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Environmental Deregulation and Emerging Risks for Maternal and Child Health 环境放松管制和产妇和儿童健康的新风险。
IF 2 4区 医学 Q2 NURSING Pub Date : 2026-01-01 DOI: 10.1016/j.jogn.2025.11.008
Roberta Lavin, Mindy B. Tinkle, Mary Pat Couig, Heidi Honegger Rogers, Hector A. Olvera-Alvarez, Xi Gong
The United States has long been a leader in protecting human health through environmental regulation. Since 2025, however, environmental deregulation has reversed or eliminated many air, land, water, and climate protections. This shift in federal policy has, and will continue to have, serious consequences for the health of pregnant women, infants, and children. In this article, we examine environmental regulatory changes since January 2025 and evaluate their current and potential effects on maternal, infant, and child health outcomes. We use Bardach’s eight-fold path to review major federal actions, including the revocation of the greenhouse gas endangerment findings, the weakening of toxic air pollution standards and their enforcement, and the rollback of environmental justice programs that directly address the disproportionate burden of environmental pollution on women, infants, and children in at-risk communities. We conclude with policy and practice recommendations to strengthen environmental health protections and safeguard maternal and child health amid ongoing deregulation.
The purpose of this series is to critically examine emerging federal and state health policy changes and their implications for the health and well-being of women, childbearing families, and young children and to provide evidence-based analyses that inform the nurses who care for these populations. The author solicitation and preparation of each article are overseen by series coordinators Mindy B. Tinkle, PhD, RN, WHNP-BC, CNE, FAAN, associate professor, and Nick Edwardson, PhD, MS, associate professor, College of Nursing, University of New Mexico, Albuquerque, NM.
长期以来,美国在通过环境法规保护人类健康方面一直处于领先地位。然而,自2025年以来,放松环境管制已经扭转或取消了许多空气、土地、水和气候保护措施。联邦政策的这种转变已经并将继续对孕妇、婴儿和儿童的健康产生严重后果。在本文中,我们研究了自2025年1月以来的环境法规变化,并评估了它们对孕产妇、婴儿和儿童健康结果的当前和潜在影响。我们使用Bardach的八重路径来评估联邦政府的主要行动,包括撤销温室气体危害调查结果,削弱有毒空气污染标准及其执行,以及撤销直接解决环境污染对高危社区妇女、婴儿和儿童造成不成比例负担的环境正义项目。最后,我们提出了政策和实践建议,以加强环境卫生保护,并在不断放松管制的情况下保障孕产妇和儿童健康。本系列的目的是严格审查新出现的联邦和州卫生政策变化及其对妇女、育龄家庭和幼儿的健康和福祉的影响,并提供循证分析,为照顾这些人群的护士提供信息。每篇文章的作者征集和准备由系列协调员Mindy B. Tinkle博士,注册护士,WHNP-BC, CNE, FAAN副教授和Nick Edwardson博士,硕士,副教授,新墨西哥州阿尔伯克基新墨西哥大学护理学院监督。
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引用次数: 0
An Upstream Perspective on Maternal–Child Environmental Health 母婴环境健康上游展望。
IF 2 4区 医学 Q2 NURSING Pub Date : 2026-01-01 DOI: 10.1016/j.jogn.2025.10.006
Patricia Butterfield PhD, RN, FAAN
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引用次数: 0
Role of the Nurse in Addressing Health Risks Related to Wildfire Smoke Exposure During Pregnancy and Childhood 护士在处理与孕期和儿童期野火烟雾暴露相关的健康风险中的作用。
IF 2 4区 医学 Q2 NURSING Pub Date : 2026-01-01 DOI: 10.1016/j.jogn.2025.06.001
Mary K. Cardon, Catherine J. Karr
Exposure to wildfire smoke is a critical environmental health concern, and the potential negative health effects of exposure on vulnerable populations such as pregnant women, infants, and children urgently requires attention. Climate change is leading to increased wildfire frequency and intensity and a prolonged and less predictable wildfire season, resulting in negative effects on air quality and health. It is critical that nurses understand the relationship between the environment and health and are equipped with the training and resources necessary to address it. Because environmental health topics are not commonly incorporated into standard nursing curricula, the aim of this article is to address this knowledge gap, provide evidence-based information, and offer practical tools and guidance that can be shared with patients and families.
暴露于野火烟雾是一个严重的环境健康问题,暴露对孕妇、婴儿和儿童等弱势群体的潜在负面健康影响迫切需要引起关注。气候变化导致野火频率和强度增加,野火季节延长且难以预测,对空气质量和健康造成负面影响。护士必须了解环境与健康之间的关系,并具备解决这一问题所需的培训和资源。由于环境健康主题通常不被纳入标准护理课程,本文的目的是解决这一知识差距,提供循证信息,并提供实用的工具和指导,可以与患者和家属分享。
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引用次数: 0
Implementation of a Nurse-Initiated Protocol for Prenatal Care in a Carceral Setting. 实施护士发起的协议产前护理在一个中心设置。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-12-31 DOI: 10.1016/j.jogn.2025.12.006
Janee' Stevenson, Andrea K Knittel, Nancy A Crowell, Ella T Heitzler

