Postpartum Nurses Research Articles

Personal Infant Feeding Experiences of Postpartum Nurses Affect How They Provide Breastfeeding Support

ObjectiveTo 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. DesignQualitative research with interviews using dialogic data generation and analysis. SettingLarge academic women and children’s hospital in the Southern United States. ParticipantsNine postpartum nurses who gave birth and breastfed or mixed-fed infants at any time in the past. MethodsIndividual, semistructured, face-to-face interviews. ResultsParticipants 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. ConclusionPersonal 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.

Exposure to routine availability of immediate postpartum LARC: effect on attitudes and practices of labor and delivery and postpartum nurses

ObjectivesNurses play an integral role in intrapartum and postpartum patient education. This exploratory study aims to assess the attitudes, knowledge, and practices of labor and delivery and postpartum nurses regarding contraception and evaluate for changes in these measures 1 year after an institutional initiative allowing routine availability of immediate postpartum long-acting reversible contraception (LARC). Study designIn 2014, Montefiore Medical Center began to routinely offer comprehensive immediate postpartum contraception. The initiative included education and feedback sessions for labor and delivery and postpartum nurses on contraception, including immediate postpartum initiation of LARC. Nurses completed anonymous surveys at the beginning of the initiative (n=59) and at 1 year (n=56). We compared baseline and 1 year survey results of contraceptive knowledge, attitudes and practices using χ2 test, Fisher's Exact Test, or t test as appropriate. ResultsNurses who stated they counseled patients on contraception “always” or “most of the time” increased from 27/59 (46%) to 40/56 (71%) (p=.005). The number of nurses who would recommend the intrauterine device and implant for postpartum contraception increased from 1/59 (2%) to 18/56 (32%) (p<.0001). Attitudes towards injectable contraception and breastfeeding remained negative; 27/59 nurses (46%) at baseline and 34/56 (61%) at 1 year agreed with the statement “DMPA [depot medroxyprogesterone acetate] has a negative effect on breastfeeding.” ConclusionsExperience working in a location with routine access to immediate postpartum contraception is associated with increased awareness among nurses of postpartum contraceptive options, especially LARC, and increased contraceptive counseling. Concerns about the impact of hormonal contraception on breastfeeding, specifically DMPA, are persistent and prevalent. ImplicationsLabor and delivery and postpartum nurses' knowledge regarding immediate postpartum contraception, particularly LARC methods, may change with exposure to routine access to these methods. This exposure may also impact nurses' practices of providing patient counseling on what methods are appropriate for postpartum women.

Nurses' professional stigma and attitudes towards postpartum women with severe mental illness.

To examine professional stigma and attitudes of parenthood towards postpartum women with severe mental illness and the association between postpartum nurses' attitudes and nursing interventions that promote motherhood. Stigma and attitudes towards parenthood of women with severe mental illness may influence nurses' clinical practices. Cross-sectional, mixed methods. The Stigma among Health Professionals towards People with Severe Mental Illness, Attitudes towards Parenthood among People with Severe Mental Illness and Nursing Interventions that Promote Becoming a Mother Questionnaires were used in the study, as well as qualitative analysis. Sixty-one postpartum nurses participated in the study. Increased stigma was associated with an increase in negative attitudes towards parenthood among people with severe mental illness, in general, and towards their parenthood skills, in particular. Postpartum nurses reported a decrease in nursing interventions and a therapeutic nurse-client relationship that fosters mother's empowerment.Themes that emerged from the qualitative analysis were postpartum nurse's perceptions of inadequacy, difficulty of postpartum nurses taking responsibility for managing women with severe mental illness and a paternalistic approach to these women, rather than empowerment, regarding infant care. Nurses providing care to postpartum women with severe mental illness and their infants may provide fewer routine postpartum interventions due to professional stigma and negative attitudes concerning parenting skills. Nurses should provide individualised, tailored care that allows women with severe mental illness to become a mother to the best of her ability. Not all women with severe mental illness are capable of caring for themselves and/or their baby. Nurses should provide individualised, tailored care that allows the women with severe mental illness to become a mother to the best of her ability.

