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Educating Nurses to Improve Awareness and Use of a Human Milk Feeding Care Pathway for Opioid-Exposed Neonates 教育护士提高对接触阿片类药物的新生儿母乳喂养护理路径的认识和使用。
Pub Date : 2024-10-01 DOI: 10.1016/j.nwh.2024.04.004
Alexandria L. Tasket, Makenna R. Black, Tracy L. Brewer, Megan Lacy Young

Objective

To increase nurses’ awareness and use of a human milk feeding (HMF) and opioid use disorder (OUD) standardized care pathway to improve rates of HMF at discharge in opioid-exposed neonates (OENs).

Design

Quality improvement project.

Setting/Local Problem

Underutilizing an HMF and OUD standardized care pathway in an academic medical center led to declining HMF rates at discharge.

Participants

Staff nurses in the women and infants department (N = 311).

Intervention/Measurements

Nurses completed an asynchronous online educational module regarding awareness and use of the HMF and OUD standardized care pathway for supporting HMF in OENs. Monthly infographics were placed in each nursing unit to reinforce content. Nurses completed pre- and posteducation surveys to evaluate their knowledge and use of the pathway. After the education, rates of OENs receiving human milk at discharge were collected from the electronic health record.

Results

A total of 240 (77.2%) nurses participated in the educational module; awareness of the pathway increased from 91.5% to 97.3%. HMF rate at discharge significantly increased from 29.8% to 59.4% (p = .03).

Conclusion

Improved awareness among nurses of a standardized HMF and OUD care pathway was associated with a doubling of HMF rates at discharge in OENs.
目标:提高护士对母乳喂养(HMF)和阿片类药物使用障碍(OUD)标准化护理路径的认识和使用,以提高暴露于阿片类药物的新生儿(OENs)出院时的母乳喂养率:环境/当地问题:一家学术医疗中心未充分利用HMF和OUD标准化护理路径,导致出院时HMF率下降:干预/测量:护士们完成了一个异步在线教育模块,内容涉及对 HMF 和 OUD 标准化护理路径的认识和使用,以支持 OEN 中的 HMF。每月在每个护理单元放置信息图表以强化内容。护士们完成了教育前和教育后调查,以评估她们对路径的了解和使用情况。教育结束后,从电子健康记录中收集了出院时母乳喂养率:共有 240 名护士(77.2%)参加了教育模块;对该途径的认知度从 91.5% 提高到 97.3%。出院时的 HMF 率从 29.8% 显著上升至 59.4%(p = .03):结论:提高护士对标准化 HMF 和 OUD 护理路径的认识与 OENs 出院时 HMF 率翻倍有关。
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引用次数: 0
Women’s Experiences With a Pregnancy Relapse Prevention Plan to Prevent Mental Health Symptom Relapse 妇女使用妊娠复发预防计划防止心理健康症状复发的经验。
Pub Date : 2024-10-01 DOI: 10.1016/j.nwh.2024.04.005
Hanneke J.W. Verboom, Peter J.J. Goossens, Sanne M. Hendriks, Bart Geerling

Objective

To describe the experiences of women with a mental health diagnosis with making and using a pregnancy relapse prevention plan (PRPP) in an effort to prevent mental health symptom relapse during the period of pregnancy, birth, and postpartum.

Design

Qualitative design with a phenomenological approach.

Setting

Participants were recruited from an outpatient clinic within a “psychiatry and pregnancy” mental health institute in the Netherlands.

Participants

Twelve women with a mental health diagnosis who gave birth.

Measurements

Data were collected by individual semistructured interviews supported by a topic list.

Results

Four categories/themes of findings emerged from the data: Making and Advantage of the PRPP, Using the PRPP, Cooperation, and Care After Childbirth.