Objective: To evaluate the effect of a nurse-initiated protocol on the times to order and implement prenatal care, nurses' intentions to change practice based on an educational session, and nurses' perceived barriers to initiation of the protocol in a carceral facility.

Design: Quality improvement project.

Setting/local problem: Southeastern United States carceral facility.

Participants: A total of 44 nurses employed by a state women's carceral facility.

Intervention/measurements: Participants attended a 30-min educational session on a nurse-initiated intake protocol, including use of the Clinical Opiate Withdrawal Scale. The session was offered multiple times during shifts to maximize attendance. Participants then completed an adapted Continuing Professional Development-Reaction Questionnaire. We abstracted de-identified data from the charts of adult incarcerated women in the pre-implementation (n = 26) and post-implementation (n = 24) phases. We compared time to order (interval from admission to entry of order for a laboratory test, medication, or intervention) and time to implementation (interval from entry of order to initiation of the laboratory test, medication, or intervention) before and after implementation of the protocol. We assessed barriers to implementing the protocol 3 months after implementation.

Results: The time to order a prenatal diet and schedule a first obstetric appointment decreased significantly (p < .001), whereas the time to order prenatal labs increased significantly (p = .03) after implementation of the protocol. We identified the following themes as barriers to implementing the protocol: Lack of Integration of the Protocol Into the Electronic Health Record, Interruptions in the Flow of Care, and Limited Resources.

Conclusions: Use of a nurse-initiated protocol standardized and improved the timeliness of the delivery of prenatal care in a carceral facility and has the potential to enhance health care quality and maternal-fetal outcomes in this high-risk population.

目的:评估护士发起的协议对订购和实施产前护理的时间的影响,护士根据教育课程改变实践的意愿,以及护士在护理机构中对启动协议的感知障碍。设计:质量改进工程。背景/当地问题:美国东南部监狱设施。参与者:一共有44名护士受雇于州妇女护理机构。干预/测量:参与者参加了一个30分钟的关于护士启动的摄入方案的教育课程,包括使用临床阿片类药物戒断量表。该课程在轮班期间多次提供,以最大限度地提高出勤率。然后,参与者完成了一份改编的持续专业发展反应问卷。我们从实施前(n = 26)和实施后(n = 24)阶段的成年被监禁妇女的图表中提取了去识别数据。我们比较了实施方案前后的订单时间(从入院到接受实验室检查、药物治疗或干预的时间间隔)和实施时间(从接受订单到开始实验室检查、药物治疗或干预的时间间隔)。我们在议定书实施3个月后评估了实施该议定书的障碍。结果:实施该方案后,订购产前饮食和安排首次产科预约的时间显着减少(p < .001),而订购产前化验的时间显着增加(p = .03)。我们确定了以下主题是实施协议的障碍:缺乏将协议整合到电子健康记录中,护理流程中断,资源有限。结论:使用护士发起的方案标准化和提高了医疗机构提供产前护理的及时性,并有可能提高这一高危人群的医疗质量和母胎结局。
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引用次数: 0
Exploring Social Identity Clusters and NICU Outcomes in the Context of Alberta Family Integrated Care. 在艾伯塔省家庭综合护理的背景下探索社会认同集群和新生儿重症监护病房的结果。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-12-29 DOI: 10.1016/j.jogn.2025.12.003
Oyinda Obigbesan, Bukola Salami, Karen M Benzies

