Maternal, Child Health and Neonatal Nursing Commons^™

Influence Of A Palliative Care Protocol On Nurses' Perceived Barriers To Palliative Care And Moral Distress, Christina Cavinder

Evidence-Based Practice Project Reports

The World Health Organization (2013) states palliative care for children should begin at diagnosis which may even occur prenatally. Neonatal palliative care is variable due to the high technological, curative environment in the newborn intensive care unit, and the uncertain prognoses of infants born at the edge of viability. The purpose of this EBP project was to determine the influence of establishing a neonatal palliative care protocol on nurses’ perceived barriers to palliative care and moral distress. Corley’s Moral Distress theory and Stetler’s Model were used as guides for the framework of the project. The protocol, based on guidelines supported …

The Impact Of Inappropriate Gestational Weight Gain On Pregnancy, Delivery, And Neonatal Outcomes, Morgan L. Isom

Undergraduate Honors Theses

Inappropriate weight gain during pregnancy is a widespread problem associated with adverse maternal and newborn outcomes. This study’s objective was to examine the impact of gestational weight gain (GWG) above and below the Institute of Medicine (IOM) guidelines on pregnancy, delivery, and newborn outcomes in a rural population. Women were recruited at the first prenatal visit, and data was collected through research interviews and examination of prenatal and delivery medical records. Prepregnancy weight and weight at delivery were obtained, and the final sample (n=913) was restricted to women with singleton pregnancies. Participants were categorized by prepregnancy body mass index (BMI) …

Birthing Positions: Is There A Connection Between Acutal Nursing Experience And Evidence-Based Research?, Leah M. Latham

Undergraduate Honors Theses

The objectives of this study were to determine whether there was an association between clinical nursing knowledge of four birthing positions and current evidence-based research of those same positions and also to identify possible areas where nursing knowledge of those birthing positions was inadequate. This pilot study used convenience sampling to survey registered nurses (RNs) and licensed practical nurses (LPNs) on labor and delivery units. The survey was distributed to three hospitals in the southeastern United States, and twenty-four RNs and LPNs participated. Participants’ knowledge did not reflect current clinical evidence in two key areas, (1) the best position to …

How Do Black Nulliparous Women Cognitively Construct Birth?, Marianne F. Moore

Dissertations and Theses (Open Access)

A focused ethnography was conducted to determine the cognitive constructions about birth described by nulliparous Black women in an urban area of the Southwestern US; also, during postpartum, how do these women reconcile expectations with the actual birth? Semi-structured interviews were conducted before birth and after birth.

Women, 16 or older, 17 - 33 weeks carrying a singleton fetus and without anomalies or problems like pre-gestational diabetes, NYHA Cardiac Class III/IV, cancer, renal failure, or sickle cell anemia that eliminated vaginal birth were sequentially recruited and sampled in an affiliated ultrasound clinic. Women scheduled for an anatomy scan were approached. …

Impact Of Cue-Based Feeding Protocol On Premature Infants' Outcomes And Hospital Length Of Stay, Diana Michele Easley Cormier

Doctoral Projects

The project was an oral feeding practice change from traditional, gestational-age/volume-driven feeding progression to developmentally-based, infant-driven feeding progression. The infant-driven (cue-based) feeding protocol was implemented with goals to improve premature infants' feeding outcomes, and decreased the infant's length of hospitalization. The project was designed to implement a cue-based feeding protocol for oral feeding initiation and progression, within the neonatal intensive care unit (NICU) at Community Regional Medical Center (CRMC), and then retrospectively evaluate the impact of the cue-based feeding protocol on feeding outcomes. In order to realize full implementation of a NICU feeding practice change, multiple components, such as electronic …

Factors Associated With Abnormal Weights In Infants In The First Year Of Life: Results From The 2010 National Ambulatory Medical Care Survey, Nikaela R. Larossa

Honors Scholar Theses

Purpose: To examine the predictors associated with abnormal infant weights for lengths in the first year of life as seen in ambulatory care settings.

