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Heather Condo DiCioccio Candace Ady James F. Bena Nancy M. Albert 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2019,48(2):189-196
Objective
To examine whether delayed newborn bathing would increase rates of in-hospital exclusive breastfeeding and plans to use human milk at discharge.Design
A retrospective, two-group, pre- and postintervention design.Setting/Local Problem
At our facility, the initial bath was completed within 2 hours of birth, and the rate of in-hospital exclusive breastfeeding was low.Participants
Couplets of mothers and healthy newborns (N = 996).Intervention/Measurements
Newborn baths were delayed at least 12 hours after birth. Pre- and postintervention data were retrieved from the hospital’s electronic medical record and administrative database. Univariate and multivariate analyses were completed.Results
Of 996 mother–newborn couplets, 448 were preintervention couplets and 548 were postintervention couplets. Of all mothers, 63.3% were White, 67.8% were married, and 67.1% gave birth vaginally. Of all newborns, 49.6% were female, and the mean (standard deviation) birth weight was 3.3 kg (0.50). We found no differences in maternal or newborn characteristics by group. Median (25th percentile, 75th percentile) times from birth to first bath before and after the intervention were 1.9 (1.6, 2.3) and 17.9 (11.9, 25.0) hours, respectively (p < .001). In-hospital exclusive breastfeeding increased from 59.8% before the intervention to 68.2% after the intervention (p = .006). In multivariate modeling, in-hospital exclusive breastfeeding increased for all couplets after the intervention (odds ratio = 1.49, 95% confidence interval [1.14, 1.96]; p = .004) and with vaginal versus cesarean birth (odds ratio = 1.60, 95% confidence interval [1.14, 2.25]; p = .006). In addition, the postintervention discharge feeding plan reflected an increase in use of human milk.Conclusion
Delaying the newborn bath was associated with increased in-hospital exclusive breastfeeding rates and use of human milk as a part of the discharge feeding plan. 相似文献3.
Wanli Xu Michelle P. Judge Kendra Maas Naveed Hussain Jacqueline M. McGrath Wendy A. Henderson Xiaomei Cong 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(3):451-463
Objective
To examine the effect of feeding type on microbial patterns among preterm infants and to identify feeding factors that promote the colonization of beneficial bacteria.Data Sources
PubMed, Cochrane Database of Systematic Reviews, Scopus, and the Cummulative Index of Nursing and Allied Health Literature were thoroughly searched for articles published between January 2000 and January 2017, using the keywords gut microbiome, gut microbiota, enteral microbiome, enteral microbiota, premature infant, preterm infant, extremely low birth weight infant, ELBW infant, very low birth weight infant, feeding, breast milk, breastfeeding, formula, prebiotic, probiotic, and long chain polyunsaturated fatty acid.Study Selection
Primary studies written in English and focused on the association between enteral feeding and gut microbiome patterns of preterm infants were included in the review.Data Extraction
We independently reviewed the selected articles and extracted information using predefined data extraction criteria including study design, study participants, type of feeding, type and frequency of biospecimen (e.g., feces, gastric aspirate) collection, microbiological analysis method, and major results.Data Synthesis
In 4 of the 18 studies included in the review, researchers described the effects of milk products (mothers’ own milk, donor human milk, and formula). In 5 studies, the effects of prebiotics were assessed, and in 9 studies, the effects of probiotics on the gut microbiome were described. Mothers’ own breast milk feeding influenced the compositional structure of preterm infants’ gut microbial community and increased diversity of gut microbiota compared with donor human milk and formula feeding. The results of the use of prebiotics and probiotics varied among studies; however, the majority of the researchers reported positive bifidogenic effects on the development of beneficial bacteria.Conclusion
Mothers’ own milk is considered the best form of nutrition for preterm infants and the gut microbial community. Variation in fatty acid composition across infant feeding types can affect microbial composition. The evidence for supplementation of prebiotics and probiotics to promote the gut microbial community structure is compelling; however, additional research is needed in this area. 相似文献4.
