{"title":"Measuring Our Way to Reducing Severe Maternal Morbidity With Quantification of Blood Loss in the Labor and Delivery Operating Room.","authors":"Jane Jach","doi":"10.1016/j.nwh.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.nwh.2025.02.006","url":null,"abstract":"<p><strong>Objective: </strong>To initiate quantification of blood loss (QBL) for all cesarean births to align with professional obstetric organizations' recommendations and to reduce hemorrhage-related severe maternal morbidity (SMM).</p><p><strong>Design: </strong>Quality improvement (QI) project.</p><p><strong>Setting/local problem: </strong>Before December 2022, a large northern California hospital relied on estimating blood loss during childbirth, contrary to recommendations from national obstetric organizations. Estimating blood loss during childbirth has been consistently shown to be inaccurate, leading to recommendations for QBL by organizations such as the Association of Women's Health, Obstetric and Neonatal Nurses, the American College of Obstetricians and Gynecologists, and the California Maternal Quality Care Collaborative. Obstetric hemorrhage is the leading cause of SMM and mortality. Accurate blood loss measurements are necessary for effective hemorrhage management.</p><p><strong>Participants: </strong>The QI team consisted of two nurse leads and their labor and delivery department's nursing professional development specialist. The labor and delivery department consists of 237 registered nurses and 14 obstetric technicians.</p><p><strong>Methods: </strong>The QI team used the Plan-Do-Study-Act method to develop a workflow for QBL in cesarean births.</p><p><strong>Results: </strong>The percentage of cesarean births in which QBL was used increased by more than 83% at 1 year after implementation. The rate of hemorrhage-related SMM in the same period was reduced by 1.8%.</p><p><strong>Conclusion: </strong>QBL was successfully implemented by staff nurses in the department and sustained within the organization. The effect on SMM cannot be directly tied to the implementation of QBL, but QBL may have affected this metric.</p>","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"De-escalation Training for Obstetric/Neonatal Health Care Workers to Improve Confidence in Managing Workplace Violence.","authors":"Jessica Lazzeri, Melissa Harlan, Laura Fennimore","doi":"10.1016/j.nwh.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.nwh.2025.01.002","url":null,"abstract":"<p><strong>Objective: </strong>To improve the confidence level of obstetric/neonatal health care staff in managing episodes of workplace violence.</p><p><strong>Design: </strong>Quality improvement project with a pretest/posttest survey design.</p><p><strong>Setting/local problem: </strong>A large, urban, academic medical center where an increase in episodes of workplace violence was observed in the obstetric/neonatal department.</p><p><strong>Participants: </strong>Eighty-seven staff members from the interdisciplinary health care team in the obstetric/neonatal department participated in the quality improvement initiative.</p><p><strong>Intervention/measurements: </strong>Crisis Prevention Institute de-escalation training was customized with scenarios commonly seen in obstetric/neonatal settings. Fourteen training sessions were offered to obstetric/neonatal staff during a 4-month period. Measurable outcomes included participant satisfaction, number of security calls to the obstetric/neonatal units, and clinician confidence in coping with patient aggression at baseline, 2 weeks posttraining, and 3 months postintervention.</p><p><strong>Results: </strong>In the obstetric/neonatal department there was an increase in rates of completion of Crisis Prevention Institute de-escalation training from 1.7% to 19% during the study period. Scores for overall clinician confidence in coping with patient aggression significantly improved from baseline at 2 weeks posttraining (from 43.51 to 68.50 [p < .001]) and at 3 months posttraining (from 43.51 to 71.54 [p < .001]).</p><p><strong>Conclusion: </strong>Customized de-escalation training sessions can contribute to active participation in de-escalation training and improvement in clinician confidence in coping with patient aggression.</p>","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Omani Women's Experiences of Cervical Cancer Screening.","authors":"Zalikha Al-Marzouqi, Haleema Al-Mamari","doi":"10.1016/j.nwh.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.nwh.2025.05.001","url":null,"abstract":"<p><strong>Objective: </strong>To examine the experiences of Omani women in North Batinah Governorate with cervical cancer (CC) screening.</p><p><strong>Design: </strong>Qualitative design directed by a constructivist grounded theory approach.</p><p><strong>Setting: </strong>Women were recruited from obstetric and gynecologic clinics in six primary health care institutions in North Batinah Governorate, Oman.</p><p><strong>Participants: </strong>Thirty women were interviewed; 20 (66.7%) were between ages 25 and 40 years, and 21 (70.0%) had given birth multiple times, 16 (53.3%) held high education certificates, and 18 (60.0%) were unemployed.