Maternal, Child Health and Neonatal Nursing Commons^™

"Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project", Amber M. Woodring, Samantha Kalkstein

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project, Samantha Kalkstein, Amber Woodring

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Socio-Cultural Correlates Of Breastfeeding Behavior Among Latina Mothers And Its Implications For Child Health, Liliana Davalos, Brisa Rodriguez Alcantar, Marissa Martinez, Christopher Johansen

Social and Behavioral Health Faculty Research

Background: Latina mothers in the United States report lower rates of breastfeeding initiation and exclusivity than their non-Hispanic counterparts. Lower rates of breastfeeding in infancy may lead to a higher rate of excess weight in childhood and adverse health conditions. Breastfeeding disparities in Latina women have been previously correlated with socio-cultural factors such as acculturation, education, income, nativity, and marital status. This study examines whether socio-cultural factors are associated with breastfeeding behaviors in Latina mothers in Nevada. Methods: Participants were Latina mothers [n = 214] over 18 years of age, with a child 2–5 years old. A logistic regression was …

Temporal Patterns Of Ectopic Pregnancy: Using The Electronic Health Record To Illuminate A Dark Corner In Women's Health, Kirsten Hepburn

Theses & Dissertations

Ectopic pregnancy remains a significant contributor to pregnancy-related morbidity and mortality, yet little is known about whether its occurrence follows discernible temporal patters that could inform prediction and prevention efforts. This dissertation aimed to explore the temporal characteristics of ectopic pregnancy through three interrelated projects: development of a new theoretical framework, a scoping review of the literature on ectopic pregnancy temporal patterns, and an empirical study using electronic health records data from a ten-year period at a single academic medical center. The Nursing Genomic and epigenomic, Environment, and Microbiome (N-GEM) situation-specific theoretical framework was introduced as a novel nursing theory …

Skin-To-Skin Contact At Birth For Very Preterm Infants And Symptoms Of Depression And Anxiety In Parents During The First Year – A Secondary Outcome Of A Randomized Clinical Trial, Siri Lilliesköld, Karoline Lode-Kolz, Björn Westrup, Nils Bergman, Kimmo Sorjonen, Ulrika Ådén, Evalotte Mörelius, Siren Rettedal, Wibke Jonas

Research outputs 2022 to 2026

Background: Mental health issues are common in parents to preterm infants. In the neonatal intensive care unit (NICU), skin-to-skin contact (SSC) as an avenue for parent-infant closeness may improve parental mental health. Few studies exist regarding its benefits when initiated immediately postbirth. The aim was to determine the effect of SSC for very preterm infants at birth on parents' mental health, by assessing symptoms of depression and anxiety within the first year. Methods: The Immediate Parent-Infant Skin-to-Skin Study was a randomized clinical trial conducted 2018–2021 at three NICUs in Sweden and Norway. Very preterm infants (28–33 weeks of gestation) were …

Improving Effective Assistant Nurse Manager Communication In Obstetrics, Julie Marie Glover

Master's Projects and Capstones

Abstract

Problem: This quality improvement project addresses inconsistent leadership communication among Assistant Nurse Managers (ANMs) in the Obstetrics (OB) department of a hospital in Northern California. ANM and staff concerns around shift handoff, huddles, and leadership responsiveness have created confusion and hindered team coordination. The project aims to improve communication effectiveness scores among OB ANMs from 50% to 75% by July 11, 2025.

Context: The project was conducted in the Maternal-Child-Health (MCH) unit of a hospital in Northern California, specifically targeting communication practices among OB ANMs. Concerns around communication practices were voiced by both ANM leadership and frontline staff, signaling …

Exploration Of The Cultural Beliefs, Values, And Practices Of African American/Black Women Or Birthing Persons Regarding Postpartum Depression: A Focused Ethnography, Stephanie Jacobs

Electronic Theses and Dissertations

Introduction: Postpartum depression (PPD) is the most prevalent perinatal mental health illness in women, affecting approximately 10% to 20% of all women in the United States, and a disproportionately higher number of African American women. The aim of this study was to explore the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression.

Research Question: What are the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression?