Laura M. Candelaria Diane L. Spatz Noreen Giordano 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(4):556-563
Objective
To examine the experiences of women who donated breast milk to a hospital-based milk bank regulated under the policies and procedures set forth by the Human Milk Banking Association of North America (HMBANA).Design
Qualitative, phenomenological design.Setting
The Mothers’ Milk Bank in a children’s hospital in the Northeastern region of the United States.Participants
Twelve HMBANA-approved milk donors older than 21 years with infants hospitalized in the NICU.Methods
Edmund Husserl’s design of interpretive phenomenology and Colaizzi’s method of data analysis were used for this study. Participants were interviewed using a face-to-face, semistructured interview format.Results
Four themes represented the experience of donating breast milk: Ripple of Hope and Help, Dynamic Interplay of Nurturance, Standing on the Shoulders of Others, and Sharing Their Stories. Donors felt proud and accomplished to provide hope for other infants and families. Nurses were crucial in facilitating and motivating donors and making donation achievable in a supportive environment. Donors felt compelled to share their experiences to teach and motivate others to donate.Conclusion
For our participants, donation of human milk was a positive, valuable, and nurturing experience. Donors reported feelings of increased self-esteem during donation that motivated them to “give back” and continue. The support of a well-trained nursing staff is essential for donors to meet their personal goals. 相似文献5.
Kimberly N. Doughty Alayne G. Ronnenberg Katherine W. Reeves Jing Qian Lindiwe Sibeko 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(3):301-315
Objective
To identify differences in breastfeeding-related knowledge, attitudes, beliefs, and experiences between women with gestational diabetes mellitus (GDM) and women without GDM.Design
Cross-sectional and prospective cohort study.Setting
Secondary analysis of data from the U.S. Infant Feeding Practices Study II.Participants
Pregnant women with GDM (n = 195) and pregnant women without GDM (n = 2,815) were included in cross-sectional analyses. For prospective analyses, complete data were available at the postpartum time point for 107 women with and 1,626 women without GDM.Methods
We compared women with and without GDM for breastfeeding knowledge, attitudes, and beliefs during pregnancy and hospital experiences and problems with breastfeeding after birth. We used multivariate logistic regression to estimate associations between GDM and dependent variables.Results
Women with GDM were less likely to say that breastfeeding is the best way to feed an infant (adjusted odds ratio [aOR] = 0.62, 95% confidence interval [CI] [0.46, 0.85]), more likely to say that the fathers of their infants prefer formula feeding (aOR = 1.74, 95% CI [1.02, 2.97]) or mixed feeding (aOR = 1.78, 95% CI [1.21, 2.61]), and more likely to say their physicians prefer formula (aOR = 2.82, 95% CI [1.17, 6.79]). Women with GDM were less likely to report feeling comfortable breastfeeding in front of female friends (aOR = 0.70, 95% CI [0.50, 0.98]). Newborns of women with GDM were less likely to stay in their mothers’ hospital rooms (aOR = 0.55, 95% CI [0.36, 0.85]).Conclusion
We identified differences in breastfeeding-related knowledge, attitudes, beliefs, and experiences between women with GDM and women without GDM that could be targets for further research and intervention. 相似文献6.
Helen Cyr-Alves Lynn Macken Kristiina Hyrkas 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(2):146-157
Objective
To describe perceived stress and symptoms of depression in fathers of infants admitted to the NICU through 2 months after discharge and to explore associations between fathers' childhood and current relationships with their own parents and their stress and symptoms of depression.Design
Observational, longitudinal.Setting
Tertiary care center in northeastern United States.Participants
English-speaking fathers of newborns admitted to the NICU.Methods
Fathers completed the Parental Stress Scale and the Edinburgh Postnatal Depression Scale (EPDS) at infants' NICU admissions (Time [T] 1), 3 weeks (T2), discharge (T3), and 2 months after discharge (T4).Results
A total of 146 fathers were enrolled between March 2013 and February 2016. Infants' mean gestational age at birth was 31.9 weeks, and 88% remained in the NICU for 3 weeks or longer. We found that 12% of fathers reported high stress levels at T1, 8% at T3, and 13% at T4. Overall EPDS scores improved over time (p < .001). From T1 to T4, the proportion of fathers with distress/minor symptoms of depression decreased from 41% to 10% and with symptoms of major depression from 16% to 2%. Statistically significant positive associations were found between fathers' EPDS scores and the quality of relationships with their fathers (at T1, T2, and T3) and with their mothers (across all time points).Conclusion
From admission to 2 months after discharge, stress and symptoms of depression persisted for some fathers of infants admitted to the NICU. Evidence-based strategies to support fathers during and after their infants' NICU hospitalizations need to be further developed, implemented, and evaluated. 相似文献7.