Lessons Learned: Implementation of Pilot Universal Postpartum Nurse Home Visiting Program, Massachusetts 2013-2016.

Purpose Home visiting programs for new families in the United States have traditionally served high-risk families. In contrast, universal home visiting models serve all families regardless of income, age, risk or other criteria. They offer an entry point into a system of care for children and families, with the potential to improve population health. This paper describes lessons learned from the first threeyears of implementing a universal home visiting model. Description Welcome Family is a universal home visiting program in Massachusetts that offers a one-time visit by a nurse to new mothers up to eightweeks postpartum. The Massachusetts Department of Public Health (MDPH) is piloting Welcome Family in four communities with the goal of expanding statewide. Assessment Welcome Family served over 3000 families in its first threeyears. Program performance measures provided a framework to examine successes and challenges related to outreach and enrollment, program operations, and linkages with community resources. Early challenges included increasing referrals to a new program and limited capacity to serve all women giving birth. Local implementing agencies tested innovative strategies and MDPH made program modifications, such as developing quarterly data reports and establishing a learning collaborative, to address identified challenges. Conclusion MDPH is committed to the success of Welcome Family and uses continuous quality improvement to maximize the impact of the program on families and the system of care in Massachusetts. Lessons learned from the Massachusetts pilot can inform other states' efforts to enhance their early childhood systems of care through expanding universal home visiting.

Nurses' Knowledge and Teaching of Possible Postpartum Complications.

The purpose of this study was to assess postpartum nurses' knowledge of maternal morbidity and mortality, and information they shared with women before discharge about identifying potential warning signs of postpartum complications. Registered nurses (RNs) who care for women during postpartum (N = 372) completed an electronic survey. Descriptive statistics and bivariate analyses were used for data analysis. Fifty-four percent of nurse participants were aware of the rising rates of maternal mortality in the United States and 12% accurately reported the correct percentage of deaths that occurred during the postpartum period. Ninety-three percent of nurses were more likely to identify hemorrhage as a leading cause of maternal mortality. On the day of discharge, 67% of RNs spent less than 10 minutes focusing on potential warning signs. Ninety-five percent of RNs reported a correlation between postpartum education and mortality; however, only 72% strongly agreed it was their responsibility to provide this education. Nurse respondents who were over the age of 40 were significantly more likely to report feeling very competent when providing education on all of the postpartum complication variables measured (p values <0.001-0.003). The majority of nurses in this study were not up-to-date on the rates and timing of maternal mortality during the postpartum period in the United States. They did not always provide comprehensive education to all women prior to discharge from the hospital after childbirth. There is a need for nurses to provide consistent messages about potential warning signs that may ultimately reduce maternal death and severity of maternal complications.

Using group model building to develop a culturally grounded model of breastfeeding for low-income African American women in the USA.

To identify barriers and supporting factors for breastfeeding, and the dynamic interactions between them, as identified by low-income African American women and lactation peer helpers. Stark breastfeeding disparities exist between African American mothers and their White counterparts in the USA. This pattern is often replicated across the globe, with marginalised populations demonstrating decreased breastfeeding rates. While breastfeeding research focused on sociocultural factors for different populations has been conducted, a more dynamic model of the factors impacting breastfeeding may help identify effective leverage points for change. Group model building was used as a grounded theoretical approach, to build and validate a model representing factors impacting breastfeeding and the relationships between them. Low-income African American women (n=21) and lactation peer helpers (n=3) were engaged in model building sessions to identify factors impacting breastfeeding. A two-cycle process was used for analysis, invivo and axial coding. The final factors and model were validated with a subgroup of participants. The participants generated 82 factors that make breastfeeding easier, and 86 factors that make breastfeeding more challenging. These were grouped into 10 and 14 themes, respectively. A final model was constructed identifying three domains impacting breastfeeding: a mother's return to work or school, her knowledge, support and persistence, and the social acceptance of breastfeeding. This study documented the sociocultural context within which low-income African American women are situated by identifying factors impacting breastfeeding, and the dynamic interactions between them. The model also provided various leverage points from which breastfeeding women can be supported. Postpartum nurses are critical in supporting breastfeeding practices. To be most effective, they must be aware of the factors impacting breastfeeding, some of which may be unique to women based on their culture.

