Traditionally, the lithotomy position is the most commonly used birthing position in western cultures. The purpose of this literature review was to examine the differences in maternal and neonatal outcomes when alternative labor positions are used. Implications for future use of alternative labor positions were explored. Peer reviewed, English-language research articles published from 2009 to 2015 were included for synthesis. Study results revealed that the lithotomy position is linked to multiple negative maternal outcomes. Birthing in a water pool or in a lateral position has been linked to more optimal maternal and neonatal outcomes compared to other positions. Health care providers, and nurses in particular, should be educated on the benefits and consequences of both the lithotomy position and alternative labor positions. Using this evidenced based research, health care professionals can educate women and families as they encounter the birthing process. Further research is needed to identify additional birthing outcomes of labor positions, specifically neonatal outcomes of the lithotomy position. In addition, research on innovative obstetric monitoring techniques will expand the opportunity to use alternative labor positions while protecting the mother and fetus.

Exposure to excessive noise during a neonates stay in the neonatal intensive care unit (NICU) can create both immediate and long term health problems such as, hearing loss, neurological deficits, and sleep pattern disturbances. The use of earmuffs or earplugs to decrease the neonate’s exposure to noise can create a more stable environment to facilitate improved growth and development. The purpose of this research was to examine the use of earmuffs or earplugs to reduce the impact of noise on neonates. A systematic review of literature was conducted using online databases including CINAHL, ERIC, Ebsco Host, Medline, and PsychINFO. The search included a combination of the following terms: ‘preterm’, ‘neonate’, ‘NICU’, ‘noise’, ‘earplugs’, and ‘earmuffs’. Peer reviewed, articles published in the English language were examined that tested noise reduction devices in the NICU setting, hearing screening of neonates, and the effect of noise reduction interventions on physiologic changes in the preterm infant receiving care in the NICU. Results yielded 8 articles between the years of 1995 to 2017 which were synthesized for review. The results indicated that the use of earmuffs or earplugs in the NICU may offer a viable solution to reducing the effects of excessive noise on neonate’s growth and development. The use of earmuffs or earplugs has been shown to positively improve vital signs, increase growth, improve physiological and motor development, and improve sleep efficiency. Further research on larger sample sizes is needed in order to validate the findings and offer substantial evidence for its use in the clinical setting.

BACKGROUND: Fetal movement count (FMC) is a non-invasive tool used to evaluate fetal well-being and prevent stillbirth. FMC decrease the chances of stillbirth occurrence (Tveit et al., 2009), but in other countries, research shows that women are not taught about the benefits of FMC (Berndl, O'Connel, & Mcload, 2013). The purposes of this study were to discover 1) the knowledge of pregnant women in their third trimester about FMC and 2) sources through which women learn about FMC. METHODOLOGY: The study is a quantitative descriptive design. An original survey consisting of 12 questions was created for the study. Inclusion criteria included women who were in their third trimester (28 weeks of gestation or more), were 18 years old or older, and speak and read English fluently. Consent to take the anonymous survey was implied by completing and returning the survey. Participants were recruited from childbirth and newborn parenting classes. RESULTS: The investigator surveyed 36 women. Eighty-three percent of women (N=30) know what FMC is. All women were seen by a physician, and 50% of them (N=18) were taught about FMC by their providers. In spite of knowing what FMC is, 50% women (15 of the 30) responded incorrectly to specific questions about FMC. DISCUSSION: Women have misconceptions about fetal movement, and about the importance of FMC. This misconception can lead women to less benefit from using FMC tools. Providers need to improve their method of transmitting information about FMC and provide detailed education about fetal movement.

