Nursing for Women''s Health最新文献

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Nursing for Women''s Health

Pub Date : 2025-04-01 DOI: 10.1016/S1751-4851(25)00046-7

引用次数: 0

Implementing Communication Boards at the Bedside to Improve Patient-Centered Care in an Inpatient Obstetric Unit 实施床边沟通委员会，改善住院产科病房以患者为中心的护理。

Nursing for Women''s Health

Pub Date : 2025-04-01 DOI: 10.1016/j.nwh.2024.10.004

Beth Anne Chapin, Meghan Duck

Objective

To implement use of custom whiteboards to improve bedside communication and shared knowledge between clinicians and patients.

Design

Quality improvement project using a seven-step evidence-based practice framework and Plan-Do-Study-Act cycles to redesign custom communication boards for specific patient (antepartum, labor, postpartum) populations.

Setting/Local Problem

Two California university medical center inpatient obstetric units where Hospital Consumer Assessment of Healthcare Providers and Systems scores in nursing communication had trended down at a time when whiteboards were being underused in patient rooms.

Participants

Staff of approximately 170 nurses, 30 physicians, and 8 midwives.

Intervention/Measurements

The project was implemented from January 2020 through July 2020; the first phase was completed in the postpartum unit, and the second phase was completed in the antepartum unit. Staff surveys and board use audits were used to collect preimplementation and postimplementation data. Third-phase labor boards were designed but were not yet implemented due to budget constraints.

Results

Project data supported that the new boards encouraged more complete information and facilitated bedside communication better than the previous iteration.

Conclusion

A customized communication board designed for a specific patient population is an effective tool to promote patient-centered care. Communication boards can reinforce safe nursing practice, facilitate discussion, and improve the patient experience.

目的：实施自定义白板的使用，以改善临床医生与患者之间的床边沟通和知识共享。设计：质量改进项目，采用七步循证实践框架和计划-执行-研究-行动周期，为特定患者（产前、分娩、产后）人群重新设计定制沟通板。环境/当地问题：两个加州大学医疗中心的住院产科病房，在病房里白板没有得到充分利用的时候，医院消费者对医疗保健提供者和系统的评估在护理沟通方面的得分呈下降趋势。参与者：大约170名护士、30名医生和8名助产士。干预/测量：项目实施时间为2020年1月至2020年7月；第一期在产后单位完成，第二期在产前单位完成。工作人员调查和董事会使用审计被用来收集实施前和实施后的数据。设计了第三阶段的劳动委员会，但由于预算限制尚未实施。结果：项目数据支持新板鼓励更完整的信息和促进床边沟通比以前的迭代。结论：针对特定患者群体定制沟通板是促进以患者为中心的护理的有效工具。交流委员会可以加强安全护理实践，促进讨论，改善患者体验。

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引用次数: 0

Nursing Safety on the Job: Workplace Violence and Personal Protection 工作中的护理安全：工作场所暴力和个人保护。

Nursing for Women''s Health

Pub Date : 2025-04-01 DOI: 10.1016/j.nwh.2024.11.001

Association of Women’s Health, Obstetric and Neonatal Nurses

引用次数: 0

Reviewer Acknowledgment 评论家承认

Nursing for Women''s Health

Pub Date : 2025-02-01 DOI: 10.1016/S1751-4851(25)00026-1

引用次数: 0

Pediatric Providers’ Perceptions of Their Role in the Early Detection of Postpartum Depression 儿科医生对其在产后抑郁症早期发现中的作用的认知。

Nursing for Women''s Health

Pub Date : 2025-02-01 DOI: 10.1016/j.nwh.2024.08.005

Laura A. Gonzalez, Emily G. Chin

Objective

To explore pediatric health care providers’ perceptions of their role in screening mothers for postpartum depression (PPD).

Design

Descriptive, qualitative methodology.

Setting

Pediatric care providers from five different institutions in the Chicago metropolitan area.

Participants

Eleven providers who see infants within their first year of life were interviewed.

Intervention/Measurements

Participants were interviewed regarding their perceptions of their role in the early detection of PPD.

Results

During the interviews and coding, six themes were identified: Screening Formally and Informally, Providers Perceiving Their Role, I Think There Should Be More Education, Falling Through the Cracks, Clinical Missed Pathways, and A Supportive Organization Has an Impact on the Role of the Provider.