Objective: To explore variations in maternal and infant outcomes among clusters of mother-infant dyads in the NICU characterized by intersecting social identity characteristics.

Design: Secondary exploratory analysis of data from a cluster randomized controlled trial conducted between December 2015 and July 2018.

Setting: Ten Level II NICUs in six cities across Alberta, Canada.

Participants: A total of 400 mothers and their preterm infants at 320⁄7 to 346⁄7 weeks gestation.

Methods: We used two-step cluster analysis to identify clusters based on maternal ethnicity, education, age, and annual family income. We employed multiple regression models to examine whether cluster membership was associated with infant length of stay, maternal psychosocial distress, and parenting self-efficacy at discharge, controlling for relevant infant and maternal characteristics and hospital setting (urban vs. regional).

Results: We identified four mother-infant dyad clusters: (1) younger, lower-education, lower-income White mothers; (2) older, higher-education, higher-income BIPOC (Black, Indigenous, or people of color) mothers; (3) diploma-educated, highest-income White mothers; and (4) university-educated, highest-income White mothers. Although cluster membership was not associated with maternal outcomes, infants of mothers in Cluster 1 had shorter lengths of stay compared with those in Cluster 4. Hospital setting was a predictor of length of stay and parenting self-efficacy.

Conclusion: Findings highlight the relevance of social identity and hospital setting in shaping NICU outcomes and support the need for equity-informed neonatal care.

目的:探讨以社会认同特征交叉为特征的新生儿重症监护病房母婴结局的差异。设计:对2015年12月至2018年7月进行的聚类随机对照试验数据进行二次探索性分析。环境:加拿大阿尔伯塔省6个城市的10个II级新生儿重症监护病房。参与者:共400名母亲和他们的早产儿在320 / 7至346 / 7周妊娠。方法:采用两步聚类分析方法,根据母亲种族、教育程度、年龄和家庭年收入进行聚类分析。我们采用多元回归模型来检验集群成员是否与婴儿住院时间、母亲心理社会困扰和出院时父母自我效能有关,并控制了相关的婴儿和母亲特征以及医院环境(城市与地区)。结果:我们确定了四个母婴双组:(1)年轻、低教育、低收入的白人母亲;(2)年龄较大、受过高等教育、收入较高的BIPOC(黑人、土著或有色人种)母亲;(3)受过高等教育、收入最高的白人母亲;(4)受过大学教育、收入最高的白人母亲。虽然群集成员与母亲的结局无关,但与群集4的母亲相比,群集1的母亲的婴儿逗留时间较短。医院环境是住院时间长短和父母自我效能感的预测因子。结论:研究结果强调了社会身份和医院环境在塑造新生儿重症监护室结果中的相关性,并支持公平知情新生儿护理的必要性。
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引用次数: 0
Scoping Review on the Consequences of Falls in Women During the Perinatal Period. 围产期妇女跌倒后果的范围审查。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-12-27 DOI: 10.1016/j.jogn.2025.12.002
Sandra Risso, Tânia Soares, Luís Octávio de Sá, Luís Miranda, Rita Rosado, Sílvia Deus, Cristina Marques-Vieira

Objective: To identify consequences of falls in women during the perinatal period.

