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Introduction & Background Black infant mortality rate is 122% higher than that of non-Hispanic white infants. In a 2021 CDC study, Black women’s maternal mortality rate was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White women. Purpose Statement & Research Question The purpose of our research was to explore reasons why Black maternal mortality is higher than White and non-Hispanic populations and what contributing health disparities are causing higher mortality rates in black infants and mothers compared to their non-Hispanic white counterparts, in the United States. Literature Review: We found articles under 5 years old from Cinhal database. Findings Examples of inclusion and exclusion criteria in our studies included: ages between 18-39, whether they had hypertension during pregnancy, or were between 22-43 weeks of gestation. Main findings from our studies include mistrust between health providers and the black pregnant women negatively impacted their adherence to safe sleep practice, and 32% of women in another study reported that they were not able to initiate their first prenatal care visit as early as preferred due to a myriad of barriers. Conclusions & Nursing Interventions The take-home message of our studies was that disparities are multifactorial. Some major nursing implications we found are that perinatal nurses should assess the psychological wellbeing in Black women throughout pregnancy and advocate for Black women who report high levels of stress, depressive symptoms, or psychological distress.

Bakgrund: Kängurumetoden (KMC) utgör en vital del av omvårdnaden av det för tidigt födda barnet. Metoden innefattar tre olika delar: hud-mot-hudkontakt mellan barn och förälder, exklusiv matning med bröstmjölk och strävan efter en tidigare hemgång alternativt flytt till en lägre vårdnivå. Evidensen för KMC belyser de positiva hälsoeffekterna som metoden har på barnet och dessutom lyfts metodens bidrag till att främja anknytningen mellan barnet och föräldern samt familjecentrerad omvårdnad. Vårdtiden på neonatalavdelningen är ofta förenad med separation mellan barn och förälder, något som kan motverkas med KMC. För en förbättrad implementering av metoden som rutin på neonatalvårdsavdelningar krävs en ökad förståelse för föräldrarnas upplevelser av KMC. Syfte: Syftet var att undersöka föräldrars upplevelser av att vårda sitt för tidigt födda barn med kängurumetoden på neonatalvårdsavdelning. Metod: Litteraturstudie med beskrivande design som inkluderade nio originalartiklar av studier med kvalitativ ansats från databaserna PubMed, CINAHL och Web of Science. Resultat: Föräldrarnas upplevelser presenterades utifrån fyra teman: (I) förutsättningar för KMC, (II) emotionell upplevelse av KMC, (III) upplevd påverkan på barnet och (IV) teamwork & jämställdhet. Föräldrarna beskrev KMC som en övervägande positiv och känslosam upplevelse som bidrog till att etablera föräldrarollen och främja den tidiga anknytningen. Samtidigt lyfte de vikten av en lugn och bekväm miljö, vårdpersonalens stöd och tillräckligt med information om KMC för att kunna genomföra metoden. Slutsats: KMC var en uppskattad metod hos föräldrar och beskrevs som essentiell för anknytningen. Föräldrar upplevde en rad faktorer som förutsättningar för utförandet av KMC. Dessa faktorer går att påverka i omvårdnadsarbetet och därför betonas sjuksköterskans väsentliga roll i främjandet av kängurumetoden. / Background: Kangaroo mother care (KMC) is a vital part of the care of the premature infant. The method includes three different aspects: skin-to-skin contact between infant and parent, exclusive feeding with breast milk and the pursuit of an earlier hospital discharge or transition to a lower level of care. The evidence for KMC highlights the positive health effects that the method has on the infant, while also describing the method's contribution to foster both bonding between infant and parent, as well as family-centered care. Care of the infant in neonatal care units (NICU) is often associated with separation between child and parent, which can be counteracted with KMC. For an improved implementation of the method as a routine in NICUs, an increased understanding of parents’ experiences of KMC is required. Aim: The aim was to investigate parents' experiences of caring for their premature infant with the kangaroo method in the NICU. Method: A literature review with a descriptive design that included nine original articles of studies with a qualitative approach from the databases PubMed, CINAHL and Web of Science. Results: The parents' experiences were divided into four themes: (I) preconditions for KMC, (II) emotional experience of KMC, (III) perceived impact on the infant and (IV) teamwork & equality. Parents described KMC as a predominantly positive and emotional experience that helped establish the parental role and nurture the early attachment. Simultaneously, they highlighted the importance of a calm and comfortable environment, the support of the healthcare staff and sufficient knowledge of KMC to be able to implement the method.Conclusion: KMC was valued by parents and described as essential for attachment. Parents perceived many factors as preconditions for the implementation of KMC. These factors can be influenced by nursing care and therefore the essential role of the nurse in the promotion of KMC is emphasized.

