Predictors of effective kangaroo mother care, exclusive breastfeeding, and skin-to-skin contact among low birthweight newborns in Amhara, Ethiopia.

Background: Globally, 20% of all newborns are born with low birth weight (LBW). There is, therefore, an urgent need to expedite the delivery of high-impact, evidenced-based, and low-cost interventions such as kangaroo mother care (KMC (defined as continuous skin-to-skin care) and exclusive breastfeeding for this vulnerable group.

Methods: A multinational World Health Organization (WHO)-supported consortium created and tested the impact of locally-specific and globally-informed phases of KMC care on KMC uptake/scale-up across multiple sites.

Obstetric Emergency Supply Chain Dynamics and Information Flow Among Obstetric Emergency Supply Chain Employees: Key Informant Interview Study.

Background: For the past several decades, the Ethiopian Ministry of Health has worked to decrease the maternal mortality ratio (MMR)-the number of pregnant women dying per 100,000 live births. However, with the most recently reported MMR of 267, Ethiopia still ranks high in the MMR globally and needs additional interventions to lower the MMR to achieve the sustainable development goal of 70. One factor contributing to the current MMR is the frequent stockouts of critical medications and supplies needed to treat obstetric emergencies.

Comparison of obstetric emergency clinical readiness: A cross-sectional analysis of hospitals in Amhara, Ethiopia.

Measuring facility readiness to manage basic obstetric emergencies is a critical step toward reducing persistently elevated maternal mortality ratios (MMR). Currently, the Signal Functions (SF) is the gold standard for measuring facility readiness globally and endorsed by the World Health Organization. The presence of tracer items classifies facilities' readiness to manage basic emergencies.

Creation of a globally informed and locally relevant KMC implementation model for population-impact in Amhara, Ethiopia.

Aim: As part of a multi-country implementation trial, we tested a regionally specific model of kangaroo mother care (KMC). Effective KMC was defined as ≥8 h of newborn-caregiver skin-to-skin contact daily plus exclusive breast feeding. The study was designed to achieve ≥80+% effective KMC coverage at the population level.

Changes in Posttraumatic Growth After a Virtual Contemplative Intervention During the COVID-19 Pandemic.

Objective: The aim of this study was to describe the effects of an intervention called "Compassion & Growth Workshops" on reported posttraumatic growth (PTG) using the Posttraumatic Growth Inventory-Expanded (PTGI-X).

Background: Few studies measure the impact of interventions, such as contemplative practices, on nurse PTG.

Methods: We delivered a series of three 2-hour microretreats to nurses and advanced practice nurses and measured their impact on PTG scores.

Using clinical cascades to measure health facilities' obstetric emergency readiness: testing the cascade model using cross-sectional facility data in East Africa.

Objectives: Globally, hundreds of women die daily from preventable pregnancy-related causes, with the greatest burden in sub-Saharan Africa. Five key emergencies-bleeding, infections, high blood pressure, delivery complications and unsafe abortions-account for nearly 75% of these obstetric deaths. Skilled clinicians with strategic supplies could prevent most deaths.

Scaling up Kangaroo Mother Care in Ethiopia and India: a multi-site implementation research study.

Objectives: Kangaroo Mother Care (KMC), prolonged skin-to-skin care of the low birth weight baby with the mother plus exclusive breastfeeding reduces neonatal mortality. Global KMC coverage is low. This study was conducted to develop and evaluate context-adapted implementation models to achieve improved coverage.

Using Routinely Collected Electronic Health Record Data to Predict Readmission and Target Care Coordination.

Patients with chronic renal failure (CRF) are at high risk of being readmitted to hospitals within 30 days. Routinely collected electronic health record (EHR) data may enable hospitals to predict CRF readmission and target interventions to increase quality and reduce readmissions. We compared the ability of manually extracted variables to predict readmission compared with EHR-based prediction using multivariate logistic regression on 1 year of admission data from an academic medical center.

Toolkit for Best Practice Use of Electronic Health Record Data in Quality Improvement.

This project piloted an educational intervention focused on use and management of EHR data by Doctor of Nursing Practice students in quality improvement initiatives. Recommendations from academic and clinical nursing promote the integration of EHR data findings into practice. Nursing's general lack of understanding about how to use and manage data is a barrier to using EHR data to guide quality improvement initiatives.

The Call for Global Health Research Mentorship for Doctorally Prepared Nurses in Low- and Middle-Income Countries.