Data sources: Academic Search Complete (EBSCO), CINAHL Ultimate (EBSCO), MEDLINE Ultimate (EBSCO), Cochrane Central Register of Controlled Trials (EBSCO), Cochrane Clinical Answers (EBSCO), Cochrane Database of Systematic Reviews (EBSCO), Cochrane Methodology Register (EBSCO), MedicLatina (EBSCO), Repositórios Científicos de Acesso Aberto de Portugal (RCAAP), SciELO, Scopus, and Web of Science.

Study selection: We included quantitative or qualitative primary studies, literature reviews, systematic reviews, expert opinion papers, organizational guidelines, and conference abstracts regarding consequences of falls in women during the perinatal period, in any context of care, that were published until November 11, 2024, in English, French, Portuguese, and Spanish.

Data extraction: We extracted the following data from the included reports: author(s), year, country, aim, study design, type of report, sample size, setting, types and consequences of falls, prevalence, and risk factors for falls.

Data synthesis: From a total of 33 articles, 27 were related to the consequences of falls during pregnancy, 3 were related to consequences of falls during both pregnancy and the postpartum period, 2 were related to consequences of falls during the perinatal period in which one does not identify the specific stage, and 1 was related to the postpartum period. We did not identify any reports of falls during childbirth. Injuries were common consequences of falls among women during the perinatal period, and the severity of falls varied from minor to severe. Obstetric injuries were severe and unique to pregnant women.

Conclusion: Pregnant women sustain varied injuries after falls and often need health care. Further research is warranted regarding the consequences of falls during childbirth and the postpartum period.

目的:确定围生期妇女跌倒的后果。数据来源:Academic Search Complete (EBSCO), CINAHL Ultimate (EBSCO), MEDLINE Ultimate (EBSCO), Cochrane Central Register of Controlled Trials (EBSCO), Cochrane Clinical Answers (EBSCO), Cochrane Database of Systematic Reviews (EBSCO), Cochrane Methodology Register (EBSCO), MedicLatina (EBSCO), Repositórios Científicos de Acesso Aberto de Portugal (RCAAP), SciELO, Scopus和Web of Science。研究选择:我们纳入了定量或定性的初步研究、文献综述、系统综述、专家意见论文、组织指南和会议摘要,涉及围产期妇女跌倒的后果,在任何护理背景下,截至2024年11月11日,以英语、法语、葡萄牙语和西班牙语发表。数据提取:我们从纳入的报告中提取了以下数据:作者、年份、国家、目的、研究设计、报告类型、样本量、环境、跌倒的类型和后果、患病率和跌倒的危险因素。数据综合:在总共33篇文章中,27篇与怀孕期间跌倒的后果有关,3篇与怀孕期间和产后期间跌倒的后果有关,2篇与围产期跌倒的后果有关,其中1篇未明确具体阶段,1篇与产后有关。我们没有发现任何分娩时跌倒的报告。受伤是围产期妇女跌倒的常见后果,跌倒的严重程度从轻微到严重不等。产科伤害是孕妇所特有的严重伤害。结论:孕妇跌倒后发生多种损伤,需要经常进行保健护理。关于分娩和产后期间跌倒的后果,需要进一步的研究。
{"title":"Scoping Review on the Consequences of Falls in Women During the Perinatal Period.","authors":"Sandra Risso, Tânia Soares, Luís Octávio de Sá, Luís Miranda, Rita Rosado, Sílvia Deus, Cristina Marques-Vieira","doi":"10.1016/j.jogn.2025.12.002","DOIUrl":"https://doi.org/10.1016/j.jogn.2025.12.002","url":null,"abstract":"<p><strong>Objective: </strong>To identify consequences of falls in women during the perinatal period.</p><p><strong>Data sources: </strong>Academic Search Complete (EBSCO), CINAHL Ultimate (EBSCO), MEDLINE Ultimate (EBSCO), Cochrane Central Register of Controlled Trials (EBSCO), Cochrane Clinical Answers (EBSCO), Cochrane Database of Systematic Reviews (EBSCO), Cochrane Methodology Register (EBSCO), MedicLatina (EBSCO), Repositórios Científicos de Acesso Aberto de Portugal (RCAAP), SciELO, Scopus, and Web of Science.</p><p><strong>Study selection: </strong>We included quantitative or qualitative primary studies, literature reviews, systematic reviews, expert opinion papers, organizational guidelines, and conference abstracts regarding consequences of falls in women during the perinatal period, in any context of care, that were published until November 11, 2024, in English, French, Portuguese, and Spanish.</p><p><strong>Data extraction: </strong>We extracted the following data from the included reports: author(s), year, country, aim, study design, type of report, sample size, setting, types and consequences of falls, prevalence, and risk factors for falls.</p><p><strong>Data synthesis: </strong>From a total of 33 articles, 27 were related to the consequences of falls during pregnancy, 3 were related to consequences of falls during both pregnancy and the postpartum period, 2 were related to consequences of falls during the perinatal period in which one does not identify the specific stage, and 1 was related to the postpartum period. We did not identify any reports of falls during childbirth. Injuries were common consequences of falls among women during the perinatal period, and the severity of falls varied from minor to severe. Obstetric injuries were severe and unique to pregnant women.</p><p><strong>Conclusion: </strong>Pregnant women sustain varied injuries after falls and often need health care. Further research is warranted regarding the consequences of falls during childbirth and the postpartum period.</p>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emergency and All-Hazards Preparedness: AWHONN Practice Brief Number 22. 紧急情况和所有危险准备:AWHONN实践摘要第22号。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-12-24 DOI: 10.1016/j.jogn.2025.11.004
{"title":"Emergency and All-Hazards Preparedness: AWHONN Practice Brief Number 22.","authors":"","doi":"10.1016/j.jogn.2025.11.004","DOIUrl":"https://doi.org/10.1016/j.jogn.2025.11.004","url":null,"abstract":"","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Health Outcomes of Women on Community Supervision in South Central Texas During the Perinatal Period. 德克萨斯州中南部妇女围产期接受社区监督的健康结果
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-12-20 DOI: 10.1016/j.jogn.2025.12.001
Allison D Ihle, Ariadna Forray, Kimberly Hughes, Rebecca L Freese, Rebecca J Shlafer