Methodology: A focused ethnography was chosen for this study and consisted of semi-structured interviews. Data was transcribed and analyzed …

Reducing Nulliparous, Term, Singleton, Vertex Cesarean Birth Rate, Roseanna Juarez

Master's Projects and Capstones

Abstract

Problem: Cesarean birth rates for nulliparous, term, singleton, vertex (NTSV) pregnancies in the United States continue to exceed the Healthy People 2030 goal of 23.6%, resulting in preventable maternal and neonatal complications and higher healthcare costs.

Context: This quality improvement (QI) initiative was conducted in a high-acuity labor and delivery unit in California’s Central Valley, an area characterized by maternal health disparities, high rates of comorbidities, and limited access to prenatal care. The goal was to reduce the NTSV cesarean rate to 18.0% by July 31, 2025.

Interventions: Guided by Kotter’s 8-Step Change Theory and the Plan-Do-Study-Act (PDSA) framework, …

Enhancing Adherence To Oxytocin Administration Guidelines To Reduce Postpartum Hemorrhage Rates In A Labor And Delivery Unit, Maya Denny

Master's Projects and Capstones

Abstract

Background: Postpartum hemorrhage (PPH) remains a critical challenge in maternal care. It shows a 13% PPH incidence rate in a high-risk labor and delivery unit in a northern California medical center, exceeding the national benchmark of 5%–10% based on 2021 ACOG data from 150 patient records.

Problem: There is inconsistent adherence to oxytocin administration guidelines, with only 60% of 100 audited charts documenting fetal and uterine activity, contributing to the elevated rate. The team is looking for a target rate of 90%.

Intervention: This involves implementing a checklist, providing training for 25 clinicians, and conducting two 30-minute simulation scenarios …

Establishment Of Neonatal Sepsis Predictors Utilizing Non-Invasive Monitoring Techniques, Dalton Janssen

Dissertations

Neonatal sepsis remains one of the leading causes of global neonatal mortality. Reactionary approaches for diagnosis and treatment have dominated the tactics in addressing neonatal sepsis but clinical intuition is an untapped resource that could lead to earlier prediction of sepsis onset. Nurses and other staff with specialized training and experience who have served as routine caregivers for a specific patient are able to identify when the patient’s status is altered. This clinical intuition may be substantiated by referencing specific patient trends in non-invasive measures over time. This retrospective, exploratory study examined whether variation in non-invasive monitoring variables could serve …

The Lived Experiences Of Fathers With Postpartum Depression: A Qualitative Study, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Background:

Although parents may joyfully anticipate the birth of a child, it's impossible for them to know ahead of time just how profoundly their lives will change. Postpartum depression (PPD) can result. While there is a substantial body of research regarding maternal PPD, paternal PPD has received far less attention and is neither adequately understood nor diagnosed. This is exacerbated by outdated but persistent sociocultural masculinity norms and the stigmas around mental health issues.

Purpose:

This study sought to explore the lived experiences of new fathers with PPD in order to provide greater insight into their experiences.

Methods:

This qualitative …

Development And Implementation Of An Ob/L&D Sbar Framework To Enhance Communication Between Obstetric Nurses And Anesthesia Providers: A Quality Improvement Initiative, Jenna E. Bigam, Laina J. Uzarski

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Effective communication between obstetric (OB) nurses and anesthesia providers is critical to ensure patient safety during epidural placements in labor and delivery (L&D) settings. At a large teaching hospital, communication gaps were identified when OB nurses requested anesthesia for epidural placements without consistently providing vital patient information. The lack of structured communication can result in important details being overlooked, which may lead to delays in care and potential patient harm. To address this, the SBAR (Situation, Background, Assessment, Recommendation) communication framework was implemented to standardize and improve information exchange. This Doctorate of Nurse Anesthesia Practice (DNAP) project aimed to enhance …

Management Of Neonates In The Special Care Nursery And Its Impact On The Developing Gut Microbiota: A Comprehensive Clinical Review, Ravisha Srinivasjois, Shripada Rao, Gavin Pereira

Research outputs 2022 to 2026

The first few days following the birth are a vulnerable time for the neonate. Sick infants experience various interventions during their stay in the neonatal unit in order to stay alive and grow. Acquisition of gut microbes is critical for the short- and long-term health of the neonate. At a time when the gut microbiome is starting to take shape, crucial interventions directed at improving the growth, development and survival of the neonate impact its development. Events prior to and after the birth of the neonate, such as maternal conditions, antibiotic exposure, type of feeds, supplemental probiotics, and neonatal intensive …

Implementation Of An Evidence-Based Postpartum Depression Screening Tool In A Level Iv Neonatal Intensive Care Unit, Morgan A. Takacs

Dissertations

Problem: Postpartum depression (PPD) affects up to 40% of mothers with infants admitted to the Neonatal Intensive Care Unit (NICU), yet many remain undiagnosed due to the absence of standardized screening protocols. Early identification and referral to Perinatal Behavioral Health Services (PBHS) is critical to support maternal well-being and improve neonatal outcomes.