Conclusion

Making and using a PRPP provided pregnant women with overview, predictability, and feelings of tranquility on all aspects related to pregnancy, childbirth, and the postpartum period. Participants appreciated the support and recognition the PRPP provided. The signal function of the PRPP for all who were involved (professional and nonprofessional caregivers) was described as an added value. Involvement of women’s partners and caretakers was essential. An evaluation afterward is recommended.
目的描述被诊断出患有精神疾病的妇女在制定和使用孕期复发预防计划(PRPP),以防止在怀孕、分娩和产后期间精神疾病症状复发的经历:设计:采用现象学方法进行定性设计:环境:从荷兰一家 "精神病与怀孕 "精神健康研究所的门诊诊所招募参与者:12名被诊断患有精神疾病的产妇:测量方法:通过个人半结构式访谈收集数据,并辅以主题列表:结果:从数据中发现了四个类别/主题:结果:从数据中发现了四个类别/主题:PRPP的制定和优势、PRPP的使用、合作以及产后护理:制定和使用 "产前计划 "为孕妇提供了有关怀孕、分娩和产后各方面的概况、可预测性和宁静感。参与者对 "分娩前计划 "提供的支持和认可表示感谢。PRPP 对所有参与人员(专业和非专业护理人员)的信号功能被视为一种附加价值。妇女的伴侣和照顾者的参与至关重要。建议事后进行评估。
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引用次数: 0
Perceptions of Supportive Factors for Reducing Risk of Maternal Mortality Among Women With Substance Use Disorders in a Rural Setting 农村地区有药物使用障碍的妇女对降低孕产妇死亡风险的支持性因素的看法。
Pub Date : 2024-10-01 DOI: 10.1016/j.nwh.2024.03.004
Kalyn M. Renbarger, Greta Slater, Barbara Phelps, Leann Brewer

Objective

To describe perceptions of supportive factors for reducing the risk of maternal mortality among women with substance use disorders (SUDs) in a rural setting.

Design

Qualitative descriptive design.

Setting/Local Problem

Participants were recruited from a rural setting in a U.S. Midwest state where rates of maternal substance use and maternal mortality are high.

Participants

Sixteen participants were recruited from a maternal residential substance use treatment center.

Intervention/Measurements

Semistructured interviews were used during which participants described their perceptions of maternal mortality and their related experiences. We analyzed the transcribed interviews using a basic inductive content analysis to yield themes and subthemes.

Results

We identified three main themes: Social Networks, Respectful Perinatal Care, and Residential Substance Use Treatment.

Conclusion

Our findings suggest that nurses and other health care providers should be knowledgeable of resources to increase the social networks of women with SUD, recognize and manage the biases and judgments they may hold against women with SUD, and advocate for and refer women with SUD to residential substance use treatment.
目的描述农村地区患有药物使用障碍(SUDs)的妇女对降低孕产妇死亡风险的支持性因素的看法:环境/当地问题:从美国中西部一个州的农村环境中招募参与者,该州的孕产妇药物使用率和孕产妇死亡率都很高:16 名参与者来自一家孕产妇药物使用住院治疗中心:我们采用了半结构式访谈,参与者在访谈中描述了他们对孕产妇死亡率的看法以及相关经历。我们采用基本的归纳内容分析法对转录的访谈进行分析,以得出主题和次主题:我们确定了三大主题:社会网络、尊重围产期护理和住院药物使用治疗:我们的研究结果表明,护士和其他医疗服务提供者应了解增加患有药物滥用症的妇女的社会网络的资源,认识并管理他们可能对患有药物滥用症的妇女持有的偏见和判断,并倡导和转介患有药物滥用症的妇女接受住院药物使用治疗。
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引用次数: 0
A Cross-Sectional Comparative Study of Vaginal Microbiota and Spontaneous Abortion at a Tertiary Care Hospital in North Karnataka, India 印度北卡纳塔克邦一家三级医院阴道微生物群与自然流产的横断面比较研究。
Pub Date : 2024-10-01 DOI: 10.1016/j.nwh.2024.04.006
Babita Belgundkar, Sangeeta Kharde, Suneel Dodamani, Shivani Tendulkar

Objective

To compare the vaginal microbiome in women who have undergone spontaneous abortion with a gestational age of less than 20 weeks to that of women who have a continued pregnancy of the same gestational age.

Design

Cross-sectional comparative research design.

Setting

The study was conducted in a tertiary care hospital of North Karnataka, India. In this rural area, many women lack awareness of prenatal care and women’s health information. Given rising rates of spontaneous abortion, studying the impact of the vaginal microbiome on pregnancy outcomes is crucial for raising local awareness.