Marzieh Araban Zahra Karimian Zohre Karimian Kakolaki Karen A. McQueen Cindy-Lee Dennis 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(2):173-183
Objective
To determine the effects of a prenatal breastfeeding self-efficacy intervention on breastfeeding self-efficacy and breastfeeding outcomes.Design
Randomized controlled trial.Setting
Four health centers in Ahvaz, Iran.Participants
A total of 120 low-risk, nulliparous women between 35 and 37 weeks gestation who intended to breastfeed their singleton infants.Methods
Women were randomly assigned to receive the breastfeeding self-efficacy intervention (n = 60) or standard care (n = 60). The intervention was multifaceted and included two prenatal group sessions, an information package with breastfeeding images, and text messages until 8 weeks postpartum to promote exclusive breastfeeding. The primary outcome was breastfeeding self-efficacy measured with the Breastfeeding Self-Efficacy Scale–Short Form, translated into Persian, at 8 weeks postpartum. Additional outcomes included rates of breastfeeding exclusivity, duration, practices, satisfaction, and problems.Results
At 8 weeks postpartum, participants in the intervention group had significantly higher mean Breastfeeding Self-Efficacy Scale–Short Form scores and rates of exclusive breastfeeding than those in the control group. No significant group differences were found with regard to breastfeeding duration.Conclusion
Emerging evidence supports the use of breastfeeding self-efficacy interventions to improve breastfeeding self-efficacy and rates of exclusive breastfeeding. Further evaluation of this prenatal intervention is warranted. 相似文献8.
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Anne I. Wright Nancy M. Hurst 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(3):342-351
Objective
To describe the experiences of postpartum nurses when feeding their own infants and explore how these experiences influence the breastfeeding support they provide to new mothers.Design
Qualitative research with interviews using dialogic data generation and analysis.Setting
Large academic women and children’s hospital in the Southern United States.Participants
Nine postpartum nurses who gave birth and breastfed or mixed-fed infants at any time in the past.Methods
Individual, semistructured, face-to-face interviews.Results
Participants described breastfeeding experiences similar to those of other women: some were positive, some negative. Most participants reported that they received less breastfeeding support than they needed during the maternity hospitalization. They attributed this to the fact that they were nurses. The infant feeding experiences of participants led them to promote breastfeeding in a more personal way and establish deeper connections with the mothers in their care. The practice of all participants changed because of their desire to prevent other mothers from experiencing the physical or psychological pain they experienced with breastfeeding.Conclusion
Personal infant feeding experiences shaped the breastfeeding practice of participants in unique and unpredictable ways. Nurses may benefit from increased breastfeeding education and support during their own maternity hospitalizations. Additionally, the inclusion of reflective narrative processes in breastfeeding education could encourage nurses to explore their personal, empirical, and clinical knowledge and construct an approach to breastfeeding practice that integrates these sources of information. 相似文献10.
Marcia L. Harris-Luna Lina Kurdahi Badr 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(6):738-748
Objective
To evaluate the effectiveness of a telephone intervention delivered by promotoras (lay health care workers) to increase the duration of exclusive breastfeeding (EBF) in Hispanic women at 12 weeks postpartum. Secondary objectives were to assess breastfeeding duration (BFD) and to evaluate background variables that may be associated with EBF and BFD.Design
Pragmatic trial.Setting
Two obstetric clinics affiliated with a community medical center in Southern California.Participants
We recruited 61 participants from the two clinics. Participants were 18 to 45 years old and planned to breastfeed their infants. Women who showed interest in the study were sequentially divided into an intervention (n = 31) or a control group (n = 30).Methods
The intervention consisted of telephone support for breastfeeding provided by certified and trained promotoras.Results
Fourteen out of 31 (45%) participants in the intervention group continued to practice EBF compared with 4 out of 30 (13%) in the control group (odds ratio = 3.39, p = .04). Breastfeeding duration in days was significantly longer for the participants in the intervention group (F =1/59 = 29.88, p < .01). The positive predictors of EBF at 12 weeks after birth were prior breastfeeding experience, perceived breastfeeding support, promotora telephone support, and higher scores on the acculturation scale. Positive predictors of BFD were breastfeeding support, promotora telephone support, and higher scores on breastfeeding self-efficacy. A negative predictor was lower household income.Conclusion
Our results indicate that a telephone support intervention delivered by promotoras may increase the rates of EBF by threefold at 12 weeks after birth. 相似文献11.
