where prenatal care is widely accessible to women, maternal and neonatal morbidity and mortality remain higher than many developing countries (CDC, 2019). Attributes of prenatal care have been studied, such as the number of visits and timing of entry into care. Additional aspects of prenatal care deserve exploration in order to make improvements in this established, valuable intervention. A woman’s engagement in her care during pregnancy has not been previously measured. The focus of this dissertation …

Spontaneous Pushing Vs Directed Valsalva Pushing, Erika Ellis, Barbara Mcclaskey

Posters

The purpose of this study is to determine if spontaneous pushing during the second stage of labor produces better maternal outcomes than the more commonly used directed Valsalva pushing. A literature review of the recent studies has been performed to determine if Valsalva pushing is simply archaic or absolutely necessary for healthier mother/baby outcomes. To recommend that women go against their primal urges to push in the man­ner that their own bodies are directing them, indicates that there must be research-based evidence to intervene in the natural order of things and use Valsalva pushing instead. When in fact, there are …

Breastfeeding And How It Affects Cognitive Development, Kylie Farris, Barbara Mcclaskey

Posters

If one was asked “which is better: breastfeeding or formula feeding?” the most common answer would be “breastfeeding.” This would be the answer 9 times out of 10. It is a known fact by a wide range of people, that in general, breastfeeding is the better option. Infants who are breastfed exclusively in the first six months of life tend to have better overall health outcomes than children that are fed only iron-fortified formula or a combination of the two. Therefore, it is likely that breastfeeding will indeed also improve cognitive developmental outcomes. That is the purpose of this study. …

Umbilical Cord Milking At Birth, Jennifer Bowers, Barbara Mcclaskey

Posters

The World Health Organization recommends delaying cord clamping for at least 30-60 seconds after the birth of a full-term newborn. However, the recommendation on the time of cord clamping is not as clear with preterm infants or infants who need immediate resuscitation. The purpose of this study was to examine the best, most recent evidence regarding the timing of cord clamping. The methodology was a literature review. Recent research has focused on umbilical cord milking prior to cord clamping. Umbilical cord milking is described as “the unclamped umbilical cord is grasped and blood is pushed toward the infant several times …

Neonatal Abstinence Syndrome, Marissa Thompson, Barbara Mcclaskey

Posters

Neonatal abstinence syndrome (NAS) is becoming more and more prevalent today. The number of women who are using narcotics while they are pregnant continues to rise. Neonatal abstinence syndrome may occur when a pregnant woman takes narcotics that cross the placenta to the fetus. The fetus then becomes dependent on the drug. When the infant is born, they are no longer receiving the drug. A large percent of these infants will go on to develop withdrawal signs and symptoms after birth. Since there has been no consistency in providing specific standardized care for treating infants with NAS, the purpose of …

Co-Bedding Preterm Infants In The Nicu, Payton Moss, Barbara Mcclaskey

Posters

Providing the best possible environment for premature infants continues to be a challenge in the neonatal inten­sive care unit (NICU). The purpose of this literature review was to examine the evidence related to the care of preterm twins and whether twins benefit from co-bedding verses keeping them separated. Co-bedding is defined as caring for two or more infants in the same incubator and is considered a developmental initiative to minimize adverse effects of preterm birth. Twins share a tight space in utero and support each other as they grow. Skin-to-skin contact with preterm infants and their mothers has been shown …

Music Therapy In Preterm Infants In The Nicu, Olivia Murdock, Barbara Mcclaskey

Posters

A neonatal intensive care unit (NICU) provides life-saving care for premature and sick newborns. However, that environment is very stressful due to the noise of equipment, alarms, and constant activity. It is important to decrease the stress for the infant as well as the parents. The purpose of this literature review was to determine if there is benefit from the use of music in the NICU. The high level of stress and anxiety that parents experience during this time may put the parent/child relationship at risk. Overstimulation and ongoing noise in the NICU may delay improvement in health and increase …

Metabolism During Pregnancy And Postpartum: How Does It Change And What Factors Influence It?, Kristin Yoho

Masters Theses & Specialist Projects

PURPOSE: Pregnancy is a physically impactful process in a woman’s life. During this time, a woman will gain weight and research has shown that many women will retain some extra weight after delivery. Because of this, recovery in the postpartum period is pivotal to avoiding the implications of weight retention. The postpartum period is vastly understudied in both the research and medical communities and this gap between pregnancy and postpartum research needs to be bridged. Therefore, the purpose of this study was to investigate metabolic changes from pregnancy to postpartum and to study how factors such as sleep and breastfeeding …

La Adherencia A Las Recomendaciones De Sueño Seguro Por Parte De Las Enfermeras En Unidades De Cuidado Intensiva Neonatal (Ucin) De Hospitales Públicos Y Privados En El Gran Buenos Aires / The Adherence To Safe Sleep Recommendations By Nurses In Neonatal Intensive Care Units (Nicus) Of Public And Private Hospitals In Grand Buenos Aires, Joelle M. Schauer

Independent Study Project (ISP) Collection

El Síndrome de Muerte Súbita de Lactante (SMSL) es “la muerte de un niño menor de 1 año que ocurre, aparentemente, durante el sueño y no puede ser explicada luego de una investigación exhaustiva, que incluye una autopsia completa, la investigación de las circunstancias de la muerte y la revisión de la historia clínica" (Jenik et al., 2015, p. 2). La Academia Americana de Pediatría (AAP) tiene recomendaciones sobre las prácticas del sueño seguro que pueden disminuir el riesgo de SMSL y otras Muertes Súbitas Inesperadas Infantiles (MSII).

El objetivo de esta investigación es analizar la adherencia a estas recomendaciones …

In The Pocket With Kangaroo Education, Brett Butler, Carly Creekmore, Skylar Suppes

Nurse Presentations

Describes a quality improvement project to deliver timely kangaroo care education that empowers parents.

Labor Dystocia: Review Of New Acog Cesarean Guidelines, Naviah Soo

Grace Peterson Nursing Research Colloquium

ABSTRACT

Background: The rate of cesarean has significantly increased over the last decade with labor dystocia being the most common indicator for primary cesarean deliveries. This diagnosis was of labor dystocia was first established in the 1950’s by Emmanual A. Friedman. Due to the stark rise in cesareans, a landmark paper by Zhang challenged his definition of labor dystocia and changed the cesarean guidelines by adjusting the parameters that defined labor dystocia. In 2014, American College of Obstetricians and Gynecologists (ACOG) introduced these new guidelines with the aim of reducing the rate of cesareans.

Objective: The purpose of this integrative …

Racial Disparities In Maternal Mortality, Natasha Shehade

Grace Peterson Nursing Research Colloquium

Abstract

Background: Black women die during childbirth at a significantly higher rate than white women. This disparity will be examined using an integrative literature review and the minority stress theory lens.

Objectives: The purpose of this proposed integrative literature review is to identify how the stressors unique to vulnerable communities as outlined by the Minority Stress Theory impact maternal mortality in the United States.

Method: An integrative literature review will be used. An analysis of the literature will be performed to determine common themes in the existing literature.

Findings/Results: The review of literature revealed three common themes: black women who …