Objective: To assess the health outcomes of women on community supervision during the perinatal period and to analyze the associations between length of community supervision and perinatal health outcomes.

Design: A cross-sectional survey study.

Setting: Individual telephone interviews in San Antonio, Texas.

Participants: Women aged 18 to 50 years (N = 60) on community supervision.

Methods: We developed survey questions to measure participants' perinatal health outcomes during pregnancy, childbirth, and the postpartum period. We used logistic regression to assess the associations between the length of community supervision and perinatal health outcomes.

Results: Most participants had an average of 4 arrests (SD = 7) and 5 years of community supervision (SD = 3), gave birth before 38 weeks gestation (n = 43; 71%), and reported feelings of depression (n = 40; 67%) and anxiety (n = 31; 52%) during their most recent pregnancies. Most participants had inadequate social support during childbirth (n = 55; 92%). More than a third of the participants experienced partner violence while on community supervision (n = 21; 35%), and a quarter experienced violence during their most recent pregnancies (n = 15; 25%). For each additional year on community supervision before birth, the odds of experiencing a pregnancy complication were 1.63 (95% confidence interval = [1.08, 2.82]) times higher.

Conclusion: The criminal legal system, although not designed to provide health care, should dedicate resources to address the perinatal health care needs of women while on community supervision.