Data Sources: A secondary data analysis was conducted using the 2010 National Ambulatory Medical Care Survey (NAMCS), in which practitioners documented single patient visits. World Health Organization (WHO) growth charts and recommendations were used to evaluate infant weight for length. Of the total visits, 603 infants were less than one year old, and 595 infants were within the length range of the WHO growth charts. Of the 595 cases, 13.6% were underweight, 5.5% were overweight, 41.2% …

Grief Pathways After Perinatal Loss On The Metaphorical Journey Of Loss, Jennifer Marie Jonely

Boise State University Theses and Dissertations

A study using qualitative descriptive methodology was done to learn of the decision pathways that mothers experiencing six types of perinatal loss recall making during their experiences of loss. Five participants describe their experience as they recall decisions within their journeys of miscarriage, stillbirth, fetal malformation; one carrying to term by choice (perinatal palliative care), the other terminating, a neonatal death and a SIDS death. Effort was made to understand specific available choices these mothers remember making along with their recollected experience of what was helpful and what was not helpful as they were navigating those choices. Exploring the experiences …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

Coming Home: The Use Of Skilled Nursing Visits On Recently Discharged Nicu Patients, Brittany Mattson

Celebrating Scholarship & Creativity Day (2011-2017)

This research analyzes the facility’s use of skilled nursing visits of premature infants and recommends the best practice to support positive patient outcomes.

The Baby Friendly Hospital Initiative, Kathryn E. Brackett

Senior Honors Theses

Abstract

The Baby-Friendly Hospital Initiative (BFHI) is a worldwide movement started by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that is aimed at providing hospitals with a certification that guarantees the best possible patient-centered care for mothers and infants. It focuses on breastfeeding as optimal infant nutrition, and implements strategies to encourage and support mothers to breastfeed their infants exclusively for six months after birth. The Ten Steps to Successful Breastfeeding are a set of 10 simple, easy to understand guidelines developed by WHO and UNICEF for implementing this initiative in the hospital setting and …

Women’S Understanding Of The Effects Of Obesity On Pregnancy, Rachel A. Daniel

Senior Honors Theses

Obesity is a serious issue and is becoming a significant problem around the world. Obesity in general causes and complicates many health problems. As obesity increases in the population at large, the incidence of obesity in pregnancy continues to increase. Obesity during pregnancy has been linked in numerous studies to multiple complications, and the issues and risks have been clearly established. Also becoming pregnant or having multiple pregnancies increases the likelihood of developing obesity. Obese women of childbearing age many times do not even know these risks exist. There is a need to educate these women before they become pregnant, …

Perinatal Distress In Women In Low- And Middle-Income Countries: Allostatic Load As A Framework To Examine The Effect Of Perinatal Distress On Preterm Birth And Infant Health, Shahirose Sadrudin Premji

School of Nursing & Midwifery

In low- and middle-income countries (LMIC), determinants of women's and children's health are complex and differential vulnerability may exist to risk factors of perinatal distress and preterm birth. We examined the contribution of maternal perinatal distress on preterm birth and infant health in terms of infant survival and mother-infant interaction. A critical narrative and interpretive literature review was conducted. Peer-reviewed electronic databases (MEDLINE, Embase, Global Health, CINHAL), grey literature, and reference lists were searched, followed by a consultation exercise. The literature was predominantly from high-income countries. We identify determinants of perinatal distress and explicate changes in the hypothalamic-pituitary-adrenal axis, sympathetic, …

Evaluation Of The Care Program At Goodall Hospital’S Center For Women’S Health, Nicole Hutzler, Lindsey Stockwell

Thinking Matters Symposium Archive

The purpose of this descriptive study is to gain a better understanding of the characteristics that can affect depression and overall compliance in prenatal care. Researchers anticipate that women’s involvement in the CARE Program will lead to a decrease in depression scores measured between the first and second trimester. The continued assessment and support provided by the CARE Coordinator is also expected to lead to fewer untreated cases of perinatal and postpartum depression.

