Nursing Midwifery Commons^™

Factors Influencing Utilisation Of Services Provided By Community Midwives And Their Non-Retention In District Thatta, Pakistan: A Qualitative Study Protocol, Bakhtawar M Hanif Khowaja, Anam Shahil Feroz, Sarah Saleem

Department of Obstetrics & Gynaecology

Introduction: Drawing on the well-acknowledged evidence of community midwives services to address the issue of high maternal mortality, the Government of Pakistan initiated the Community Midwifery (CMW) programme in 2006 to provide skilled birth attendance to pregnant women living in rural areas. Despite a large investment in CMW programme, the availability of community midwives in rural areas following their training is a constant struggle. The concerns related to the training, support and acceptability of community midwives need to be studied in order to identify gaps in the provision of skilled maternal and newborn healthcare. Therefore, this study aims to explore …

Implicit Bias Training For Perinatal Nursing, Racheal Lakine-Harden

Dissertations

Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias …

Implementation Of Quantitative Blood Loss Tool To Detect Postpartum Hemorrhage After Vaginal Delivery, Rachael Williams

Dissertations

Problem Maternal deaths and comorbidities related to postpartum hemorrhage (PPH) continue to be high despite being quite preventable. The delay in recognition and treatment of PPH due to the use of imprecise estimated blood loss (EBL) instead of precise measurement using quantitative blood loss (QBL) attributes to this issue.

Methods For this quality improvement (QI) project, a descriptive, observational design was used to gather quantitative data regarding QBL implementation instead of EBL as well as the number of PPH’s identified. A pilot cohort of staff nurses participated by documenting QBL two hours after each delivery. The nurses were given an …

The Effects Of Early Lactation Support On Breastfeeding Exclusivity Rates, Alexa Fleming

Dissertations

Abstract

Problem Breastfeeding exclusively for the first 6 months of a child’s life is the recommendation across medical professionals. Unfortunately, exclusive breastfeeding rates are on the decline due to insufficient support, lack of self-efficacy and inadequate hospital interventions.

Methods For this quality improvement (QI) project, a descriptive observational study design was used to identify appropriate participants who were planning to have a full-term, healthy, exclusively breastfed newborn. Within one hour after delivery, a lactation specialist provided the mother with breastfeeding education and assistance with the initial latching process. At the time of discharge, data was collected to examine if the …

Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King

Doctor of Nursing Practice Projects

Background: The benefits of breastfeeding are commonly known; however, the rates of exclusive breastfeeding among the Black community are less than those of other ethnic groups. Providing breastmilk or formula to an infant is an individual decision. Influential factors such as cultural background, employment status, socioeconomic status, level of education, and availability of support from family members and health care providers correlate with the method a mother chooses to feed her infant. Increasing breastfeeding initiation immediately after birth is a necessary precedent for uptake in the exclusivity of breastfeeding.

Purpose: This Doctor of Nursing Practice project aims to improve prenatal …

A Qualitative Inquiry On Smokers’ Perceptions Of Smoking Cessation During Covid-19, Sajid Iqbal, Rubina Barolia, Kiran Iftikhar, Pammla Petrucka, Jeniefer Anastasi, Faris Farooq Saeed Khan, Naheed Feroz Ali

School of Nursing & Midwifery

Background: This qualitative exploratory study explores smokers’ perspectives regarding smoking cessation processes amid the COVID-19 pandemic.
Methods: Purposive sampling was employed to conduct semi-structured interviews with cigarette smokers visiting cardiac and pulmonary clinics at a tertiary care hospital in Karachi, Pakistan. Thematic analysis was performed to identify themes from the participants’ responses.
Results: Three themes emerged from the thematic analysis. These were smoking cessation facilitators, smoking cessation barriers, and COVID-19 impacts on smoking cessation. Awareness and education, threat of acquiring health problems, religious beliefs and family or support system behave as smoking cessation facilitators. While, role modeling, associating smoking to …