Simulation is a critical component of nursing education. It provides a safe environment to practice and evaluate skills, supplements clinical hours, and removes barriers to a well-rounded education. Nurses are expected to be educators as part of our scope of practice, and simulation can facilitate this. One topic of nursing importance is lactation education, as breastfeeding has been shown to have multiple benefits for both mother and baby. National rates of exclusive breastfeeding for the first 6 months do not currently meet CDC recommendations. The pedagogy known as the Protégé Effect suggests that learning can be improved through teaching. Breastfeeding is a topic that inherently involves patient education but is currently given minimal attention in most nursing curricula. The purpose of this thesis is primarily to determine whether breastfeeding education within simulation improves student self-efficacy and secondarily, to explore the ramifications on clinical performance. A literature review was conducted across CINAHL, MEDLINE, Applied Science & Technology Source, ERIC, ScienceDirect, and Google Scholar to find studies comparing breastfeeding education to student self-efficacy within a simulated environment. Inclusion criteria included medical and nursing students at undergraduate- and graduate-level education, full text, written in English, and any student-led teaching opportunities about lactation and breastfeeding. After critical appraisal, 8 qualitative and quantitative articles were included in the study. Current literature strongly suggests breastfeeding simulations improve self-efficacy, but the findings are preliminary in nature. More research is needed. Including breastfeeding education in simulation can better prepare nursing students to assume their role as educators.

The purpose of this research is to evaluate the coping strategies of families and childbearing women after intrauterine fetal demise and early infant death. The secondary purpose is to examine the effect of grieving strategies after intrauterine fetal demise compared to early infant death on time until subsequent pregnancy in women of childbearing age. A literature review exploring parental grief and coping strategies to cope with loss and its effect on the subsequent pregnancy was conducted from various online databases. All reviewed articles in the analysis indicated that coping strategies consist of a diverse number of mechanisms during the bereavement process. Results show that positive mechanism such as talking about the experience of fetal and infant death was beneficial in the grieving journey and showed a positive correlation to a shorter time to subsequent pregnancy. Identification of strategies to improve mental health in women after fetal demise and early infant death are of value to pregnancy counseling following demise and improving time to conception outcomes after emotional trauma caused by perinatal loss. There is great value in understanding the connection between conception after the early death of an infant and intrauterine fetal demise in helping healthcare providers support family planning goals.

Perineal lacerations can be caused by a variety of risk factors such as a large fetal head circumference, birthing positions that place strain on the sacrum, and first-time births. Preventing perineal tears can be challenging for laboring women. Exploring the possible prevention methods to decrease the severity of perineal tearing or preventing it altogether can be beneficial for laboring women's physical and mental health. The primary purpose of this literature review was to examine which interventions are most likely to prevent perineal tearing during childbirth. The secondary purpose was to evaluate natural perineal tears in comparison to surgical incision, or episiotomy, and the time to recovery outcomes. A comprehensive literature review examining various prevention methods was conducted from several databases. Peer-reviewed research articles from 2003-2022 regarding the use of perineal massages, birthing positions, manual perineal protection, warm compress, and Kegel exercises were analyzed and included in this literature review. Although many articles suggested factors such as large fetal head circumference and first-time childbirth were factors often challenging to manipulate, the data indicates that several prevention methods may prove to be beneficial in limiting the severity of perineal tearing.