Predictors and measurement of satisfaction with postpartum care in a government hospital.

In this study, the predictors of satisfaction with postpartum care at a government hospital were evaluated. The descriptive research sample included 300 mothers in their postpartum period. Data were collected using a questionnaire and the Postpartum Nursing Care Evaluation Scale. The regression analysis undertaken showed that mothers who received prenatal care had a significantly higher evaluation score (compared to those who had not received prenatal care), as had mothers who had a caesarean delivery (compared to vaginal birth), as well as those who had received support from friends and relatives during their postpartum period (compared to those who did not receive such support). Our recommendation is that postpartum nursing care be improved for mothers who deliver vaginally, have not received prenatal care, were unintentionally pregnant, and have problems with breastfeeding. The results will help nurses who work with an international population of postpartum women to give professional, systematic, and patient-centered care to postpartum mothers in order to increase patient satisfaction.

Factors Influencing the Breastfeeding Practices of Young Mothers Living in a Maternity Shelter: A Qualitative Study.

Young mothers have the lowest breastfeeding rates in Canada. Young mothers and their infants who access maternity shelters are especially at risk for poor outcomes, some of which breastfeeding may help to mitigate, yet little is known of the breastfeeding practices of this population. Research aim: The purpose of this study was to answer the research question, "What factors influence the breastfeeding practices of young mothers who live or have lived in a maternity shelter?" The study was conducted using interpretive description methodology and inductive content analysis. Data were collected by means of one-on-one interviews, with the participants recruited from a maternity shelter in Ontario, Canada. Nine young mothers ages 17 to 24 years, who had initiated breastfeeding and resided at a maternity shelter, were interviewed. The five themes that emerged from the data were as follows: (a) choice, (b) special, (c) importance of early postpartum support, (d) being part of the "in crowd," and (e) importance of ongoing supports. The participants in this study took ownership of their choice to breastfeed. Hospital postpartum nurses and lactation consultants had a critical role in the establishment of early breastfeeding, and ongoing, accessible, and nonjudgmental peer, family, and community support were important to breastfeeding duration. A combination of emotional and practical supports from multiple trusted sources, including professional and peer supports on an ongoing basis, enabled young mothers to reach their breastfeeding goals.

Research of the influence of critical nursing intervention on pain and comfort of patients with postpartum hemorrhoids

Objective To explore the experience in critical nursing intervention for patients with postpartum hemorrhoids. Methods 100 primiparas with hemorrhoids who had normal delivery in our hospital were assigned, by odd or even number of the delivery date, into the control group including 53 patients or the observation group including 47 patients. Patients in the control group received normative vital signs monitoring, hemorrhoid swelling observation, bowel movement observation, medication observation, dietary nursing, psychological support, treatment for complications, health education, and discharge instruction, etc. Patients in the observation group received critical analysis and nursing in addition to the care received in the control group. The hemorrhoid pain intensity and patient-perceived comfort were observed for both groups at 2 h, 24 h and 48 h postpartum. Results The hemorrhoid pain intensity score at 2 h postpartum was (1.30±0.46) points and (1.32 ± 0.47) points, respectively, in the observation group and control group; the comfort score at 2h postpartum was (5.04 ± 0.83) points and (5.11 ± 0.82) points, respectively, in the observation group and control group, without statistically significant difference (t=0.245, 0.426, P > 0.05); the hemorrhoid pain intensity score at 24h postpartum was (2.85±0.62) points and (3.53 ± 0.58) points, respectively, in the observation group and control group; the comfort score at 24 h postpartum was (5.85 ± 1.02) points and (4.17 ± 0.89) points, respectively, in the observation group and control group, with statistically significant difference (t=5.643, 8.784, P < 0.01); the hemorrhoid pain intensity score at 48 h postpartum was (2.55 ±0.50) points and (3.42 ± 0.50) points, respectively, in the observation group and control group; the comfort score at 48h postpartum was (7.47 ± 1.10) points and (6.47 ± 0.89) points, respectively, in the observation group and control group, with statistically significant difference (t=8.606, 5.001, P <0.01). Conclusions Critical nursing intervention for postpartum patients with hemorrhoids could significantly alleviate hemorrhoid pain, improve patient comfort, and facilitate postpartum recovery. Key words: Hemorrhoids; Evaluation studies; Pain; Postpartum nursing; Comfort