A fetus hears and responds to maternal sounds as early as 26 weeks' gestation. When born prematurely, a neonate may face health challenges due to overall organ immaturity and hospitalization in the Neonatal Intensive Care Unit, where developmentally important maternal sounds are replaced with routine hospital noise. A potential intervention that can provide meaningful auditory stimulation these neonates lack is implementation of maternal sound interventions. These interventions replicate the intrauterine auditory environment by playing recorded maternal speech and heart sounds in the incubator. A literature review was completed to identify effects on neurodevelopmental, nutritional, and physiological measurements this intervention may have on premature neonates. A review of the literature was conducted using the databases CINAHL Plus with Full Text, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, MEDLINE, and PsycINFO. Search terms utilized were: Voice/Sound; preterm/prematur*; neonat*/infant*/newborn; and matern*/mother*. Results were refined using limiters of peer-reviewed, publication date of 2012-2017, and English language. Twelve articles met the criteria for review. The maternal sounds intervention was found to correlate with improved neurodevelopment in the first months of life, especially relating to auditory and language areas of the brain. Nutritional outcomes were positive, but studies were inconsistent with findings. The physiological measurements were positively affected, with strong evidence of a calming effect, and lowering of the heart rate. Results indicated recorded maternal sound interventions were associated with positive health outcomes in premature neonates. Further research with larger sample sizes and uniform study designs are needed to validate the findings.

Childhood obesity is a growing epidemic in the United States that has short-term and long-term health consequences for the children affected. Nurses are patient advocates and are responsible for speaking up for the patient; in the pediatric population, a nurse must act as an advocate on behalf of the child. The purpose of this literature review is to look at different barriers to nursing interventions in regard to childhood obesity. A literature review was done by using different databases, with 11 articles having similar themes and interventions used. The main themes from the literature review were parental willingness and involvement in weight loss strategies with their child, a lack of training for nurses in the area of childhood obesity, and a lack of standardized assessment methods for charting and tracking children's weight status. The research suggests that the more involved a parent is, the more successful the child's weight loss will be. Additionally, an overall lack of training in health promotion was noted among nurses alone with a feeling of discomfort when speaking to parents and children about the child's weight, indicating a need for further education in health promotion techniques. Finally, articles did not commonly use a standardized assessment method to track weight status in the pediatric population, making cross-examination of different result difficult and points to a need for a standardized measure that is as objective as possible, such as a body fat percentage measure.

This thesis examined the experience of compassion fatigue in nurses through analysis of research studies conducted within the past ten years. A literature review was completed using CINAHL Plus with Full Text, MEDLINE, and PsycINFO databases. Efficacy of current management strategies and interventions was evaluated. Findings indicate that educating nurses working in high-risk units improves self-recognition and lowers compassion fatigue levels. Institutional factors such as a lack of managerial support and organizational commitment contribute to the experience of compassion fatigue. An organization's involvement in maximizing compassion satisfaction through meaningful recognition of nurses' contributions to care and implementation of organizational prevention programs minimizes the risk of developing compassion fatigue. Once self-recognition by nurses and organizations participation level in mitigating compassion fatigue is addressed, interventions can be implemented to attenuate the experience of compassion fatigue. Resiliency programs and mindfulness-based interventions were efficacious in mitigating compassion fatigue.

Maternal morbidity and mortality are prevalent issues worldwide that profoundly affects low- and middle-income countries (LMICs) in Africa. Estimates vary, but by the end of 2015, at least 300,000 women died in LMICs due to preventable pregnancy and childbirth conditions. Pregnant women die from complications that could be detected and managed if they were able to receive early access to necessary health interventions. Mobile technology is increasingly common across the globe, including LMICs, and incorporating digital health technologies, especially mobile phone (mHealth) programs, can offer a possible solution to morbidity and mortality related to pregnancy. A literature review analyzing the impact of mHealth programs on maternal health was conducted from various online databases. Nineteen articles that were published in the last ten years and contained technology-based interventions used for maternal health were reviewed. Inclusion criteria included countries listed as low-income and middle-income in the 2017 World Bank list of economies. The studies suggest mHealth programs have the potential to reduce maternal morbidity and mortality by increasing knowledge of safe health practices for pregnant women, community health workers, and traditional birth attendants. Mobile health technology also provides crucial information to providers when complications arise and can improve health facility utilization leading to increased deliveries with skilled birth attendants. This reinforces the need for more mHealth initiatives to be implemented in LMICs, addressing the barriers and community characteristics to positively impact and reduce maternal death in these settings.