目的:评价围生期社区监护妇女的健康状况,分析社区监护时间与围生期健康状况的关系。设计:横断面调查研究。地点:德克萨斯州圣安东尼奥的个人电话访谈。参与者:接受社区监督的18至50岁女性(60人)。方法:我们开发了调查问题来测量参与者在怀孕、分娩和产后期间的围产期健康状况。我们使用逻辑回归来评估社区监护时间与围产期健康结果之间的关系。结果:大多数参与者平均有4次逮捕(SD = 7)和5年的社区监督(SD = 3),在妊娠38周之前分娩(n = 43, 71%),并报告在最近怀孕期间感到抑郁(n = 40, 67%)和焦虑(n = 31, 52%)。大多数参与者在分娩期间没有足够的社会支持(n = 55; 92%)。超过三分之一的参与者在社区监督期间经历过伴侣暴力(n = 21; 35%),四分之一的参与者在最近怀孕期间经历过暴力(n = 15; 25%)。出生前每多接受一年社区监护,出现妊娠并发症的几率就增加1.63倍(95%可信区间=[1.08,2.82])。结论:刑事法律制度虽然不是为提供保健服务而设计的,但在社区监督的同时,应将资源用于解决妇女的围产期保健需求。
{"title":"Health Outcomes of Women on Community Supervision in South Central Texas During the Perinatal Period.","authors":"Allison D Ihle, Ariadna Forray, Kimberly Hughes, Rebecca L Freese, Rebecca J Shlafer","doi":"10.1016/j.jogn.2025.12.001","DOIUrl":"https://doi.org/10.1016/j.jogn.2025.12.001","url":null,"abstract":"<p><strong>Objective: </strong>To assess the health outcomes of women on community supervision during the perinatal period and to analyze the associations between length of community supervision and perinatal health outcomes.</p><p><strong>Design: </strong>A cross-sectional survey study.</p><p><strong>Setting: </strong>Individual telephone interviews in San Antonio, Texas.</p><p><strong>Participants: </strong>Women aged 18 to 50 years (N = 60) on community supervision.</p><p><strong>Methods: </strong>We developed survey questions to measure participants' perinatal health outcomes during pregnancy, childbirth, and the postpartum period. We used logistic regression to assess the associations between the length of community supervision and perinatal health outcomes.</p><p><strong>Results: </strong>Most participants had an average of 4 arrests (SD = 7) and 5 years of community supervision (SD = 3), gave birth before 38 weeks gestation (n = 43; 71%), and reported feelings of depression (n = 40; 67%) and anxiety (n = 31; 52%) during their most recent pregnancies. Most participants had inadequate social support during childbirth (n = 55; 92%). More than a third of the participants experienced partner violence while on community supervision (n = 21; 35%), and a quarter experienced violence during their most recent pregnancies (n = 15; 25%). For each additional year on community supervision before birth, the odds of experiencing a pregnancy complication were 1.63 (95% confidence interval = [1.08, 2.82]) times higher.</p><p><strong>Conclusion: </strong>The criminal legal system, although not designed to provide health care, should dedicate resources to address the perinatal health care needs of women while on community supervision.</p>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Decreasing Time to Treatment in Women With Hypertensive Disorders of Pregnancy in a High-Volume Hospital Obstetric Triage Setting. 在大容量医院产科分诊设置中减少妊娠期高血压疾病妇女的治疗时间。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-12-10 DOI: 10.1016/j.jogn.2025.11.006
Meredith Hunter Elischer, Ann Schaeffer

Objective: To increase the percentage of women with severe-range blood pressure during the perinatal period who are treated within 30 min from 25% to at least 50% within 8 weeks.

Design: Plan-Do-Study-Act model comprising four 2-week cycles with data-driven tests of change every cycle.

Setting: A high-volume, community, academic obstetric triage.

Patients: We conducted interventions with women identified at risk for or diagnosed with hypertensive disorder of pregnancy (N = 182). In addition, we surveyed a convenience sample of women (n = 30) about their understanding of hypertension care and maternity care staff (n = 39) about their knowledge of treatment for hypertensive disorders of pregnancy.

Intervention/measurements: We implemented two interventions: standardized screening for hypertensive disorders of pregnancy using a modified preeclampsia early recognition tool and an algorithm-based checklist for effective treatment for hypertensive disorders of pregnancy. We measured use and outcomes through chart review and analyzed data with descriptive statistics.