Limited research about nursing mentorship in low- and middle-income countries (LMICs) is holding science back. This article describes the strengths and challenges associated with global health research mentorship for doctorally prepared nurses whose scholarship focuses on LMICs. Using reflexive narrative accounts from current and former nurse mentors and nurse mentees who participated in a NIH-funded global health doctoral research program, emerging themes revealed the perspectives of mentors and mentees, producing a global health mentoring model for nursing research mentorship relevant to LMICs.

Valent USA LLC strategies, innovations, and collaborations to deal with herbicide resistance and achieve sustainability.

In conjunction with our parent company Sumitomo Chemical, Valent USA LLC continues to research, develop, and steward products that assist growers in the management of existing and emerging weed resistance issues in their fields. The knowledge gained through collaboration with universities and industry stakeholders in how to effectively manage and prevent the spread of herbicide-resistant weeds is being incorporated into the development and stewardship of our products. Valent demonstrates our commitment to herbicide stewardship by developing products which incorporate multiple-effective modes of action using flumioxazin as a foundational component for preemergence residual weed control.

Collaborative Development and Implementation of a Video-Based Curriculum Expansion to Improve Refugee Women's Birth Experiences in the United States.

Many refugee and immigrant women in the United States experience cultural and language barriers when seeking pregnancy-related medical care. Such barriers may delay needed care and adversely impact birth outcomes. Embrace Refugee Birth Support (Embrace) in Clarkston, Georgia, supports pregnant refugee women by offering birth education classes in the women's primary languages.

Neonatal care and community-level treatment seeking for possible severe bacterial infection (PSBI) in Amhara, Ethiopia.

Background: In Ethiopia, neonatal mortality accounts for approximately 54% of under-five deaths with the majority of these deaths driven by infections. Possible Severe Bacterial Infection (PSBI) in neonates is a syndromic diagnosis that non-clinical health care providers use to identify and treat newborns with signs of sepsis. In low- and middle-income countries, referral to a hospital may not be feasible due to transportation, distance or finances.

Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation.

Introduction: Kangaroo Mother Care (KMC) is the practice of early, continuous and prolonged skin-to-skin contact between the mother and the baby with exclusive breastfeeding. Despite clear evidence of impact in improving survival and health outcomes among low birth weight infants, KMC coverage has remained low and implementation has been limited. Consequently, only a small fraction of newborns that could benefit from KMC receive it.

Clinical cascades as a novel way to assess physical readiness of facilities for the care of small and sick neonates in Kenya and Uganda.

Background: Globally, there were 2.7 million neonatal deaths in 2015. Significant mortality reduction could be achieved by improving care in low- and middle-income countries (LMIC), where the majority of deaths occur.

Leveraging Graduate Academic-Practice Partnerships to Transform Health System Outcomes.

Academic and clinical site partnerships are not new. However, many of these have not resulted in graduates of nursing education programs who are prepared to fulfill their full potential as newly employed professionals. This article describes an education program for Doctorate of Nursing Practice (DNP) students in which the students, under the close supervision of academic faculty, utilize their statistical analyses and complex system coursework to study and address "wicked" problems faced by health care organizations.

Measuring movement towards improved emergency obstetric care in rural Kenya with implementation of the PRONTO simulation and team training program.

As the proportion of facility-based births increases, so does the need to ensure that mothers and their newborns receive quality care. Developing facility-oriented obstetric and neonatal training programs grounded in principles of teamwork utilizing simulation-based training for emergency response is an important strategy for improving the quality care. This study uses 3 dimensions of the Kirkpatrick Model to measure the impact of PRONTO International (PRONTO) simulation-based training as part of the Linda Afya ya Mama na Mtoto (LAMMP, Protect the Health of mother and child) in Kenya.

Beyond signal functions in global obstetric care: Using a clinical cascade to measure emergency obstetric readiness.

Background: Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed using tracers derived from the maternal signal functions model.

Are CNM-Attended Births in Texas Hospitals Underreported?

Introduction: Accurate data on the number of births attended by certified nurse-midwives and certified midwives (CNMs/CMs) are required to establish the public health benefits attributed to the midwifery model of care and the role of CNMs/CMs in the US health care system. However, the number of CNM/CM-attended births may be underreported in birth certificate data. The purpose of this project was to estimate the number of births CNM practices attended in Texas hospitals in 2014 and to describe Texas CNMs' knowledge about their hospitals' policies on naming CNMs as birth attendants.

The development and implementation of a strategic and tactical planning framework at Mayo Clinic Arizona.

This article describes the Mayo Arizona process for developing an information technology strategic plan. The background of organizational events that gave rise to this strategic planning process is presented. A cross-functional team of key IT stakeholders was convened; the team used a facilitated process to derive a pro forma set of IT strategic objectives from the larger organization's emerging strategic plan.