Marianne H. Hutti John A. Myers Lynne A. Hall Barbara J. Polivka Susan White Janice Hill Meredith Grisanti Jaclyn Hayden Elizabeth Kloenne 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(2):125-136
Objective
To evaluate the ability of the Perinatal Grief Intensity Scale (PGIS) when used within 8 weeks of perinatal loss to predict intense anxiety and severe depression symptoms in women 3 months later (Time 2 [T2]).Design
Prospective survey.Setting
Participants were recruited from hospitals in Louisville, KY and via the Internet.Participants
Women (N = 103) who experienced perinatal loss.Methods
Data were collected using the PGIS, Beck Anxiety Inventory, and the Center for Epidemiologic Studies Depression Scale. We used logistic regression, odds ratios, and receiver operating characteristic curve analysis.Results
The PGIS had 97.9% sensitivity and 29.6% specificity to predict severe depression symptoms and 95.2% sensitivity and 56.2% specificity to predict intense anxiety at T2. A baseline PGIS score greater than or equal to 3.53 predicted severe depression symptoms (odds ratio = 1.82, 95% confidence interval [CI] [1.46, 2.18], p = .014) and intense anxiety (odds ratio = 1.43, 95% CI [1.07, 1.82], p = .029) at T2. The receiver operating characteristic curves of the PGIS suggest the PGIS performs well at predicting (screening positive) for severe depression symptoms (area under the curve = 0.86, 95% CI [0.79, 0.94], p < .001) and intense anxiety (area under the curve = 0.86, 95% CI [0.78, 0.93], p < .001) after perinatal loss.Conclusion
The PGIS accurately predicted intense anxiety and severe depression symptoms 3 to 5 months after perinatal loss. This instrument may help health care providers identify women who need further mental health evaluation after perinatal loss. 相似文献12.
Angela Hui Ping Kirk Jinling Yang Woei Chyi Sim Lydia Yi Xin Chia Ying Lau 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2019,48(2):121-130
Objective
To evaluate the efficacy of topical application of human breast milk to reduce umbilical cord separation time.Data Sources
We used a three-step search strategy. First, we searched six electronic databases from inception through July 16, 2018: PubMed, Cochrane, CINAHL, Embase, Scopus, and ProQuest Dissertations and Theses Global. We used the following search terms: infant, newborn, baby, babies, colostrum, breast milk expression, breast milk, breastmilk, mother milk, human milk, umbilical cord, and umbilicus. We included published trials in English without any time limit to optimize the search. Second, we searched for ongoing clinical trials and grey literature. Last, we conducted a manual review of the reference lists of the identified articles.Study Selection
From 1,303 articles initially screened, eight articles reporting seven randomized controlled trials (RCTs) were included in the systematic review and meta-analysis.Data Extraction
Two independent reviewers used a standardized extraction form to extract data from eligible articles. We evaluated the quality of individual and overall evidence according to risk of bias and the Grade of Recommendation, Assessment, Development, and Evaluation (GRADE) system.Data Synthesis
Allocation concealment was not clearly identified in any of the studies. In only two trials were participants and personnel blinded to the intervention group, and in none was the assessment of outcomes blinded. The overall quality of evidence was very low for RCTs according to the GRADE criteria. We found a significant reduction in time to cord separation with the topical application of human breast milk (z = 6.22, p < .001), with a mean difference of –1.01 day (95% confidence interval [–1.3,–0.690]) compared with dry cord care. Incidence of omphalitis was not significantly different (risk ratio = 0.82, 95% confidence interval [0.57, 1.18], z = 1.06, p = .29) between human breast milk and dry cord care groups.Conclusion
Topical application of human breast milk is an effective and safe way to reduce cord separation time. Given that the overall quality of the included RCTs was very low, further well-designed trials are needed. 相似文献13.
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Anne M. Teitelman Su Kyung Kim Roshani Waas Amanda DeSenna Rebecca Duncan 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(6):844-852
Objective
To identify salient beliefs about human papillomavirus (HPV) vaccine completion among young adult women who live in economically disadvantaged urban communities and to describe the integration of those beliefs into the development of a mobile health (mHealth) application to promote vaccine completion.Design
Theory-based, community-informed, mHealth application development process.Setting
Two federally supported family planning clinics in a large metropolitan area in the Northeastern region of the United States.Participants
Thirty-five young adult women ages 18 to 26 years who lived in economically disadvantaged communities.Methods
Participants completed a baseline survey and postclinic survey after they received the first doses of the HPV vaccine. Results informed the content of the application with additional input from a community advisory board and provider advisory board.Results
One third of participants had prior sexually transmitted infections, but fewer than half used condoms during most recent intercourse. Most participants (n = 30 and 32 [86% and 91%]) had correct knowledge about HPV and cervical cancer, and most (n = 31, 89%) intended to get the next dose of the HPV vaccine. Twelve salient beliefs about HPV vaccine completion were identified and used to develop the NowIKnow mHealth application. The application includes information, motivational content, a discussion forum, and vaccine completion reminders.Conclusion
Theory-based research and user-centered design can be systematically integrated into the development of mHealth applications. With content tailored to the target population, use of this novel intervention has the potential to reduce cancer disparities by reaching disadvantaged young adult women. 相似文献15.