Neonatal abstinence syndrome (NAS) in infants presents unique challenges in feeding and weight gain. The unpredictable clinical manifestations associated with the newborns withdrawal from exposure to drugs in utero can lead to costly delays in transition of the infant out of the Neonatal Intensive Care Unit (NICU).The purpose of this review of literature was to explore feeding positions and nutritional intake with the greatest impact on weight gain in infants with neonatal abstinence syndrome (NAS) following delivery. The secondary purpose was to compare the clinical manifestations of infants with NAS that influence nutritional intake and their relationship to length of time and cost of stay in the NICU. A review of literature was performed using multiple databases. Articles focusing on feeding position and nutrition intake were identified for interventions to effectively promote weight gain, while reducing clinical manifestations common in infants with NAS. Articles exploring improved feeding and weight gain in infants with NAS and reduced length of stay in the NICU were also synthesized for cost reductions to the facility. Results from 12 studies comparing various feeding positions that optimized nutrition, and reduced negative clinical manifestations in infants with NAS were synthesized for content relevant to the research questions. Results suggest a relationship between placing infants in the c-position, and side-lying position to reduce sensory stimulation, with reducing clinical manifestations for infants actively experiencing withdrawal symptoms from NAS. Providing chin and cheek support as needed, decreasing eye contact during feeding periods, and providing darker quiet environments all play an important role in allowing infants with NAS to optimize their weight gain. As previously stated, to manage nutritional intake and optimize weight gain, reduction of clinical manifestations through pharmacological and non-pharmacological interventions must be actively incorporated into the infants' plan of care.

During their very early stages of life, both healthy and ill infants go through painful routine medical procedures. Exposure to repeated painful stimuli early in life is known to have short and long-term adverse effects, particularly if the infant's pain is not well managed. The purpose of this integrative literature review was to investigate the effectiveness of breastfeeding on relieving acute pain in infants undergoing routine painful medical procedures compared to other non-pharmacologic interventions. A literature search was conducted using Cumulative Index to Nursing Allied Health Literature (CINAHL), MEDLINE, APA PsychINFO, Cochrane Database, and Google Scholar databases. The final number of articles meeting inclusion criteria and analyzed in this review was 10. The non-pharmacological interventions for reducing pain responses in infants that were compared to breastfeeding for effectiveness included the use of sweet tasting solutions, music therapy, and environmental comfort measures. Overall, findings indicated that breastfeeding was most effective in reducing pain responses among infants compared to other non-pharmacologic interventions. Further, breastfeeding in conjunction with the other non-pharmacologic interventions provided added benefit to pain reduction. Findings suggest that breastfeeding is a simple, non-pharmacologic intervention that can be used in clinical nursing practice to reduce the pain response of infants during minor medical procedures.

Despite PPD’s global extent, scarce research that addresses culturally competent alternative interventions exists. The purposes of this thesis were to 1) analyze the existing literature on non-pharmacological treatment of PPD in the US and across selected cultures; 2) determine the effectiveness of cross-cultural non-pharmaceutical therapy; and 3) examine and suggest ways health care providers can integrate non-pharmacologic interventions into PPD treatment in the US. The systematic electronic search comprised the databases Cumulative Index to Nursing and Allied Health Literature, Medline, PsycINFO and SAGE Research Methods. Searches were limited to English language, peer reviewed, and research articles between 2007 and 2017. A second search was performed through global Healthcare Organizations websites. The World Bank’s country classifications by income level were adopted to present the findings. This review found that passing el calor to the newborn, yoga; and cognitive-behavioral, interpersonal, family, and bright light therapies are successful interventions. Further, seclusion periods were identified as adequate interventions only when women voluntarily adopt the practice and have family support, with less social restrictions. While other non-pharmacological treatments’ effectiveness was not ascertained, this thesis encourages healthcare professionals to integrate cultural traditions congruent with clients’ preferences. Recommended nursing interventions and suggestions for improvement of current practice are also discussed.