Midwives’ Associations’ Dual Role In Supporting Members And Driving The Profession Forward: A Qualitative Interview Study From Bangladesh, Mosammat Ratna Mon, Most Nargis Parvin, Joy Kemp, Sharmin Shobnum Joya, Christina Pedersen, Ulrika Byrskog, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Background: Professional midwives are being introduced as a long-term solution to improve maternal and newborn health in Bangladesh and to contribute to Universal Health Coverage. Professional midwives’ associations are a core element of a strong midwifery profession according to the International Confederation of Midwives (ICM). The Bangladesh Midwifery Society (BMS) was formed in 2010 to advocate for the introduction of professional midwifery in Bangladesh. Since 2017 BMS has benefitted from an international twinning partnership with the Royal College of Midwives (RCM) UK and has undergone significant organizational development.

Objective: The study aimed to describe the experiences, knowledge and attitudes of …

Knowledge, Attitudes, And Preparedness For Managing Pregnant And Postpartum Women With Covid-19 Among Nurse-Midwives In Kenya, Rose Maina, Rachel Kimani, James Orwa, Bernard Mutwiri, Carolyne K. Nyariki, Sheila Shaibu, Valerie Fleming

School of Nursing & Midwifery, East Africa

Introduction: Globally, maternal morbidity and mortality have increased during the COVID-19 pandemic. Given the high burden of maternal and neonatal mortality in Kenya prior to COVID-19, front line health workers, including nurse-midwives, must be competent to ensure continued quality maternal services. Knowledge and awareness of COVID-19 transmission influence nurse-midwives risk perception and ability to implement prevention strategies.

Objective: We examined nurse-midwives’ knowledge, attitudes, and preparedness in managing pregnant and postpartum women with COVID-19 in Kenya.

Methods: A cross-sectional online survey was conducted among 118 nurse-midwives between July 2020 and November 2020. A 31-item survey comprising 15 knowledge, …

Midwife-Led Community Transformation (Milcot) Nursing Now Challenge In Uganda, Harriet Nayika, Cliff Aliga, Lisa Bayliss-Pratt, Robert Kagwire, Grace Edwards

School of Nursing & Midwifery, East Africa

Summary

This paper describes the journey of a young African midwife utilising the Nursing Now Nightingale Challenge framework to undertake a gap analysis and a mapping exercise to provide high-quality continuous professional development education for midwives working in isolation in a deprived suburb in Uganda. The project was completed in three stages:

• Stage one mapped out the services available within Nansana, Uganda
• Stage two identified the gaps in education for midwives and nurses within the area
• Stage three developed and offered educational study days for nurses, midwives and adolescents based on the gap analysis.

Swot Analysis Of Community Midwifery Program In Pakistan, Bakhtawar Muhammad Hanif Khowaja, Anam Feroz, Farina Abrejo, Sarah Saleem

Journal of Asian Midwives (JAM)

The community midwifery program was launched in 2006 by the Government of Pakistan as a major initiative to provide skill birth attendance to women living in rural areas of Pakistan. The main purpose of the program is to extend maternal and newborn services to the communities, through the selection and training of community midwives (CMWs) from rural areas, and to deliver services to their local communities. However, there is a substantial difference between the number of CMWs trained and those working at their birthing stations. Therefore, this paper uses a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis to evaluate the different …

Hidden Relationships: Perspectives On Leadership And Management In Afghan Maternity Services - An Ethnographic Exploration, Rachel Arnold, Edwin Van Teijlingen, Kath Ryan, Immy Holloway

Journal of Asian Midwives (JAM)

Introduction: Health system leaders have a vital role to play in ensuring the delivery of high-quality care. Improving the quality of healthcare, particularly in low-income countries often focuses on the performance of healthcare providers and the availability, acceptability, and uptake of services. The role that health service leaders play in facilitating effective care has received less attention in the literature. This study explored the perspectives of Afghan maternity care providers, managers and other stakeholders on leadership and the provision of quality maternity care.
Methods: This ethnographic study used semi-structured interviews, participant observation, and background interviews for data collection. …

Jam – Summer 2022: One Crisis After Another…., Rafat Jan, Edwin Van Teijlingen, Kiran Mubeen

Journal of Asian Midwives (JAM)

No abstract provided.