Kathleen O&#x;Rourke Joseph Teel Erika Nicholls Daniel D. Lee Alyssa Covelli Colwill Sindhu K. Srinivas 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(2):264-272
Objective
To improve staff perception of the quality of the patient admission process from obstetric triage to the labor and delivery unit through standardization.Design
Preassessment and postassessment online surveys.Setting
A 13-bed labor and delivery unit in a quaternary care, Magnet Recognition Program, academic medical center in Pennsylvania.Participants
Preintervention (n = 100), postintervention (n = 52), and 6-month follow-up survey respondents (n = 75) represented secretaries, registered nurses, surgical technicians, certified nurse-midwives, nurse practitioners, maternal-fetal medicine fellows, anesthesiologists, and obstetric and family medicine attending and resident physicians from triage and labor and delivery units.Methods
We educated staff and implemented interventions, an admission huddle and safety time-out whiteboard, to standardize the admission process. Participants were evaluated with the use of preintervention, postintervention, and 6-month follow-up surveys about their perceptions regarding the admission process. Data tracked through the electronic medical record were used to determine compliance with the admission huddle and whiteboards.Results
A 77% reduction (decrease of 49%) occurred in the perception of incomplete patient admission processes from baseline to 6-month follow-up after the intervention. Postintervention and 6-month follow-up survey results indicated that 100% of respondents responded strongly agree/agree/neutral that the new admission process improved communication surrounding care for patients. Data in the electronic medical record indicated that compliance with use of admission huddles and whiteboards increased from 50% to 80% by 6 months.Conclusion
The new patient admission process, including a huddle and safety time-out board, improved staff perception of the quality of admission from obstetric triage to the labor and delivery unit. 相似文献16.
Jill McArdle Asta Sorensen Christina I. Fowler Samantha Sommerness Katrina Burson Leila Kahwati 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(2):191-201
Objective
To assess implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units.Design
Mixed-methods implementation evaluation.Setting/Local Problem
Labor and delivery units (N = 18) in 10 states participating in the Safety Program for Perinatal Care (SPPC). Shoulder dystocia is unpredictable, requiring rapid and coordinated action.Participants
Key informants were labor and delivery unit staff who implemented SPPC safety strategies.Intervention/Measurements
The SPPC was implemented by using the TeamSTEPPS teamwork and communication framework and tools, applying safety science principles (standardization, independent checks, and learn from defects) to shoulder dystocia management, and establishing an in situ simulation program focused on shoulder dystocia to practice teamwork and communication skills. Unit staff received training, a toolkit, technical assistance, and unit-specific feedback reports. Quantitative data on unit-reported process improvement measures and qualitative data from staff interviews were used to understand changes in use of safety principles, teamwork/communication, and in situ simulation.Results
Use of shoulder dystocia safety strategies improved on the units. Differences between baseline and follow-up (10 months) were as follows: in situ simulation (50% vs. 89%), teamwork and communication (67% vs. 94%), standardization (67% to 94%), learning from defects (67% vs. 89%), and independent checks (56% vs. 78%). Interview data showed reasons to address management of shoulder dystocia, various approaches to implement safety practices, and facilitators and barriers to implementation.Conclusion
Successful management of shoulder dystocia requires a rapid, standardized, and coordinated response. The SPPC strategies to increase safety of shoulder dystocia management are scalable, replicable, and adaptable to unit needs and circumstances. 相似文献17.