</p><p><strong>Methods: </strong>Data were collected via semistructured interviews. Purposive sampling was used initially, followed by theoretical sampling until data saturation. Constant comparative analysis was used.</p><p><strong>Results: </strong>Three main themes were determined: Sociocultural Aspects, Personal Aspects, and Health Care Aspects that influenced women's judgments about completing screening for CC. Sociocultural aspects were mainly about beliefs, stigma, and the influential role of other Omani women regarding CC screening tests. Personal aspects reflected women's knowledge and physical and psychological barriers to CC screening tests. Health care aspects were the challenges women encountered related to obtaining CC screening.</p><p><strong>Conclusion: </strong>Some women who had previously undergone CC screening chose not to repeat CC screening tests due to physical and psychological issues. These findings suggest that the Ministry of Health in Oman should develop policies, health education (online and printed sources), and supportive programs to enhance women's awareness and knowledge of CC screening and increase screening rates among women.</p>","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Kendrick, Amy D. Bell, Cyril Amoin, James deVente, Kathy Shaffer
{"title":"Collaboration Through Interdisciplinary Education on Fetal Heart Monitoring in the Perinatal Setting","authors":"Jennifer Kendrick, Amy D. Bell, Cyril Amoin, James deVente, Kathy Shaffer","doi":"10.1016/j.nwh.2024.10.006","DOIUrl":"10.1016/j.nwh.2024.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>To conduct interdisciplinary fetal monitoring education focused on communication strategies to improve attitudes toward collaboration among members of the perinatal team.</div></div><div><h3>Design</h3><div>Participants received interdisciplinary fetal monitoring education from the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and were surveyed preclass, at the immediate conclusion of the in-person interdisciplinary class, and within 60 days postclass using the Jefferson Survey of Attitudes Toward Physician-Nurse Collaboration (JSAPNC). Scores were calculated and analyzed by applying the scale provided by the JSAPNC’s author.</div></div><div><h3>Setting</h3><div>An academic medical center providing level IV maternal care located in the southeast region of the United States.</div></div><div><h3>Participants</h3><div>Physicians, registered nurses, and certified nurse-midwives attending AWHONN’s Intermediate Fetal Heart Monitoring (FHM) Course from January 2024 through March 2024.</div></div><div><h3>Intervention/Measurements</h3><div>The reliable and validated JSAPNC tool was used to survey participants. Survey scores were compared for the total scores and four identified constructs (<em>shared education and collaborative relationships, caring versus</em> c<em>uring, nurse’s autonomy,</em> and <em>physician’s authority</em>) to better understand collaboration and interdisciplinary education.</div></div><div><h3>Results</h3><div>Attitudes toward collaboration demonstrated statistically significant improvement among the perinatal team after participation in an interdisciplinary AWHONN Intermediate FHM Course.</div></div><div><h3>Conclusion</h3><div>The findings establish that interdisciplinary education is associated with improved attitudes around collaboration.</div></div>","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":"29 3","pages":"Pages 152-160"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Couple in the Parking Lot","authors":"Melanie Chichester","doi":"10.1016/j.nwh.2025.04.001","DOIUrl":"10.1016/j.nwh.2025.04.001","url":null,"abstract":"","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":"29 3","pages":"Pages 205-206"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eneida Patrícia Teixeira, Rita de Cassia Teixeira Rangel, Anna Carolina Raduenz Huf Souza, Cristina M.G. de L. Parada, Fiona A. Lynn, Maria de Lourdes de Souza
{"title":"Comparing Brazilian Guidelines for Normal Birth Care to Other National and International Guidelines","authors":"Eneida Patrícia Teixeira, Rita de Cassia Teixeira Rangel, Anna Carolina Raduenz Huf Souza, Cristina M.G. de L. Parada, Fiona A. Lynn, Maria de Lourdes de Souza","doi":"10.1016/j.nwh.2025.02.003","DOIUrl":"10.1016/j.nwh.2025.02.003","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the Brazilian national guidelines for normal birth care to guidelines from the National Institute for Health and Care Excellence (NICE) and the World Health Organization (WHO) on levels of evidence, quality, and applicability for the prevention of maternal mortality.</div></div><div><h3>Design</h3><div>A review and evaluation of guidelines was conducted using the Appraisal of Guidelines for Research & Evaluation II instrument translated and validated for Brazilian Portuguese.