Conclusion

This study demonstrates the need to increase awareness and ensure that proper national guidelines are implemented by health care providers, policymakers, and organizations to secure a proper and efficient protocol to ensure the practice of screening all mothers. In addition, the results from this study have implications for public policy, nursing practice, education, and further research.

目的：探讨儿科卫生保健提供者在筛查母亲产后抑郁症（PPD）中的作用。设计：描述性定性方法。背景：来自芝加哥地区五个不同机构的儿科护理提供者。参与者：采访了11位为一岁以内的婴儿提供服务的提供者。干预/测量：参与者接受采访，了解他们对早期发现PPD的作用的看法。结果：在访谈和编码过程中，确定了六个主题：正式和非正式筛选，提供者感知他们的角色，我认为应该有更多的教育，掉进裂缝，临床错过的途径，以及一个支持性组织对提供者角色的影响。结论：本研究表明需要提高认识，并确保卫生保健提供者、政策制定者和组织实施适当的国家指南，以确保适当和有效的协议，以确保对所有母亲进行筛查。此外，本研究的结果对公共政策、护理实践、教育和进一步的研究具有启示意义。

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引用次数: 0

Content Validity for the NICU Caregiver Behavior Checklist 新生儿重症监护病房护理人员行为量表的内容效度。

Nursing for Women''s Health

Pub Date : 2025-02-01 DOI: 10.1016/j.nwh.2024.08.006

Amy Carroll, Cecilia Roan, Catherine Verrier Piersol, Michele Kacmarcik Savin

Objective

To update and establish content validity for the Checklist of NICU Caregiver Behaviors.

Design

Structured literature review and Delphi analysis.

Setting/Local Problem

Neonates born prematurely or who are sick in the NICU are frequently exposed to harmful stimuli that can affect brain development and result in adverse neurodevelopmental outcomes. In response to this risk, NICU caregiving now encompasses protecting and promoting neurodevelopment to affect long-term outcomes for neonates and their families. Developmentally supportive care (DSC) includes internationally recognized best practices for the care of neonates in the NICU. Implementation and operationalization of DSC is a priority for neonatology. Although evidence-supported guidelines exist for effective DSC strategies in the NICU, no validated tool exists to support implementation at the point of care.

Participants

Nine expert reviewers from the United States and India including four occupational therapists, one nurse practitioner, one clinical nurse specialist, and three neonatal medicine specialists.

Intervention/Measurements

The Checklist of NICU Caregiver Behaviors had been updated based on a structured review of the evidence. The updated checklist was then shared with a group of professionals with DSC expertise who provided further recommendations using a modified Delphi survey process.

Results

The project yielded the current NICU Caregiver Behavior Checklist. Expert reviewers provided 53 actionable recommendations in Round 1 and 18 actionable recommendations in Round 2 to support clarity and use of the tool. In response, the NICU Caregiver Behavior Checklist was reformatted as a collection of five checklists, each representing a core measure of DSC; the introduction section was expanded; language was broadened; and clarifications were provided to promote observations of target behaviors and allow for more site-specific recommendations and assessments.

Conclusion

This evidence-based tool can be used as part of DSC education, as a self-assessment tool, and as a measure of NICU caregivers’ use and quality of DSC.

目的：更新和建立《新生儿重症监护病房护理人员行为检查表》的内容效度。设计：结构化文献回顾和德尔菲分析。环境/局部问题：新生儿早产或在新生儿重症监护室生病的新生儿经常暴露于有害的刺激，这些刺激会影响大脑发育并导致不良的神经发育结果。为了应对这种风险，新生儿重症监护室的护理现在包括保护和促进神经发育，以影响新生儿及其家庭的长期预后。发展支持护理（DSC）包括国际公认的新生儿在新生儿重症监护室护理的最佳做法。DSC的实施和操作是新生儿学的优先事项。尽管针对NICU中有效的DSC策略存在有证据支持的指南，但没有经过验证的工具来支持在护理点实施。参与者：来自美国和印度的9名专家评审，包括4名职业治疗师、1名执业护士、1名临床护理专家和3名新生儿医学专家。干预/测量：基于对证据的结构化回顾，NICU护理人员行为检查表已经更新。更新后的清单随后与具有DSC专业知识的一组专业人员共享，他们使用改进的德尔菲调查过程提供进一步的建议。结果：该项目产生了当前的新生儿重症监护病房护理人员行为检查表。专家审稿人在第一轮提供了53项可操作的建议，在第二轮提供了18项可操作的建议，以支持工具的清晰度和使用。作为回应，NICU护理人员行为检查表被重新格式化为五个检查表的集合，每个检查表代表DSC的核心测量；引言部分进行了扩充；语言被拓宽了；并提供了澄清，以促进对目标行为的观察，并允许更多的具体地点的建议和评估。结论：该循证工具可作为DSC教育的一部分，作为自我评估工具，并可作为NICU护理人员DSC使用和质量的衡量标准。

