MCN. The American journal of maternal child nursing
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MCN Am J Matern Child Nurs · May 2012
Nurse-led education mitigates maternal stress and enhances knowledge in the NICU.
Maternal stress common to the neonatal intensive care unit (NICU) experience often impairs bonding, plays a role in postpartum depression and anxiety, and decreases maternal milk production. This study evaluated the effect of a nurse-led intervention pertaining to the experience of having a baby in the NICU on maternal stress in a population of high-risk pregnant women at three different time points. ⋯ Nurse-led patient education is an effective intervention strategy when aiming to reduce maternal stress in the NICU. Family-centered interventions tailored to the care of the high-risk mother and infant can improve patient outcomes.
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To understand women's experiences as older first-time mothers during the transition to menopause. ⋯ Increasingly, nurses and nurse midwives will be caring for women aged 40 and older as they navigate motherhood during the transition to menopause. Through their stories, women can share concerns they have about mothering at an older age, and the effect of perimenopausal symptoms on their mothering experiences. Nurses should offer anticipatory guidance to women who delay motherhood until midlife, provide information about the transition to menopause, and assess the older mother's level of social support. Nurses can help build capacity for support within community and professional resources, such as hospital supported mother/baby and breastfeeding support groups.
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As any perinatal nurse knows, retained vaginal sponges are an obstetrical and postpartum patient safety problem. As surgical sponge counts are not routine in some obstetrical units for vaginal births, our healthcare system chose to institute a rigorous process to eliminate retained sponges in all vaginal births. This article describes this process, along with the lessons learned, when Catholic Healthcare West implemented the Sponge ACCOUNTing System in its 32 hospitals in California, Arizona, and Nevada. Implementation of this process involved the standardization of practice for obstetricians, certified nurse midwives, nurses, obstetric technicians, radiologists, and radiology technicians in the management and accounting of surgical sponges.
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MCN Am J Matern Child Nurs · Sep 2011
Case ReportsA state-wide obstetric hemorrhage quality improvement initiative.
The mission of the California Maternal Quality Care Collaborative is to eliminate preventable maternal death and injury and to promote equitable maternity care in California. This article describes California Maternal Quality Care Collaborative's (CMQCC's) statewide multistakeholder quality improvement initiative to improve readiness, recognition, response, and reporting of maternal hemorrhage at birth and details the essential role of nurses in its success. ⋯ In participating hospitals, nurses have been the primary drivers in developing both general and massive hemorrhage policies and procedures, ensuring the availability of critical supplies, organizing team debriefing after a stage 2 (or greater) hemorrhage, hosting skills stations for measuring blood loss, and running obstetric (OB) hemorrhage drills. Each of these activities requires effort and leadership skill, even in hospitals where clinicians are convinced that these changes are needed. In some hospitals, the burden to convince physicians of the value of these new practices has rested primarily upon nurses. Thus, the statewide initiative in which nurse and physician leaders work together models the value of teamwork and provides a real-time demonstration of the potential for effective interdisciplinary collaboration to make a difference in the quality of care that can be achieved. Nurses provide significant leadership in multidisciplinary, multistakeholder quality projects in California. Ensuring that nurses have the opportunity to participate in formal leadership of these teams and are represented at all workgroup levels is critical to the overall initiative. Nurses brought key understanding of operational issues within and across departments, mobilized engagement across the state through the regional perinatal programs, and developed innovative approaches to solving clinical problems during implementation. Nursing leadership and integrated participation was especially critical in considering the needs of lower-resource settings, and was essential to the toolkit's enthusiastic adoption at the unit/service level in facilities across the state.