Discharge Education on Maternal Morbidity and Mortality Provided by Nurses to Women in the Postpartum Period

ObjectiveTo explore what types of educational materials and discharge information are currently used by postpartum nurses to educate women about the warning signs of postpartum complications to determine what key messages should be presented to women after birth and before discharge. DesignExploratory qualitative. SettingSix hospitals located in New Jersey and Georgia. ParticipantsFifty-two nurses. MethodsSix focus group discussions were conducted using a semistructured interview guide to elicit data on how and what nurses taught women about maternal post-birth warning signs. The focus group discussions were audiotaped, transcribed, coded, and clustered into categories. ResultsMost nurses described some of the warning signs related to maternal morbidity and mortality to the women; however, these elements were not the primary focus of the education throughout the hospital stay and were most often discussed on the day of discharge. Nurses also did not consistently describe the same signs and symptoms of the warning signs with each and every woman. The primary mechanism for education consisted of individualized instruction with booklets or folders of information. ConclusionThese data indicate that improvements may be needed in how nurses educate women who just gave birth about the most common post-birth warning signs before they are discharged from the hospital. These findings also suggest that nurses need more information and guidance on how to teach all women about the post-birth warning signs.

Routine availability of immediate postpartum LARC methods: effect on nursing attitudes and practices

Objectives: Nurses play an integral role in intrapartum and postpartum patient education. This study aims to assess the attitudes, knowledge and practices of labor and delivery and postpartum nurses regarding postpartum contraception and evaluate for changes in these measures 1 year after an institutional initiative allowing routine availability of immediate postpartum long-acting reversible contraceptive (LARC) methods. Methods: In 2014, Montefiore Medical Center began an initiative to routinely offer comprehensive immediate postpartum contraception. The initiative included nursing educational and feedback sessions on postpartum contraception, including immediate postpartum initiation of a LARC method. Anonymous surveys were completed at the beginning of the initiative and repeated after 1 year. Descriptive statistics were obtained, baseline and 1-year results were compared using chi-square tests and multivariate regression was used to evaluate associations. Results: The sample consisted of 59 nurses at baseline and 56 after 1 year. The proportion of nurses who stated they counseled patients on contraception always or most of the time increased from 46% to 71% (p=.005). The proportion who would recommend the IUD and implant for postpartum contraception increased from 2% to 32%, (adjusted OR, 20.7; p=.005). Attitudes toward the injectable for breastfeeding women remained negative: 46% at baseline and 61% at 1 year agreed with the statement that DMPA has a negative effect on breastfeeding. Conclusions: Experience working in a location with routine access to immediate postpartum contraception is associated with increased awareness among nurses of postpartum contraceptive options, especially LARC methods and increased contraceptive counseling. Concerns about the impact of hormonal contraception on breastfeeding, specifically DMPA, are persistent and prevalent.