Methods: This evidence-based quality improvement project utilized a descriptive and correlational design to evaluate the impact of implementing the Patient Health Questionnaire-8 (PHQ-8) for PPD screening among mothers of infants born ≤ 32 weeks’ gestation in a Level IV NICU. A convenience sample of 29 mothers received the …

Implementation Of Quantitative Blood Loss To Detect Postpartum Hemorrhage After Vaginal Birth, Raven S. Simpson

Dissertations

Problem: In the U.S., postpartum hemorrhage (PPH) is attributed to maternal morbidity and mortality, resulting in long-lasting effects of extended recoveries, surgical interventions, birth-related trauma, interruptions in mother-infant bonding, or death. Performing estimated blood loss (EBL) measurement methods postpartum is subjective and often associated with over- and underestimations of blood volume. The delay in recognition interferes with timely, efficient, and appropriate interventions, yielding a PPH (≥1000ml).

Methods: A quality improvement (QI) project was initiated with a descriptive, pre-implementation/post-implementation focus on a high-risk Labor and Delivery unit to explore the effects of Quantitative Blood Loss (QBL) measurements on the identification of …

Implementation Of A Human Papillomavirus Vaccination Toolkit Postpartum, Emily R. Leone

Dissertations

Problem: Human papillomavirus (HPV) is the most common sexually acquired infection in the world (DeCherney et al., 2018). Even a single dose of the HPV vaccine can provide up to 97% protection against HPV 16 and 18, which are the strains that cause 70% of all cervical cancers (Barnabas et al., 2022). Missouri ranks 35th in the country for HPV vaccination (Office of Disease Prevention and Health Promotion, 2020).

Methods: This quality improvement project implemented an HPV toolkit consisting of: 1) staff nurse education in the form of a written presentation 2) patient and provider education in the form of …

Integrating Kangaroo Care Into Cesarean Delivery Practices: A Pathway To Enhanced Health Outcomes, Julia Swords

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Cesarean deliveries often interrupt early mother-infant bonding, delaying the initiation of breastfeeding and limiting opportunities for skin-to-skin contact. Despite national guidelines promoting immediate postpartum contact, cesarean-born infants receive kangaroo care (KC) at significantly lower rates than those born vaginally. Prior to this project, only 2% of cesarean births at the project site received KC, highlighting a significant gap in care delivery.

Aim of the Project: The aim was to evaluate the feasibility and impact of implementing kangaroo care during cesarean deliveries in a community hospital to improve neonatal outcomes and adherence to evidence-based postpartum practices.

Review of the Evidence: …

2024 Nursing Annual Report, System Of Texas Children's Health

2024

No abstract provided.

Advocating For A Neonatal Fellowship Based On The Fundamentals Of Care, Angela Cyr, Megan Flynn

MaineHealth Maine Medical Center

Objective: Address knowledge gaps in neonatal care using the Fundamentals of Care Framework.

Implementation Of One Key Question® Screening Tool To Increase Reproductive Life Planning At A Community Health Clinic, Laura D. Adams

Doctor of Nursing Practice Final Manuscripts

Introduction: This evidence-based practice project implemented and evaluated the One Key Question® (OKQ) screening tool to improve pregnancy intention screening and reproductive health counseling in primary care. The goal was to better identify reproductive health needs among women of reproductive age and enhance provider engagement in preconception and contraceptive counseling.

Background: Nearly half of all pregnancies in the U.S. are unintended, and many women do not receive timely reproductive health counseling. Despite national recommendations, pregnancy intention screening is often missed in primary care. Early identification of reproductive goals supports better outcomes through tailored education, contraception, or preconception care. OKQ is …