Mcn-The American Journal of Maternal-Child Nursing最新文献

Purpose: The purpose of this study is to describe the experiences of women with symptoms of perinatal mental health disorders who recently gave birth and participated in a virtual peer support specialist program for maternal mental health during the COVID-19 pandemic.

Study design and methods: A qualitative descriptive design was used to describe the experiences of six women with symptoms of perinatal mental health disorders who participated in a peer support specialist program. Participants were recruited from online Indiana-based Facebook parenting groups targeted to women with young children. Semi-structured interviews were conducted, and data were analyzed using a basic inductive content analysis.

Results: We identified three main themes: 1) Seeking help for mental health symptoms, 2) Receiving unbiased peer support, and 3) Improving mental health symptoms.

Clinical implications: Implications for nursing practice include developing strategies to increase peer networks for women in the perinatal period, increasing the screening of women for symptoms of perinatal mental health disorders, and conducting more research on the efficacy of a peer support specialist programs for improving maternal mental health.

Purpose: The purpose of this quality improvement project was to promote newborn thermoregulation.

Background: Thermoregulation is a primary concern in the newborn population because poor thermoregulation contributes to impaired metabolic functioning, specifically glucose and respiratory regulation. In severe cases, if untreated, impaired thermoregulation can lead to increased risk of morbidity and mortality.

Methods: Two types of newborn bathing methods were evaluated for their effects on thermoregulation in a sample of healthy newborns: traditional sponge baths and immersion swaddle baths. Nurses monitored newborn temperatures pre- and postbathing. Temperatures were taken immediately prebath then postbath for each bathing technique until the infants were warm. Weekly data were collected over the course of 6 weeks, with 2 cycles of sponge and swaddle baths for comparison. The goal was to decrease the amount of time infants spent under the warmer after their first bath. Three Plan-Do-Study-Act cycles were initiated throughout this project to monitor existing bathing methods as well as successful implementation of the change.

Results: Ninety newborns were enrolled; 30 preintervention and 60 newborns per postintervention (30 per cycle). Postintervention, significant improvements in thermoregulation were found among immersion swaddle bath infants in shorter return times to baseline prebath temperatures ( p = .001).

Conclusion: In this project, introduction of immersion swaddle bathing positively correlated with improved thermoregulation in newborns. Using swaddle bathing instead of traditional sponge bathing may potentially have positive implications in other newborn settings. More research is needed on types of newborn bathing techniques.

Purpose: Medicaid-eligible pregnant women are a chronically stressed population with various negative perinatal effects due in part to their challenging financial status. Increasingly, they use social media to obtain social support; however, experiences of using social media for social support are unknown. The purpose of this study was to explore experiences of Medicaid-eligible pregnant women using Facebook groups.

Study design and methods: Semistructured interviews of pregnant women who used Facebook groups for social support were conducted. Eligibility or insurance coverage by Medicaid was considered as a proxy for low socioeconomic status. Thematic analysis was completed.

Results: Fourteen pregnant women were interviewed. Several themes were identified. The overarching theme was social support through an online community, connections, and information support with affirmation woven through to build connections. Participants felt nurses, midwives, and physicians should recommend Facebook groups to obtain social support.

Clinical implications: Most participants found their experiences via Facebook overwhelmingly positive, even if they had some negative encounters. Participants found social support via Facebook groups. Recommendations for nurses include recognizing social media as a venue to access social support, starting peer-led communities for Medicaid-eligible women using social media, and engaging in policy work on social media recommendations for pregnant women. It is unknown what effect this social support has on their chronic stress.

Purpose: To analyze the effect of peanut balls for labor support on the nulliparous term singleton vertex (NTSV) cesarean and overall cesarean birth rates in our maternity service.

Study design and methods: Retrospective analysis of participants from a 30-bed maternity unit discharged between January 1, 2018, and December 31, 2023.

Results: Among 4,005 participants, those who used a peanut ball ( n = 1,680) during labor were significantly younger, more likely to be nulliparous, and more likely to give birth at term compared to nonpeanut ball users. Multivariable logistic regression showed that peanut ball use was associated with increased odds of vaginal birth (OR = 1.21, 95% CI [1.03, 1.43], p = .0239), after adjusting for age, gestational age, and parity. Age and gestational age were also significant predictors of vaginal birth, whereas race was not.

Clinical implications: Using peanut balls for labor support may support vaginal birth without compromising neonatal outcomes. Education for all members of the maternity team is an important aspect of implementing peanut balls for labor support. Continued implementation and evaluation of peanut ball use, along with other labor support strategies, shows potential for improving vaginal birth rates while maintaining safe neonatal outcomes.

Background: Chorioamnionitis has serious maternal-newborn risks. Risk factors include prelabor rupture of membranes (PROM), vaginal exams, and inadequate perineal hygiene. There may be opportunities to reduce chorioamnionitis with PROM and newborns affected by chorioamnionitis within the Joint Commission Measure of Unexpected Newborn Complications (PC-06) using an infection prevention bundle.

Problem: An internal audit found an increased incidence of newborns born to women with chorioamnionitis. Patients with PROM had a 6.2% chorioamnionitis rate compared to a 3.6% overall chorioamnionitis rate.

Interventions: A quality improvement project using an infection prevention bundle for PROM was implemented using three interventions: avoiding unnecessary vaginal exams in PROM diagnosis, hourly pericare with peripad changes, and hand hygiene compliance.

Results: Data were compared from first quarter 2023 before bundle implementation through third quarter 2023 post bundle implementation. The rate of chorioamnionitis was decreased among patients with PROM from 8.1% (9/111) in first quarter 2023 to 3.1% (4/126) in third quarter 2023. There were fewer newborns affected by chorioamnionitis within PC-06, from 9% (3/32) in first quarter 2023 to 7% (3/46) in third quarter 2023. PROM with chorioamnionitis within PC-06 was 0% (0/32) at first and (0/46) third quarter 2023.

Conclusions: Bundle adherence with PROM could help decrease chorioamnionitis and contribute to fewer newborn complications related to chorioamnionitis.