</div></div><div><h3>Setting</h3><div>Guidelines were selected using criteria such as national or international use and interest, scope, and whether they were a source for other clinical guidelines. Three guidelines and supporting documents related to the guidelines’ development were included in the review and evaluation.</div></div><div><h3>Methods</h3><div>Data were narratively synthesized under four dimensions: (a) quality and applicability of the guidelines, (b) score of each domain in the guidelines, (c) interrater agreement index, and (d) evidence on the consideration of risk and prevention of maternal mortality.</div></div><div><h3>Results</h3><div>The Brazilian guidelines presented weaknesses in two domains: (a) Accuracy in Development and (b) Applicability. The overall evaluation of the Brazilian guidelines had a rating of 33%, which is lower than the rating for the NICE and WHO guidelines. These scores reflect limitations in systematic evidence gathering, the transparency of recommendations, and the lack of tools and guidance for practical implementation.</div></div><div><h3>Conclusion</h3><div>The Brazilian guidelines should be reformulated following a process of appropriate planning and development that aligns with international standards.</div></div>","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":"29 3","pages":"Pages 180-199"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Information for Readers","authors":"","doi":"10.1016/S1751-4851(25)00087-X","DOIUrl":"10.1016/S1751-4851(25)00087-X","url":null,"abstract":"","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":"29 3","pages":"Page A3"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine E. Pinto, Helen L. Graham, Judith M. Scott, Melissa J. Benton
{"title":"Effect of Endometriosis on Disease-Specific Quality of Life","authors":"Katherine E. Pinto, Helen L. Graham, Judith M. Scott, Melissa J. Benton","doi":"10.1016/j.nwh.2024.09.005","DOIUrl":"10.1016/j.nwh.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate disease-specific quality of life (QOL) in women with endometriosis and assess concurrent validity of the Endometriosis Impact Questionnaire (EIQ).</div></div><div><h3>Design</h3><div>Observational, cross-sectional design.</div></div><div><h3>Setting</h3><div>Online survey.</div></div><div><h3>Participants</h3><div>Women ages 18 to 49 years who self-reported a diagnosis of endometriosis.</div></div><div><h3>Measurement</h3><div>Disease-specific QOL was measured with the EIQ and the Endometriosis Health Profile-5 (EHP-5). Health-related QOL was measured with two WHOQOL-BREF questions.</div></div><div><h3>Results</h3><div>There were 413 participants with complete data included in the analysis. Mean <em>(SD)</em> age at participation was 33.9 (7.1) years and at diagnosis was 28.9 (7.0) years. Responses to the EIQ demonstrated that endometriosis had the greatest effect on QOL through physical-psychosocial symptoms and fertility problems. Lifestyle behaviors related to alcohol and tobacco use were the least affected by endometriosis. Scores on the EHP-5 demonstrated similar results, with social support, self-image, and feelings of control being most impacted. Health-related QOL was also found to be impaired. Participants rated their overall QOL as <em>neither poor nor good</em> and their overall satisfaction with their health as <em>dissatisfied.</em> Concurrent validity for the EIQ was acceptable. Women who reported worse disease-specific QOL on the EIQ also had worse disease-specific QOL on the EHP-5 (<em>p</em> ˂ .01) and worse health-related QOL on the WHOQOL-BREF questions (<em>p</em> ˂ .01).</div></div><div><h3>Conclusion</h3><div>Endometriosis significantly impairs disease-specific QOL in addition to general health-related QOL. The EIQ is a valid measure of disease-specific QOL and can be used to assess the impact of endometriosis on the multiple dimensions of women’s lives. It is recommended that providers use this tool to obtain a more in-depth understanding of the effect on QOL and tailor patient-specific care that targets the multidimensions of endometriosis.</div></div>","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":"29 3","pages":"Pages 170-179"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Understanding the Health Benefits of Tai Chi Practice for Managing Pain After Breast Cancer Treatment","authors":"Frankie B. Hale, Allyssa L. Harris","doi":"10.1016/j.nwh.2024.11.004","DOIUrl":"10.1016/j.nwh.2024.11.004","url":null,"abstract":"<div><div>This short review summarizes a recent U.S.-based study in which researchers evaluated the impact of tai chi mind-body exercises on health outcomes of breast cancer survivors. The researchers examined the efficacy of a tai chi intervention for managing aromatase inhibitor arthralgia in patients with breast cancer. They concluded that mind-body–related practices likely contributed to improved health outcomes. Nurses can guide patients about the impact that mind-body practices may have on the health and well-being of breast cancer survivors.</div></div>","PeriodicalId":39985,"journal":{"name":"Nursing for Women''s Health","volume":"29 3","pages":"Pages 200-204"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}