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引用次数: 0

Breastfeeding Experiences of Women With Gestational Diabetes Mellitus 妊娠糖尿病妇女的母乳喂养经验。

Nursing for Women''s Health

Pub Date : 2025-02-01 DOI: 10.1016/j.nwh.2024.07.006

Kimberly N. Doughty, Jenna A. LoGuidice, Jennifer Schindler-Ruwisch, Kelsi McCarthy, Emily Bower

Objective

To understand the perinatal experiences of women with gestational diabetes mellitus (GDM) who intended to breastfeed.

Design

Qualitative descriptive study.

Setting

Online focus groups conducted via Zoom.

Participants

Women who had GDM in their most recent pregnancy, had a full-term birth in the United States, and were no more than 18 months postpartum.

Methods

Virtual focus groups were held between November 2022 and August 2023. Focus group transcripts were coded and analyzed to identify major themes and subthemes.

Results

Three major themes and 14 subthemes emerged: (a) Challenges, including subthemes of GDM Diagnosis, Doubt, Physical Challenges, Balancing Demands, Lack of Support, and Pressure or Judgment; (b) Lack of Information or Support From Health Care Providers, with subthemes of Separation of GDM From Breastfeeding, Inadequate Information or Support, and Provider Neutrality; and (c) Facilitating or Motivating Factors, including subthemes of Knowledge; Intention, Confidence, and Determination; and Positive Support.

Conclusion

Women with GDM experienced many breastfeeding challenges and felt they had received little information or support from health care providers, including but not limited to nurses. They also expressed feelings of pressure or judgment about their infant feeding choices, reported a desire to know more about the connection between GDM and breastfeeding, and highlighted the value of having support systems in person or online.

目的：了解妊娠期糖尿病（GDM）拟母乳喂养妇女的围生期经历。设计：定性描述性研究。环境/局部问题：患有GDM的妇女及其婴儿受益于母乳喂养，但其纯母乳喂养率低于没有GDM的妇女，造成这些差异的原因尚不完全清楚。参与者：最近一次怀孕时患有GDM的妇女，在美国足月分娩，产后不超过18个月。干预/测量：虚拟焦点小组在2022年11月至2023年8月期间举行。对焦点小组记录进行编码和分析，以确定主要主题和次级主题。结果：出现了3大主题和14个子主题：(a)挑战，包括GDM诊断、疑虑、身体挑战、平衡需求、缺乏支持和压力或判断；(b)卫生保健提供者提供的信息不足，其分主题为：GDM与母乳喂养分离、信息或支持不足以及提供者中立；(c)促进或激励因素，包括知识的分主题；意图、信心和决心；积极的支持。结论：GDM妇女经历了许多母乳喂养挑战，并感到她们从卫生保健提供者（包括但不限于护士）那里获得的信息或支持很少。她们还表达了对婴儿喂养选择的压力或判断，希望更多地了解GDM和母乳喂养之间的联系，并强调了拥有面对面或在线支持系统的价值。

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引用次数: 0

Evaluation of Labor Mirror Use During the Active Pushing Phase of the Second Stage of Labor 评估第二产程主动用力阶段使用分娩镜的情况。

Nursing for Women''s Health

Pub Date : 2025-02-01 DOI: 10.1016/j.nwh.2024.07.004

Robin L. Driver, Lynn Shaffer, Jennifer L. Doyle

Objective

To evaluate whether the use of a labor mirror during the active pushing phase of the second stage of labor is associated with a shorter duration of pushing. Additionally, we examined maternal and neonatal outcomes secondary to mirror use versus non–mirror use.

Design

Retrospective observational cohort study.

Setting/Local Problem

Community hospital in the midwestern United States with a Level 3 maternity center and approximately 2,000 births annually.

Participants

Four hundred fifty-three women ≥18 years old who had a singleton pregnancy at term (37–41 weeks’ gestation) with a spontaneous vaginal birth.