Implementation Of A Mhealth Program Within A Homeless Population Of Young Mothers, Maureen Byrnes

Seton Hall University DNP Final Projects

Purpose: Despite major medical advancements and education, more than 500,000 babies are born prematurely and an estimated 28,000 infants die before their first birthday annually (www.marchofdimes.com/peristats). New Jersey’s infant mortality rate appears exemplary when compared to the United States overall infant mortality rate. Yet, New Jersey’s infant mortality rate, preterm birth rate and low birth rate by mother’s race reveal a far greater risk for infants born to a mother who is African American (www.nj.gov/health/epht/outcome.shtml). The need for innovative approaches to improving New Jersey’s maternal-infant health is paramount. Mobile phones may provide an appropriate means of …

Breastfeeding Education: Improving Initiation And Duration Of Breastfeeding, Rhonda Coffey

Nursing Theses and Capstone Projects

The purpose of this research study was to examine the level of self-efficacy for new mothers attending a formal breastfeeding education compared to those that did not. Participants were asked to complete the Breast Feeding Self-Efficacy Scale - Short Form via telephone. Twenty primigravida mothers who were breastfeeding at the time of discharge agreed to participate. A Pearson correlation coefficient was calculated examining the relationship between the participant's level of self-efficacy and participation in formal breastfeeding. The Pearson correlation coefficient was positive but was not statistically significant ( r (18)= .250, p > .05) indicating no relationship between the participant's self-efficacy …

The Benefits Of Breastfeeding, Avery Kordus

Senior Honors Theses

Breastfeeding research is plentiful, and the majority of the literature shows that breast milk is the superior form of infant nutrition except in the rare circumstances of infant metabolic disorders, maternal drug use, or positive HIV status. In comparison to formula, breast milk provides improved cognition, development, behavior, bonding, nutrition, digestion, immunity, and long-term health with fewer diseases and conditions in infants. Mothers are benefited by breastfeeding through bonding, faster weight loss, and reduction in certain cancers and conditions. Breast milk contains the proper amount of carbohydrates, fats, proteins, vitamins, and minerals, and is also specialized for each infant and …

Effect Of Laser-Cut Slow-Flow Nipples On Preterm Feeding Performance, Katlyn Elizabeth Mcgrattan

MUSC Theses and Dissertations

Background: Dysphagia of prematurity is a highly prevalent condition that carries negative developmental, social, and financial implications. Although the modification of bottle nipple properties is a widely used treatment for dysphagia of prematurity, there have been a paucity of investigations examining the effect of this intervention on refined measures of feeding performance. Methods: Healthy preterm infants were evaluated for measures of milk ingestion and respiratory performance during oral intake on a laser-cut slow-flow and standard-flow nipple. Time to achieve hospital discharge milestones was recorded. Results: Few differences were observed in feeding performance between slow-flow and standard-flow nipples. Characteristics of respiration …

Interaction Coaching And Holistic Obstetric Nursing Care, Megan Ellis-Gardner

A with Honors Projects

The quality of the bond between mother and child has ongoing consequences, setting the infant's psychosocial and cognitive development. This paper suggest Increases in training and additional staff to promote early interventions to support a woman's transition into motherhood and facilitate a strong maternal-child bond.

Midline Catheter Use In The Newborn Intensive Care Unit, Tricia L. Romesberg

UNF Graduate Theses and Dissertations

Ongoing evaluation of current practice and incorporation of evidence based research into guidelines and protocols is a requirement for the provision of high quality, cost efficient care. Despite some literature describing observational data, midline catheters (MCs) are not an appropriate vascular access device for Newborn Intensive Care Unit (NICU) patients due to insufficient high level evidence demonstrating safety and efficacy. In addition, national guidelines for MC use in neonatal and infant patients lacks sufficient information for safe and effective use of MCs.

The results of this small, online survey indicate that while some neonatal nurses and Nurse Practitioners report the …

Hearing The Child's Voice: Their Lived Experience In The Pediatric Intensive Care Unit, Andrea Prentiss

All Publications

Background: More than 200,000 children are admitted annually to Pediatric Intensive Care Units (PICUs) in the US. Research has shown young children can provide insight into their hospitalization experiences; child reports rather than parental reports are critical to understanding the child’s experience. Information relating to children’s perceptions while still in the PICU is scarce.

Aims: The purpose of this qualitative study was to investigate school age children’s and adolescents’ perceptions of PICU while in the PICU; changes in perceptions after transfer to the General Care Unit (GCU); differences in perceptions of school age children/adolescents and those with more invasive procedures. …