Background: Parents of NICU patients have high stress levels compared to other populations, which negatively impact their mental health. The kangaroo care (KC) method has been used for its numerous benefits for infants, but not as widely studied for its impacts on parental stress. The purpose of this integrative literature review is to examine and synthesize the existing evidence regarding kangaroo care and its impact on the stress levels of NICU parents. Methods: A literature search was conducted utilizing CINAHL Plus with Full Text, MEDLINE, and APA PsychInfo databases to identify relevant articles. Articles were included if they were published within the last five years (2018-2023), discussed parental subjective and/or objective measures of stress, and implemented a KC intervention in the NICU. A total of seven articles were analyzed and synthesized. Results: Key findings in this review included how KC is implemented and its effects on subjective and objective stress. Findings from all seven articles demonstrate that KC is effective in decreasing cortisol, increasing oxytocin, and decreasing subjective parental stress. Discussion: KC as an intervention for stress reduction for NICU parents showed an overall positive effect on parental stress measures. It may be beneficial for NICU providers to encourage KC not only for the positive benefits on the infant, but for the positive effects it can have on parental stress. However, additional research is necessary in subsequent populations, geographical locations, and with different measures of stress to improve generalizability of the results.

Problem: Necrotizing Enerocolitis (NEC) is one of the leading causes of morbidity and mortality in neonatal intensive care units (NICU), affecting 7% to 14% of premature neonates weighing less than 1500g (Lin et al., 2008). Healthcare costs for the treatment of NEC account for roughly 20% of the 5 billion dollars spent on infants in the NICU annually (Gephart, McGrath, Effken & Halpern, 2012). Nutritional supplements, such as probiotics, may be used prophylactically to prevent NEC in this high-risk population. Objective: A literature review was performed to examine which strains of probiotics show the most potential in reducing the incidence of necrotizing enterocolitis. Method: A literature review was performed using CINAHL, Science Citation Index, Science Direct, Medline, Academic One file, PsychINFO, and PUBMED databases. Key words included enterocolitis, Necrotizing*/PC OR NEC* AND probiotics*. After applying exclusion criteria, 9 articles remained for this review. Results: A variety of probiotic strains used to reduce the incidence of NEC were identified, along with inconsistent times of initiation, number of colony forming units and length of treatment. The most commonly studied probiotic strains include Lactobacillus species, Bifidobacterium species, and Saccharomyces species. After detailed analysis, it appears that a combination of Bifidobacterium species and Lactobacillus species reduce the incidence of NEC from an 8% (Fernández-Carrocera et. al, 2013) reduction up to 100% reduction in the incidence of NEC (Braga, Pontes da Silva, Cabral de Lira, & Lima, 2011). These two species, when combined, were more successful when compared to Saccharomyces species or Lactobacillus species alone. Conclusion: Although there is positive support for the proactive use of probiotics for the reduction of the incidence of NEC in premature neonates, the inconsistencies between studies are a barrier for determination of a specific treatment recommendation. Although the combination of Bifidobacterium species and Lactobacillus species has been shown to have an impact on the reduction of NEC incidence, the research inconsistencies provide a barrier to generalizations for treatment. Additional research that focus on Bifidobactrium species in combination with Lactobacillus species is needed. Furthermore, the use of probiotics as a preventative treatment for NEC has not been thoroughly researched in extremely premature infant populations (gestation). Therefore, although the results are promising, further research is needed before this can be determined as a safe preventative method. The current questions remaining include: when prophylactic treatment should be initiated, how long prophylactic treatment should last, the number of colony forming units to be administered, and what is the long-term impact of probiotic administration on the normal gut flora, if any.