Interprofessional Participation in a Statewide Collaborative to Recognize and Treat Hypertension in Pregnancy

Poster Presentation Objective To standardize the identification and treatment pregnant/postpartum women presenting with blood pressures ≥ 160 and/or ≥ 105 within 30 minutes of validated elevated blood pressure. Design Plan‐do‐study‐act cycles (PDSA) were used to implement the evidence‐based guidelines from the California Maternal Quality Care Collaborative (CMQCC) Preeclampsia Toolkit. Physician, pharmacy, and nursing staffs were educated on the guidelines and the acute hypertensive order set developed by the Memorial Care Women's Best Practice Team. The team actively participated in the CMQCC Preeclampsia Collaborative. Sample All pregnant/postpartum women presenting perinatal care areas with elevated blood pressures. Methods Initial elevated blood pressures are reevaluated within 15 minutes using a manual sphygmomanometer and appropriate size cuff. Physicians are contacted, the acute hypertensive order set is initiated, and labetalol or hydralazine are immediately administered. Blood pressures are reassessed every 15 to 20 minutes and medication treatment is continued until blood pressures reach values less than threshold. Upon event completion, a debrief is conducted. Implementation Strategies Perinatal nursing staff were educated on the use of a manual sphygmomanometer and choice of appropriate cuff. A self‐learning module with competency evaluation was required. Postpartum nurses were taught to administer intravenous hydralazine. Physicians were provided written communication of the new protocol and order set. The pharmacist assured that the necessary level of drugs was in stock. Rolling manual blood pressure kits with assorted cuffs and guidelines were distributed. Electronic message boards were used to continually educate staff. Debrief forms provided feedback to the implementation team to complete PDSA cycles, enhance adherence to the guidelines, and improve feedback to staff. Results The baseline data from April 2013 indicate that 14.3% of women with blood pressures meeting the criteria were treated. By June 2014, 84.2% were treated within 30 minutes and 89.5% were treated within 60 minutes. Conclusion/Implications for Nursing Practice Understanding the potential for maternal morbidity and mortality has increased the recognition of care providers and enhanced the treatment of acute hypertension. Methodology and implementation strategies were effective in achieving the standardized identification and treatment of pregnant/postpartum women presenting with hypertension. Unanticipated challenges included providing training in the basic fundamentals of blood pressure measurement and obtaining institutional approval for intravenous hydralazine to become standard practice for postpartum nurses. Next steps in nursing practice include evaluation of hypertensive patient within one week of hospital discharge and implementation in the emergency department.

OHEP: An Oral Health Education Program for Mothers of Newborns

IntroductionThe purposes of the study were to determine (a) the knowledge base of mothers of newborns on oral health for newborns and young infants and (b) the effectiveness of an oral health education program provided to mothers of newborns prior to discharge from the postpartum unit. MethodsNinety-four mothers of healthy newborns on a postpartum unit were randomized to the treatment or control group. A pretest was administered to each mother to assess the mother's knowledge of infant oral health. The treatment intervention was a DVD designed collaboratively by an interprofessional team of nurse practitioners and dental faculty to educate the mothers on oral health care for their newborns. The control intervention was a DVD on newborn nutrition. All participants received routine newborn nursery discharge instructions by the postpartum nurses and physicians. Follow-up appointments were scheduled 6 and 12 months later for administration of the posttest to the mothers and for oral health assessments of the infants. ResultsPretest questionnaire results revealed that most mothers lacked knowledge about oral health care for infants and young children, especially concerning vertical transmission of streptococcus mutans through food-sharing practices. In addition, 28.4% of the mothers were not aware of the benefits of fluoride as a prevention strategy for dental caries. A significant no-show rate for the planned follow-up visits in the dental clinic hindered our plans to evaluate the effectiveness of the oral health educational program on prevention of dental white spots or decay when the study infants were 6 and 12 months old, respectively. DiscussionThe knowledge deficit of mothers of newborns regarding oral health care for infants may be one of the contributing factors to the high prevalence rate of dental caries in children younger than 71 months. An oral health educational program provided to mothers on the postpartum unit prior to discharge from the hospital may help increase mothers' knowledge about oral health care and prevention of dental caries in infants and young children.