Participants

Two hundred women; 100 experienced spontaneous abortion within 20 weeks’ gestation, and 100 maintained pregnancy with the same gestational age.

Measures

Vaginal swab was used to detect participants’ vaginal microbiota. DNA was extracted from the vaginal samples; the 16S ribosomal RNA sequencing method was used to identify the organisms present.

Results

A pathogen detection rate of 13.15% (n = 200 women) was found in vaginal cultures. The percentages of bacterial detection in women who had spontaneous abortion and those whose pregnancies continued were 19.9% and 7.9%, respectively (p < .05). Compared to women who sustained their pregnancy, women who experienced spontaneous abortion had five common species: Escherichia coli (48%), Enterococcus faecalis (28%), Enterococcus faecium (12%), Pseudomonas fluorescens (7%), and Pseudomonas cedrina (5%); the most prevalent species among those with sustained pregnancy were Lactobacillus iners (58%), Lactobacillus crispatus (32 %), and E. coli (10%; p < .05).

Conclusion

The vaginal microbiomes of women with spontaneous abortion were more varied and irregularly distributed with bacteria. The bacteria identified could affect a woman’s pregnancy outcome and perhaps be associated with spontaneous abortion. It is vital for nurses to provide education to women who are in the fertile period regarding prenatal screening, sexually transmitted infections, and perineal care.
目的:比较胎龄不足 20 周的自然流产妇女与同胎龄继续妊娠妇女的阴道微生物群:比较胎龄小于 20 周的自然流产妇女与胎龄相同的继续妊娠妇女的阴道微生物群:设计:横断面比较研究设计:研究在印度北卡纳塔克邦的一家三级医院进行。在这个农村地区,许多妇女缺乏产前保健意识和妇女健康信息。鉴于自然流产率不断上升,研究阴道微生物组对妊娠结局的影响对于提高当地的认识至关重要:200 名妇女,其中 100 名在妊娠 20 周内经历过自然流产,另外 100 名在相同孕龄下保持妊娠:采用阴道拭子检测参与者的阴道微生物群。从阴道样本中提取 DNA,采用 16S 核糖体 RNA 测序法鉴定微生物:阴道培养的病原体检出率为 13.15%(n = 200)。自然流产妇女和继续妊娠妇女的细菌检出率分别为 19.9% 和 7.9%(P < .05)。与继续妊娠的妇女相比,自然流产的妇女有五种常见的细菌:大肠杆菌(48%)、粪肠球菌(28%)、粪肠球菌(12%)、荧光假单胞菌(7%)和雪松假单胞菌(5%);在持续妊娠的妇女中,最常见的菌种是内氏乳杆菌(58%)、脆片乳杆菌(32%)和大肠杆菌(10%;P < .05):自然流产妇女的阴道微生物组更多样化,细菌分布也更不规则。结论:自然流产妇女阴道微生物组的细菌种类更多,分布更不规则,所发现的细菌可能会影响妇女的妊娠结局,也可能与自然流产有关。护士向处于生育期的妇女提供有关产前检查、性传播感染和会阴护理的教育至关重要。
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引用次数: 0
Optimizing Maternal and Neonatal Outcomes in Perinatal Patients With Diabetes: AWHONN Practice Brief Number 21 优化围产期糖尿病患者的孕产妇和新生儿预后:AWHONN实践简报第21期。
Pub Date : 2024-10-01 DOI: 10.1016/j.nwh.2024.05.001
An official practice brief from the Association of Women’s Health, Obstetric and Neonatal Nurses.
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引用次数: 0
Exploring the Feasibility, Acceptability, and Potential Benefits of the Mom Movement Intervention (MOMmi) 探索妈妈运动干预(MOMmi)的可行性、可接受性和潜在益处。
Pub Date : 2024-08-01 DOI: 10.1016/j.nwh.2024.01.006

Objective

To explore the feasibility, acceptability, and potential benefits associated with a mind–body intervention and varied delivery styles among women during the postpartum period.

Design

Mixed-methods feasibility study.

