CoHP - SoN - Student Works

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RACIALLY CONCORDANT CARE IN THE TREATMENT AND PREVENTION OF POSTPARTUM DEPRESSION IN AFRICAN AMERICAN WOMEN
(2023-04-20) Nyambo, Leslie; Bedi, Sarah
Postpartum depression (PPD) is part of the postpartum mood disorders experienced by women during the postpartum stage. It is characterized by feelings of extreme sadness, depressed mood, and loss of interest in formerly liked activities (Liu et al., 2015). Postpartum depression (PPD) is an ongoing issue notably for African American women. Ethnic, cultural, physiological, and demographic factors all play a role in the high prevalence of PPD in African American women compared to Caucasian women. Racially concordant and culturally aware peripartum care is crucial in the prevention, and treatment of PPD among African American women. Racially concordant care is one that is provided by a healthcare provider of the same racial or ethnic background as the patient (Shen et al., 2019). Its preference among minority populations is vastly due to the evidence that it greatly reduces instances of racism and bias, and increases patient satisfaction (Shen et al., 2019). The review method of the research was done using the PICO question, “In African American women, what is the effect of racially concordant perinatal care on the prevention and treatment of postpartum depression compared with discordant care within the postpartum period?” Using CINAHL Ultimate database, research of relevant literature was conducted using the following key terms: African American women, racially concordant care, and postpartum depression. Evidence-based practices such as racially concordant care and culturally-aware practices are important and should be implemented in nursing education as part of lowering health disparities. While racially concordant care for every African American mother might not be feasible, nurses that are informed and able to provide culturally sensitive screenings and postpartum care are crucial in decreasing the prevalence of postpartum depression in African American women.
The Opioid Crisis: A Primary Care Perspective
(2023-05) Day, Cheyanne L.
Cannabis has been medicinally used for thousands of years. It has been studied extensively for many years and is now legal in thirty-eight states due to its analgesic properties and potential to reduce opioid addiction. Chronic pain affects an estimated fifty million adults in the United States, and in the next ten years, it will cost over ten billion dollars annually. As a result of the high number of opioid prescriptions leading to overdoses and deaths, many policymakers, clinicians, and providers are considering alternative pain management options. This Capstone Project aimed to explore and analyze the most current scientific and empirical evidence relating to medical cannabis as an alternative treatment to opioids for chronic pain. The question that guided the project was, in adults 18 and over, does the use of medical cannabis, compared to opioids, result in improved pain management within a six-month period? Evidence suggests that cannabis is a promising alternative to opioids and supports medical cannabis as a treatment option for chronic pain management. As a result of this research, it is hoped that current and future providers can apply it to their practice when treating chronic pain.
Domestic Violence and Children’s Mental Health
(2023-05) Thompson, Zainab
Exposure to domestic violence is a significant predictor of children’s mental health problems. Children exposed to domestic violence will likely develop internalizing and externalizing disorders, substance abuse disorders, poor school outcomes, and a lack of prosocial behaviors (Colizzi et al., 2020). Exposure to family violence contributes to adverse childhood experiences (ACEs), which are linked to causing trauma and long-term psychological distress (Lloyd, 2018). Most mental health problems begin during the teenage years when children encounter ACEs and continue to adversely affect them in adulthood (Colizzi et al.). Children's mental health problems become a burden to the guardians, community, and society and are associated with increased healthcare costs (Orr et al., 2020). Therefore, preventing mental disorders development and reinforcing resilience in violence-exposed children is thus relevant to evade these negative consequences. The project aimed to identify the effects of family or domestic violence exposure on children, the protective and risk factors that influence the effects of violence exposure, and the intervention applicable to prevent violence-exposure effects for children aged below thirteen years. The project’s recommended intervention is a public health preventive approach at the primary, secondary, and tertiary levels to prevent violence-exposed children from developing mental health problems and disorders. Specifically, the intervention will include mindfulness training, cognitive behavior therapy, psychosocial fulfillment, and learning to regulate social and emotional responses to challenges faced, which will help prevent the development of mental health problems in children and teenagers. The reviewed literature suggests that the intervention should be evidence-based, and population-based, incorporate risk assessments and promotion of protective factors, integrate multisector and multilevel collaboration, and be operationalized within a socio-ecological framework (Carlson et al., 2019; Colizzi et al. ; Eriksson et al., 2022; Fong et al., 2019). Eventually, the intervention will reinforce resilience and positively 3 influence the mental health of at-risk and violence-exposed children to offer a better quality of life. Catering for children facing developmental adversity is essential to prevent negative consequences later in life. Future research should focus on how to best implement this intervention that specifically targets violence-exposed children and their mental health.
Effects of Distraction Techniques During Immunizations
(2023-05) Walker, April M.
Routine vaccine injections are some of the most common painful procedures during childhood especially when they are administered without adopting any pain management practice. According to the Center for Disease Control and Prevention (2022), an experience of pain is a biological component that makes some people react very strongly to the idea of procedures involving a needle. Pain from a needle is usually not severe but the brain still focuses on it. Therefore, managing the pain can reduce fear and avoidance of medical care during childhood related experiences of painful procedures such as immunizations. The purpose of this project is to determine if the use of distraction techniques vs. no distraction techniques during immunizations decrease pain levels. An Evidence Based Practice (EBP) conceptual framework will be used to provide evidence that distraction techniques during childhood immunizations decrease pain levels. The expected outcome of this project is to increase awareness of the use of distraction techniques vs. no distraction techniques while administering immunizations to children. The hope is that this study will prove effective for implementing distraction techniques for children receiving immunizations and provide education for healthcare facilities, healthcare providers, and parents to implement appropriate pain and distress management strategies during future vaccinations (Ouach et al., 2019).