Results: After the intervention, the percentage of women treated within 30 min increased to 97%. Mean medication administration times decreased from 41.4 to 11.2 min (p < .001), which demonstrated a significant improvement in care.

Conclusion: Standardized screening and care improved time to treatment among women with hypertensive disorders of pregnancy. This advanced practice nurse-led initiative is adaptable for widespread implementation.

目的:提高围生期重度高血压妇女在30分钟内接受治疗的百分比,从25%提高到8周内至少50%。设计:计划-执行-研究-行动模型,包括四个2周的周期,每个周期都有数据驱动的更改测试。设置:高容量,社区,学术产科分诊。患者:我们对确定有妊娠期高血压疾病风险或诊断为妊娠期高血压疾病的妇女(N = 182)进行了干预。此外,我们还调查了方便抽样妇女(n = 30)对高血压护理的了解情况,以及产科护理人员(n = 39)对妊娠期高血压疾病治疗的了解情况。干预/测量:我们实施了两项干预措施:使用改进的子痫前期早期识别工具对妊娠期高血压疾病进行标准化筛查,以及基于算法的妊娠期高血压疾病有效治疗清单。我们通过图表回顾来衡量使用情况和结果,并使用描述性统计分析数据。结果:干预后,30分钟内接受治疗的妇女比例提高到97%。平均给药时间从41.4分钟减少到11.2分钟(p < 0.001),表明护理有显著改善。结论:标准化的筛查和护理提高了妊娠期高血压疾病妇女的治疗时间。这种先进的实践护士主导的倡议是适用于广泛实施。
{"title":"Decreasing Time to Treatment in Women With Hypertensive Disorders of Pregnancy in a High-Volume Hospital Obstetric Triage Setting.","authors":"Meredith Hunter Elischer, Ann Schaeffer","doi":"10.1016/j.jogn.2025.11.006","DOIUrl":"https://doi.org/10.1016/j.jogn.2025.11.006","url":null,"abstract":"<p><strong>Objective: </strong>To increase the percentage of women with severe-range blood pressure during the perinatal period who are treated within 30 min from 25% to at least 50% within 8 weeks.</p><p><strong>Design: </strong>Plan-Do-Study-Act model comprising four 2-week cycles with data-driven tests of change every cycle.</p><p><strong>Setting: </strong>A high-volume, community, academic obstetric triage.</p><p><strong>Patients: </strong>We conducted interventions with women identified at risk for or diagnosed with hypertensive disorder of pregnancy (N = 182). In addition, we surveyed a convenience sample of women (n = 30) about their understanding of hypertension care and maternity care staff (n = 39) about their knowledge of treatment for hypertensive disorders of pregnancy.</p><p><strong>Intervention/measurements: </strong>We implemented two interventions: standardized screening for hypertensive disorders of pregnancy using a modified preeclampsia early recognition tool and an algorithm-based checklist for effective treatment for hypertensive disorders of pregnancy. We measured use and outcomes through chart review and analyzed data with descriptive statistics.</p><p><strong>Results: </strong>After the intervention, the percentage of women treated within 30 min increased to 97%. Mean medication administration times decreased from 41.4 to 11.2 min (p < .001), which demonstrated a significant improvement in care.</p><p><strong>Conclusion: </strong>Standardized screening and care improved time to treatment among women with hypertensive disorders of pregnancy. This advanced practice nurse-led initiative is adaptable for widespread implementation.</p>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Continuous Labor Support Position Statement. 持续劳动支持职位声明。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-12-05 DOI: 10.1016/j.jogn.2025.10.001
{"title":"Continuous Labor Support Position Statement.","authors":"","doi":"10.1016/j.jogn.2025.10.001","DOIUrl":"https://doi.org/10.1016/j.jogn.2025.10.001","url":null,"abstract":"","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","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
Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing
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