Intervention/Measurements

The use of a ceiling-mounted labor mirror offered before or at the beginning of the active pushing phase of the second stage of labor. Use was determined by patient choice.

Results

One hundred seventy-seven (39.1%) women elected use of the labor mirror. Mirror users and nonusers were similar in terms of clinical and demographic characteristics except for epidural use (93.2% vs. 86.6%, respectively; p = .0298). Among nulliparous women who used the mirror, second stage labor duration was shortened by an average of 19.4 minutes (p = .0198). This effect was not seen in multiparous women (p = .2208). Mirror users and nonusers did not differ on rates of postpartum hemorrhage (p = .5498) or chorioamnionitis (p = .6528). Among nulliparous and multiparous women, Apgar scores and NICU admission rates did not differ between mirror users and nonusers.

Conclusion

The labor mirror represents a simple, noninvasive tool for labor and delivery units. Use of the labor mirror during the active pushing phase of the second stage of labor may be associated with decreased pushing duration for nulliparous women.

目的：评价在产程第二阶段的主动推产阶段使用产镜是否与缩短推产时间有关。此外，我们还检查了使用镜子与不使用镜子的产妇和新生儿的结局。设计：回顾性观察队列研究。环境/当地问题：美国中西部的社区医院，拥有三级产科中心，每年约有2 000名新生儿。参与者：453名年龄≥18岁，足月单胎妊娠（37-41周妊娠）顺产的女性。干预/测量：在第二产程的主动推动阶段之前或开始时，使用安装在天花板上的分娩镜。使用由患者选择。结果：177例（39.1%）妇女选择使用产镜。除硬膜外使用外，镜子使用者和非使用者在临床和人口学特征方面相似(分别为93.2%和86.6%；P = .0298)。在使用镜子的产妇中，第二产程平均缩短19.4分钟（p = 0.0198）。这种影响在多产妇女中未见（p = .2208）。镜子使用者和非使用者在产后出血（p = .5498）或绒毛膜羊膜炎（p = .6528）的发生率上没有差异。在无产和多产妇女中，使用镜子和不使用镜子的妇女的Apgar评分和NICU入院率没有差异。结论：分娩镜是一种简单、无创的分娩和分娩工具。在产程第二阶段的主动推搡阶段使用产镜可能与产妇推搡时间缩短有关。

{"title":"Evaluation of Labor Mirror Use During the Active Pushing Phase of the Second Stage of Labor","authors":"Robin L. Driver, Lynn Shaffer, Jennifer L. Doyle","doi":"10.1016/j.nwh.2024.07.004","DOIUrl":"10.1016/j.nwh.2024.07.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether the use of a labor mirror during the active pushing phase of the second stage of labor is associated with a shorter duration of pushing. Additionally, we examined maternal and neonatal outcomes secondary to mirror use versus non–mirror use.</div></div><div><h3>Design</h3><div>Retrospective observational cohort study.</div></div><div><h3>Setting/Local Problem</h3><div>Community hospital in the midwestern United States with a Level 3 maternity center and approximately 2,000 births annually.</div></div><div><h3>Participants</h3><div>Four hundred fifty-three women ≥18 years old who had a singleton pregnancy at term (37–41 weeks’ gestation) with a spontaneous vaginal birth.</div></div><div><h3>Intervention/Measurements</h3><div>The use of a ceiling-mounted labor mirror offered before or at the beginning of the active pushing phase of the second stage of labor. Use was determined by patient choice.</div></div><div><h3>Results</h3><div>One hundred seventy-seven (39.1%) women elected use of the labor mirror. Mirror users and nonusers were similar in terms of clinical and demographic characteristics except for epidural use (93.2% vs. 86.6%, respectively; <em>p</em> = .0298). Among nulliparous women who used the mirror, second stage labor duration was shortened by an average of 19.4 minutes (<em>p</em> = .0198). This effect was not seen in multiparous women (<em>p</em> = .2208). Mirror users and nonusers did not differ on rates of postpartum hemorrhage (<em>p</em> = .5498) or chorioamnionitis (<em>p</em> = .6528). Among nulliparous and multiparous women, Apgar scores and NICU admission rates did not differ between mirror users and nonusers.</div></div><div><h3>Conclusion</h3><div>The labor mirror represents a simple, noninvasive tool for labor and delivery units. Use of the labor mirror during the active pushing phase of the second stage of labor may be associated with decreased pushing duration for nulliparous women.</div></div>","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":"29 1","pages":"Pages 17-24"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824665","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