Providers’ Perceptions of Medical Interpreter Services and Limited English Proficiency (LEP) Patients

Patient’s ability to understand and effectively communicate health information facilitates disease prevention, self-management of illness, the adoption of healthy behaviors, and their ability to act on important public health information. However, patients who have limited English proficiency (LEP) are significantly disadvantaged. Previous studies have shown the benefit of medical interpreter services in bridging the health communication gap between patients and providers. This qualitative study, focusing on medical interpreter utilization within obstetrical and neonatal services, provides perspectives from multiple types of providers to further explore the role of medical interpreter services and specific barriers to the use of such services. Five separate focus groups were conducted with postpartum nurses, labor and delivery/triage nurses, obstetrics and gynecology (OBGYN) resident physicians, neonatal intensive-care unit (NICU) nurses, and faculty physicians, nurse practitioners, and midwives. The data show that barriers to the utilization of professional medical interpreters can be categorized by distinct but related institutional- and individual-level factors. Further interpretation of the barriers, however, suggests that providers’ use/non-use of interpreter services is merely one piece of a much “bigger picture” regarding difficulties and challenges in delivering care to a growing culturally diverse patient population, and that these cultural challenges, not just the availability of interpreter services, may affect providers’ ability to deliver effective and efficient care. It is argued that simply adding additional communication-based resources may not be sufficient to impact providers’ attitudes and behaviors or the overarching organizational culture regarding LEP patients.

Nurses’ Current Breastfeeding Knowledge: An Evidenced-Based Change Project

Nurses are accountable for providing current evidence-based information to patients in the clinical setting. Postpartum nurses are in the forefront of supporting exclusive breastfeeding rates to comply with professional and national standards. The aim of this project was to compare postpartum nurses’ current breastfeeding knowledge and the immediate effects of an educational session encompassing 3 common clinical practices (separation of mother and newborn, formula supplementation, and pacifier use in breastfeeding newborns) that are considered barriers to exclusive breastfeeding. The outcome indicated the nurses’ current breastfeeding knowledge or an increased their breastfeeding knowledge before and after the educational session.

The Effect of a Postpartum Nursing Intervention Program for Immigrant Mothers.

PURPOSE: The purposes of this study were to develop a postpartum nursing intervention program for immigrant women and evaluate the effects on postpartum depression, child rearing confidence, home environment, and infant temperament.METHODS: This research was a non-equivalent control group pre-test and post-test design. Participants were pregnant immigrant women from China, Vietnam, and the Philippines residing in Kyunggi province and Seoul. Twenty women were assigned to the intervention group, and 19 women to the control group. For the intervention group, the women were visited at home and provided emotional support and parenting education for three months. To analyze the intervention effects, repeated measure ANOVA and t-test were used.RESULTS: Child rearing confidence was higher in the experimental group than the control group at interaction effect of time and group, six weeks and three months postpartum. However, there were no significant effects for maternal depression, infant temperament, and husband support. Home Observation for Measurement of the Environment (HOME) score in the experimental group was higher than that of the control group at three month postpartum.CONCLUSION: Results indicate that the nursing intervention program had positive effects and can be used to further the health status of immigrant mothers and children.

The effect of responsibility grouping nursing on self-care ability and psychological state of puerpera

Objective To investigate the application effect of responsibility grouping nursing in postpartum care for puerpera.Methods A total of 80 cases of primipara were divided into the observation group and the control according to different nursing methods,the control group was given routine postpartum nursing,and the observation group was given responsibility grouping nursing.Results Self-care skills,health knowledge,self responsibility,self-care ability scores in the observation group were significantly higher than those in the control group (P ＜ 0.05).Breastfeeding,hip bath care,and other aspects of the knowledge scores of neonatal nursing in the observation group were significantly higher than those in the control group (P ＜ 0.05).The score of SAS,SDS in the observation group were significantly lower than those in the control group,nursing satisfaction was significantly higher than that in control group,the hospitalization time was significantly shorter than that in the control group (P ＜ 0.05).Conclusions Responsibility grouping nursing can effectively improve the postpartum nursing quality and maternal self-care ability,reduce the adverse psychological. Key words: Responsibility grouping nursing; Postnatal care; Self-care ability; Psychological state

The effect of postpartum individualized nursing on breast-feeding and life quality of puerperal women