Milena Frazer Amy Ciarlo Jill Herr Carrie-Ellen Briere 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(4):520-528
Objective
To decrease rates of admission hypothermia (<36 °C) in very-low-birth-weight (VLBW) newborns (<1,500 g).Design
Quality improvement initiative.Setting/Local Problem
Urban, Level IV NICU with 32 patient beds. The number of VLBW newborns admitted with temperatures less than 36 °C was greater than in comparable NICUs in the Vermont Oxford Network.Participants
Neonates born in 2016 who weighed less than 1,500 g at birth.Intervention/Measurements
Based on the literature and the needs of our unit, our team decided to focus efforts on equipment (chemical mattresses and polyurethane-lined hats for newborns who weighed <1,000 g and polyurethane-lined hats for newborns who weighed <1,500 g), staff education/awareness, and temperature documentation and workflow. Axillary temperature measurements for all neonates who weighed less than 1,500 g were tracked on admission.Results
The processes involved in this quality improvement initiative were successfully implemented, and use of new equipment began January 1, 2016. In 2016, only 9.6% (n = 7) of VLBW newborns were admitted with temperatures less than 36 °C, compared with 20.2% (n = 19) in 2015 and 32.4% (n = 24) in 2014 (p = .003). Overall, the mean admission temperature for neonates who weighed less than 1,500 g rose from 36.2 °C in 2014 to 36.6 °C in 2016 (p = .001).Conclusion
We reduced the number of VLBW neonates admitted with temperatures less than 36 °C and increased overall admission temperatures for neonates who weighed less than 1,500 g with the addition of polyurethane-lined hats and chemical mattresses. 相似文献18.
Brenda Chagolla Debra Bingham Barbara Wilson Benjamin Scheich 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(5):698-706
Objective
To measure whether implementation of a comprehensive, 18-month, multihospital, multiregion postpartum hemorrhage (PPH) project influenced intrapartum clinicians’ perceptions of patient safety.Design
Pre- and post-survey design.Setting
Survey results from eight hospitals in Georgia, New Jersey, and Washington that participated in the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) PPH Project were included in the final analysis. The number of annual births at the hospitals ranged from 1,290 to 3,567.Participants
There were 473 respondents for the pre-implementation survey: 50.5% (239) were registered nurses, 27.1% (128) were physicians, and 22.4% (106) were other intrapartum clinicians. The post-implementation survey included 426 respondents: 62.9% (268) registered nurses, 18.5% (79) physicians, and 18.6% (79) other intrapartum clinicians.Intervention/Measurements
A paired t test was used to compare Safety Attitudes Questionnaire (SAQ) domain scores. Pearson’s chi-square test was used to analyze perceptions before and after the intervention.Results
Baseline SAQ scores were high in all six domains. Improvements were noted in five of the six domains measured; none reached statistical significance. A significant improvement was found in reported perception of the quality of nursing care after implementation of the PPH Project.Conclusion
SAQ scores remained high and showed some improvement among participating hospitals. Participation in the PPH Project increased overall perceptions of safety among the clinicians at these hospitals. 相似文献19.
Joanna C.M. Cole Michelle Olkkola Haley E. Zarrin Kelsey Berger Julie S. Moldenhauer 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(1):84-93
Objective
To describe the implementation of a nurse-led project to screen parents for depression and traumatic stress in the postpartum period after visiting their newborns in the NICU.Design
A standardized universal mental health postpartum screening and referral protocol was developed for parents of high-risk neonates.Setting/Local Problem
The project occurred at the Garbose Family Special Delivery Unit, the world's first obstetrics unit housed within a pediatric hospital serving healthy women who give birth to newborns with prenatally diagnosed fetal anomalies. Parents of neonates admitted to the NICU are at greater risk to develop postpartum psychological distress; therefore, early identification is critical.Patients
A total of 1,327 participants were screened, including 725 women who gave birth to live newborns at the Garbose Family Special Delivery Unit and 602 fathers.Intervention/Measurements
Obstetric nurses asked parents to complete a screening tool that assessed their psychological risk in the postpartum period. A system for mental health triage and referral was available for parents with elevated scores.Results
Overall monthly screening procedure compliance rates were high (96.5% mothers and 79.6% fathers). Women (5.5%, n = 40) and men (5.5%, n = 33) showed high risk for traumatic stress, and 35.9% (n = 260) of women and 9.5% (n = 57) of men showed elevated risk for major depression in the imediate postpartum period.Conclusion
Incorporating the screening process into routine nursing practice with immediate mental health triage and referral made the program feasible. The risk factors identified add to the growing knowledge about parents of newborns in the NICU. 相似文献20.
Debra Bingham Benjamin Scheich Brian T. Bateman 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(5):707-718