Mindfulness-Based Intervention to Prevent Burnout in Healthcare Professionals
(2023-05) Richardson, Chester J.
Background: Burnout appears to effect two thirds of providers, and has been steadily rising among healthcare providers, with more than one third of healthcare providers meeting criteria for severe burnout, with nurses that have experienced burnout being 2 to 3 times more likely to leave their positions (Vells et al., 2021). The risk of burnout in healthcare providers is high, 78% of physicians, 44.2% of medical students, 45% of residents, and 50% of nurses in the United States reporting some type of burnout in their careers (Chemali et al., 2019). Purpose: The purpose of this review of the literature is to explore the current knowledge for the expected positive effects and the ability to implement a stress reduction intervention, such as mindfulness meditation, to prevent burnout in healthcare workers. Methods: Key words used for the literature search included: nurses, healthcare professionals, physicians, mindfulness, meditation, burnout, burnout prevention, mindfulness based stress reduction, MBSR, and stress. Studies required both a mindfulness based intervention and the testing of outcomes to assess for the correlation between the interventions and outcomes. Findings: The review of the literature showed a reduction in burnout symptoms, indicating that mindfulness-based interventions to reduce burnout among healthcare professionals in the hospital setting is promising. Conclusions: Mindfulness-based stress reduction interventions can be a promising tool to better the lives of those that give direct care to patients, families, and communities. Given the positive outcomes the research has shown in preventing and reducing burnout in healthcare professionals, MBSR therapies are a potential cost saving and quality of life improving intervention that can be provided to a wide reaching group of individuals.
Improving Recognition of Postpartum Depression Using A Standardized PHQ-9 Score
(2023-05) Morrill, Rebecca
Current screenings for postpartum depression (PPD) lack evidence-based standardized guidelines regarding tools, frequency, and timing. A lack of consensus on critical PPD screening scores exists causing gaps in care regarding when to refer women for further mental health services. Providers indicate their schedule is too busy to conduct meaningful interviews with patients thus leading to lack of assessments all together. Gaps exist with implementation protocols as well as training for staff. The purpose of this study is to determine if identification of a patient with a Patient Health Questionnaire-9 (PHQ-9), set as the standard screening tool, of a score of ten or higher should receive a referral for mental health treatment. Furthermore, to disseminate a synthesis of evidence regarding screening for PPD to include suggested intervals of screening, and identification of at-risk patients who score high on the PHQ-9. The effects of PPD can extend long after the neonatal period, threatening the life of the mother-infant dyad if missed. Research indicates only twenty percent of women who screen high for PPD will actually obtain mental health services, even though by the year 2030 PPD is predicted to be the second largest health problem. Literature and evidence indicate that screenings completed within two days of birth are able to identify how likely a patient is to develop anxiety or depression up to a two to eight-week period postpartum. A comprehensive literature review was conducted and yields high level evidence recommending the use of the PHQ-9 as a widely validated tool for screening for depression in the perinatal setting. Compared to existing tools such as PHQ-2, WHO-5, and EPDS, evidence determined PHQ-9 to have the highest validity and reliability for screening against minor depressive symptoms. Strong evidence suggests a cutoff score of 10 and above for identification of depression. When applied to the perinatal population, a cutoff score of 10 is useful for clinicians to initiate referral. Implementing the PHQ-9 tool at standard intervals, 3 applying a standard cutoff score for referral and recognizing at-risk mothers for PPD will further decrease associated mortality with untreated PPD and improve the mother-infant bond.
THE EFFECT OF THE JADA DEVICE ON POSTPARTUM HEMORRHAGE IN THE FIRST 24 HOURS
(2025-04-17) Dow, Hazel; Bedi, Sarah
Postpartum hemorrhage (PPH), an extreme loss of blood after birth, is the leading cause of maternal mortality worldwide. 80% of the time, this is due to uterine atony. The uterus is tired after birth and remains completely relaxed. A woman experiencing PPH can bleed out and die in minutes. In the past, controlling a PPH took hours utilizing traditional uterotonic medications and balloon-tamponade devices. Women frequently lost their uterus and were left with lifelong reproductive issues. However, now, we can solve this problem in as little as three minutes with the Jada Device. The Jada device was created in 2011 and FDA approved in 2020. It is a vacuum-tamponade device. It is inserted into the atonic uterus and suctions it, forcing it to clamp down and stopping the hemorrhage. A balloon-tamponade device is simply inflated and puts pressure on the walls of the uterus. The Jada device, however, treats the cause of the hemorrhage (uterine atony) instead of simply masking it, as the balloon device does. Right now, the Jada device is in 2,000 hospitals nationwide. However, there are over 6,000 in the nation total, not to mention the rest of the world. The risk for fatal PPH skyrockets in underdeveloped countries. This device needs to be put into every hospital in every country in the world. The Jada device is the solution for PPH when traditional uterotonics have failed. A balloon tamponade system is 87% effective, while the Jada system boasts 94% efficacy. Other options are surgical intervention, which is risky and likely not available in underdeveloped countries and rural areas. The Jada device can be used anywhere and by almost anyone.

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