Objective To explore the application effect of postpartum individualized nursing care in the postpartum nursing.Methods A total of 100 cases of puerperal women were divided into the observation group and the control group according to different postpartum nursing methods,the control group was given routine nursing,the observation group was given postpartum individualized nursing,nursing effects were compared between the two groups.Results Initial time of lactation in the observation group was shorter than that in the control group,breast milk to meet the newborn in 72h and breast-feeding rates were significantly higher than those in the control group (P ＜ 0.05).maternal role adaptation,nursing satisfaction score in the observation group was significantly higher than that in the control group,postpartum depression scores were significantly less than those in the control group (P ＜ 0.05).Life quality scores in the observation group were significantly higher than those in the control group (P ＜ 0.05).Conclusions Postpartum individualized nursing is helpful to improve the maternal role adaptation,promote early lactation and life quality. Key words: Postpartum nursing; Individualized; Breast-feeding; Life quality

Designing Adult Code Simulations for Antepartum and Postpartum Nurses

Poster Presentation Purpose for the Program To improve the ability of nurses in the postpartum and antepartum units to respond in the event of a maternal code. Even very experienced nurses expressed that though they knew how to perform cardiopulmonary resuscitation, the maternal code experience was overwhelming and they felt unprepared. Proposed Change The leadership of the antepartum and postpartum units and the nursing simulation faculty at the hospital collaborated to propose a simulation‐based learning experience for the registered nurse (RN) staff of these units. Simulation‐based learning provides an opportunity to practice skills in a safe environment while helping the nurse develop critical thinking skills, promote effective communication, and work collaboratively with other members of the team. Implementation, Outcomes, and Evaluation Over a period of months, the program faculty (simulation staff, nurse educators, and staff nurses) created two maternal code simulations. The final program involved three stages: skills sessions, simulated code scenarios, and debriefings. During the skill sessions the staff reviewed skills, such as use of the defibrillator, contents of the code cart, medications used in a code, and communication techniques. The participants toured the simulation lab before the actual simulation to see how the room was set up and how the manikin worked. When it was time for each scenario, participants were given role cards to remind them of critical activities during a code. The primary nurse received a report on the mock patient and the simulation started. One half of the group participated in each simulation whereas the other half watched the scenario on a live feed in a conference room. Immediately after each scenario a debriefing session took place. Consistent themes during debriefing included discussions about the role of the nurse in a code situation, effective communication in an emergency, and the value of effective team work. Without exception, results of the 196 written evaluations indicated that staff nurses felt more knowledgeable and confident about adult codes after the simulation. Implications for Nursing Practice Based on the overwhelming positive feedback of simulation‐based learning, the program was offered again the following year to all RN staff. Anecdotally, many nurses in the second year of the simulation program commented that they also felt more confident in other emergencies in the units after having participated in the maternal code simulation the previous year. The current plan is to offer simulation‐based learning experiences to all RNs in the antepartum and postpartum units annually.

Protótipo de sistema de documentação em enfermagem no puerpério

OBJETIVO: Desenvolver protótipo de sistema de documentação em enfermagem no puerpério. MÉTODOS: Planejamento de software utilizou modelo baseado em orientação a objetos, que englobou: compreensão e definição do contexto e dos modos de utilização projeto de arquitetura do sistema, identificação dos principais objetos do sistema, desenvolvimento dos modelos do projeto, especificação das interfaces dos objetos. Foram utilizadas as linguagem Structured Query Language (SQL), MySQL e Hypertext Preprocessor (php). RESULTADOS: O protótipo apresenta os requisitos planejados, entre eles: uso da Classificação Internacional para a Prática de Enfermagem (CIPE®) versão 1.0 como código de apoio para execução do processo de enfermagem; apresentação dos eixos da CIPE® versão 1.0 em ordem de uso; geração de relatórios sobre a prática de uso dos processos de enfermagem. CONCLUSÃO: O protótipo de sistema de documentação proposto foi desenvolvido com sucesso com possibilidade de registros de enfermagem por meio de linguagem padronizada.