A Day I Will Never Forget 我永远不会忘记的一天。

Nursing for Women''s Health

Pub Date : 2025-02-01 DOI: 10.1016/j.nwh.2024.08.004

Lauren Weber

引用次数: 0

Obstetric Violence From the Perspectives of Midwife Leaders in Hospitals in Nigeria 从尼日利亚医院助产士领导者的角度看产科暴力。

Nursing for Women''s Health

Pub Date : 2025-02-01 DOI: 10.1016/j.nwh.2024.09.001

Adetunmise Oluseyi Olajide, Racheal Toyin Oyebamiji, Omolola Yetunde Oyedeji

Objective

To describe midwife leaders’ (i.e., midwives in managerial positions) perspectives on the forms of obstetric violence (OV) women experience in hospitals in Nigeria.

Design

An interpretative qualitative phenomenological approach and the community readiness model (CRM) were used.

Setting

Three hospitals in Nigeria, where OV is recognized as a violation of fundamental human rights that negatively affects maternal and child health outcomes.

Participants

Six midwife leaders were purposively selected, with two representatives from select government-owned hospitals throughout Nigeria.

Intervention/Measurement

Data collection was carried out through key informant interviews and analyzed thematically using NVivo software.

Results

Six themes emerged, highlighting various forms of OV observed by midwife leaders: Physical Abuse, Verbal Abuse, Discrimination Based on Specific Patient Attributes, Nonconsented Care, Nonconfidential Care, and Detainment of Patients.

Conclusion

The findings substantiate the persistent occurrence of OV in government-owned facilities, emphasizing the urgent need for preventive measures to mitigate its detrimental effects on maternal and child health outcomes.

摘要描述助产士领导（即担任管理职位的助产士）对尼日利亚医院中妇女遭受的产科暴力形式的看法：设计：采用解释性定性现象学方法和社区准备模型（CRM）：环境：尼日利亚的三家医院，产科暴力被认为是对基本人权的侵犯，对母婴健康产生了负面影响：干预/测量：通过关键信息提供者访谈收集数据，并使用 NVivo 软件进行专题分析：结果：出现了六个主题，突出了助产士领导观察到的各种形式的暴力侵害：结果：出现了六个主题，突出了助产士领导观察到的各种形式的暴力侵害行为：身体虐待、言语虐待、基于特定患者属性的歧视、非同意护理、孕期非保密护理以及在医疗机构拘留妇女：调查结果表明，在政府所有的医疗机构中，长期存在着对妇女的体罚和虐待现象，因此迫切需要采取预防措施来减轻这种现象对母婴健康的不利影响。

{"title":"Obstetric Violence From the Perspectives of Midwife Leaders in Hospitals in Nigeria","authors":"Adetunmise Oluseyi Olajide, Racheal Toyin Oyebamiji, Omolola Yetunde Oyedeji","doi":"10.1016/j.nwh.2024.09.001","DOIUrl":"10.1016/j.nwh.2024.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>To describe midwife leaders’ (i.e., midwives in managerial positions) perspectives on the forms of obstetric violence (OV) women experience in hospitals in Nigeria.</div></div><div><h3>Design</h3><div>An interpretative qualitative phenomenological approach and the community readiness model (CRM) were used.</div></div><div><h3>Setting</h3><div>Three hospitals in Nigeria, where OV is recognized as a violation of fundamental human rights that negatively affects maternal and child health outcomes.</div></div><div><h3>Participants</h3><div>Six midwife leaders were purposively selected, with two representatives from select government-owned hospitals throughout Nigeria.</div></div><div><h3>Intervention/Measurement</h3><div>Data collection was carried out through key informant interviews and analyzed thematically using NVivo software.</div></div><div><h3>Results</h3><div>Six themes emerged, highlighting various forms of OV observed by midwife leaders: <em>Physical Abuse</em>, <em>Verbal Abuse</em>, <em>Discrimination Based on Specific Patient Attributes</em>, <em>Nonconsented Care</em>, <em>Nonconfidential Care</em>, and <em>Detainment of Patients</em>.</div></div><div><h3>Conclusion</h3><div>The findings substantiate the persistent occurrence of OV in government-owned facilities, emphasizing the urgent need for preventive measures to mitigate its detrimental effects on maternal and child health outcomes.</div></div>","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":"29 1","pages":"Pages 53-62"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839953","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}

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