Scholarship & Research
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Item Implementation of a tummy time protocol: a quality improvement project in a level 3B NICU(Montana State University - Bozeman, College of Nursing, 2024) Chaffin, Taylor Christine; Chairperson, Graduate Committee: Benjamin J. Miller; This is a manuscript style paper that includes co-authored chapters.Background: Infants who spend prolonged periods in the supine position, particularly in the NICU, face an increased risk of plagiocephaly and developmental delays. Supine sleeping is recommended by the American Academy of Pediatrics, "Back to Sleep" campaign, which has successfully reduced sudden infant death syndrome by 40-60%. However, an increase in cranial abnormalities was observed following the widespread adoption. Daily tummy time supports motor development, reduces the risk of plagiocephaly, and promotes parental bonding. Methods: A six-week tummy time protocol was implemented in a level 3b NICU for infants who were 32 weeks corrected gestational age and medically stable. Brief 1-2-minute tummy time sessions were completed in the infant's bed or while holding with a parent. Tummy time sessions, education, and return demonstrations were documented on a bedside tracker. Pre- and post-implementation surveys were distributed to staff to gather perspectives. Parent surveys were distributed at discharge to evaluate readiness to complete tummy time at home. Results: Between January 15th and February 25th, only 23 out of 42 eligible infants had tracker sheets returned (55%). Out of 504 eligible days, tummy time sessions were recorded on 214 days, accounting for 42%. Post-implementation staff surveys showed positive results regarding their confidence in educating parents (M=4.7, sd=0.47) and the ease of implementation (M=4.38, sd=0.65). Comparing the results of the pre-and post-implementation surveys using a t-test yielded no significance. Obstacles to compliance included difficulty integrating new workflows, time constraints for education completion, tummy time, and documentation. Conclusion: Implementing the Tummy Time Protocol was crucial in changing practice patterns to align with best practices for infants admitted to the NICU. However, more work must be done to integrate tummy time sessions, early education, and documentation into a new workflow. Suggestions for improvement were provided, focusing on incorporating documentation into the electronic health record (EHR) system to improve compliance and reduce the risk of losing tracking sheets. In addition, future research is necessary to evaluate the long-term effects of tummy time implementation within the NICU. Specifically, research should focus on rates of plagiocephaly and outpatient therapy referrals following discharge from the NICU.Item Father-specific education in the inpatient setting(Montana State University - Bozeman, College of Nursing, 2019) Smith, Pamela Alejandra; Chairperson, Graduate Committee: Sandra Benavides-VaelloThe early postpartum period is an important period of time to prepare mothers and fathers for parenthood. Father's involvement in children's lives has shown to be beneficial for the child's health and the entire family dynamics too. Evidence shows that parental education increases knowledge and confidence levels in parents. Currently, the majority of educational efforts and programs target mothers, leaving men with none or minimal tools to succeed as fathers of a newborn. A major goal of Healthy People 2020 in relation to children's health is a ten percent reduction in infant and neonatal deaths. One key approach for reaching this goal includes increasing the amount of educational and community based programs for infant and child health to increase knowledge in parents (both mothers and fathers) of safe practices with infants and children. This pre/post-quasi-experimental project was designed to evaluate gender specific education and changes in parental confidence level when exposed to educational literature. The project was implemented in the maternity unit at St. Vincent's Healthcare in Billings, Montana. With a total of 32 fathers as participants. Results of the project indicated an overall maintenance or improvement of parent confidence level evidenced by a maintenance or increase in Karitane Parenting Confidence Scale scores. Results of the project are expected to facilitate fathers' responsiveness to baby and better bonding of baby to father in the immediate future. Outcomes are expected to lead to positive consequences in children's health and development. Results also indicate the educational intervention with fathers was overall successful in fulfilling the purpose of this scholarly project.Item Behavior modification of children by parents in the home : a modified case study approach(Montana State University - Bozeman, College of Professional Schools, 1971) Slaughter, Constance LawrenzItem The perceived level of communication of pregnant and non-pregnant teenagers with their parents(Montana State University - Bozeman, College of Nursing, 1974) Williams, Valeria Flo Handley