The Psychological Toll Of Covid-19 Pandemic On Private Practice Midwives In Indonesia And Its Relation With Perceived Knowledge And Individual Adaptability, Amelia Citra Kirana, Gracia Ivonika, Dewa Ayu Mirah Ardrini, Maria Stephani Dwitya, Ratih Ibrahim, Ray Wagiu Basrowi

Journal of Asian Midwives (JAM)

COVID-19 had serious impacts on the lives and health of people across the globe. Due to the high-risk nature of their work midwives frequently report personal/professional adverse psychological impacts. However, there is a lack of studies examining the psychological impacts of the COVID-19 pandemic on private practice midwives in Indonesia and beyond. This study examines the psychological impacts of the pandemic on private practice midwives in Indonesia, as well as its association with individual adaptability and perceived knowledge about COVID-19. A total of 423 private practice midwives, who were active practitioners during the pandemic, completed an online survey, comprising five …

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 …

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 …

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 …

A Cohort Comparison Study On Women In Threatened Preterm Labor Given Nifedipine Or Nifedipine And Salbutamol Tocolysis In Air Medical Retrieval, Breeanna Spring Walsh, Fergus W. Gardiner, Dianne Bloxsome, David Ford, Brennen W. Mills, Simon M. Laws

Research outputs 2022 to 2026

Objective: Women with threatened preterm labor in remote Australia often require tocolysis in the prevention of in-flight birth during air medical retrieval. However, debate exists over the tocolytic choice. Methods: A retrospective analysis was undertaken on data containing women who required air medical retrieval for threatened preterm labor within Western Australia between the years 2013 and 2018. Results: A total number of 236 air medical retrievals were deemed suitable for inclusion; 141 received nifedipine, and 95 women received salbutamol + nifedipine. Tocolytic efficaciousness was reported in 151 cases, proportionally more (P < .05) from the women who received salbutamol + nifedipine (n = 68, 71.6%) compared with the women who received nifedipine only (n = 83, 58.9%). Those receiving salbutamol + nifedipine were more likely to suffer maternal tachycardia (n = 87 [91.6%] vs. n = 62 [44.0%]), fetal tachycardia (n = 26 [27.4%] vs. n = 13 [9.2%]), nausea (n = 17 [17.9] vs. n = 5 [3.55%]), and vomiting (n = 12 [12.6%] vs. n = 2 [1.4%]). Three women who received salbutamol + nifedipine had serious side effects including echocardiographic changes, chest pain, and metabolic and lactic acidosis. Conclusion: Salbutamol + nifedipine tocolysis was proven to be more effective than nifedipine only. Although salbutamol + nifedipine had increased temporary side effects, most were nonsevere and managed in-flight.

Perinatal Care In Western Uganda: Prevalence And Factors Associated With Appropriate Care Among Women Attending Three District Hospitals, Mercy Muwema, Dan K. Kaye, Grace Edwards, Gorrette Nalwadda, Joanita Nangendo, Jaffer Okiring, Wilson Mwanja, Elizabeth N. Ekong, Joan N. Kalyango, Joaniter I. Nankabirwa

School of Nursing & Midwifery, East Africa

Background: Perinatal mortality remains high globally and remains an important indicator of the quality of a health care system. To reduce this mortality, it is important to provide the recommended care during the perinatal period. We assessed the prevalence and factors associated with appropriate perinatal care (antenatal, intrapartum, and postpartum) in Bunyoro region, Uganda. Results from this study provide valuable information on the perinatal care services and highlight areas of improvement for better perinatal outcomes.

Methods: A cross sectional survey was conducted among postpartum mothers attending care at three district hospitals in Bunyoro. Following consent, a questionnaire was …