Setting

Fraser Valley, British Columbia, Canada.

Participants

Forty-three women (93% White), with an average age of 32.1 (SD = 2.9) years, who had given birth within the last 6 months.

Methods

Participants were randomized to three physical activity groups. Validated questionnaires were administered before and after the 12-week intervention. Attendance and feasibility metrics and qualitative semistructured interviews were conducted to assess the intervention.

Results

The intervention and trial were partially feasible, and retention to the intervention was high; however, adherence as assessed by attendance was lower than expected. There was high acceptability among those in the group-based, in-person intervention. There was moderate acceptability among those in the individual, home-based asynchronous program.

Conclusion

Findings highlight the necessity of better understanding what is desired by this population or simply providing more options to participants so that we can tailor physical activity to their needs and provide the necessary support.

目的探索产后妇女对身心干预和不同分娩方式的可行性、接受度和潜在益处:设计:混合方法可行性研究:地点:加拿大不列颠哥伦比亚省弗雷泽谷:43名妇女(93%为白人),平均年龄为32.1岁(SD=2.9),在过去6个月内分娩:方法:参与者被随机分配到三个体育锻炼组。在为期 12 周的干预前后进行了经过验证的问卷调查。为评估干预措施,还进行了出勤率和可行性度量以及定性半结构式访谈:结果:干预和试验具有部分可行性,干预的持续率较高;但是,根据出勤率评估的坚持率低于预期。以小组为基础的面对面干预的接受度较高。结论:研究结果突出表明,我们有必要更好地了解这类人群的需求,或者干脆为参与者提供更多的选择,这样我们就能根据他们的需求量身定制体育活动,并提供必要的支持。
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引用次数: 0
Information for Readers 读者信息
Pub Date : 2024-08-01 DOI: 10.1016/S1751-4851(24)00134-X
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引用次数: 0
Assessment and Care of the Late Preterm Infant 早产晚期婴儿的评估和护理。
Pub Date : 2024-08-01 DOI: 10.1016/j.nwh.2024.02.004
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引用次数: 0
Having Enough Milk to Sustain a Lactation Journey: A Call to Action 有足够的奶水来维持哺乳期:行动呼吁。
Pub Date : 2024-08-01 DOI: 10.1016/j.nwh.2024.02.007

The rates of human milk feeding are suboptimal worldwide. Recommendations for healthy, term mother–infant dyads include early breastfeeding initiation, frequent skin-to-skin contact, and frequent breastfeeding. The normal physiology of lactation can be affected by prenatal factors such as diabetes, obesity, and excessive gestational weight gain. Furthermore, birth-related factors such as early-term gestation, stressful labor, unscheduled cesarean birth, and postpartum hemorrhage can additionally disrupt recommended practices such as early initiation of breastfeeding and skin-to-skin contact. Given that the first 2 to 3 days postpartum are critical to achieving timely secretory activation and establishing an adequate volume of milk, a proactive approach to care can include building awareness of risk factors and development of protocols for the effective early initiation of lactation.

全世界的母乳喂养率都不尽如人意。对健康的足月母婴伴侣的建议包括尽早开始母乳喂养、频繁的皮肤接触和频繁的母乳喂养。哺乳的正常生理过程会受到产前因素的影响,如糖尿病、肥胖和妊娠体重增加过多。此外,与分娩有关的因素,如过早妊娠、紧张分娩、计划外剖宫产和产后出血等,也会干扰推荐的做法,如尽早开始母乳喂养和肌肤接触。鉴于产后最初的 2 到 3 天对于实现及时的分泌激活和建立充足的乳量至关重要,因此积极的护理方法可包括建立对风险因素的认识和制定有效的早期开始哺乳的方案。
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引用次数: 0
The Best Decision 最佳决定
Pub Date : 2024-08-01 DOI: 10.1016/j.nwh.2024.04.001
{"title":"The Best Decision","authors":"","doi":"10.1016/j.nwh.2024.04.001","DOIUrl":"10.1016/j.nwh.2024.04.001","url":null,"abstract":"","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":"28 4","pages":"Pages 320-322"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141051918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Nursing for Women''s Health
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