Midwives' and Other Perinatal Health Workers' Perceptions of the Black Maternal Mortality Crisis in the United States.

INTRODUCTION: This study aimed to identify how perinatal health workers, especially midwives, explained US Black maternal mortality and morbidity and what ameliorative measures they suggested across categories of primary social determinants, health care access, and provider practices. METHODS: Using a mixed closed-ended and open-ended researcher-designed exploratory survey, 227 perinatal health workers responded to a series of questions probing views of causation and strategies for improvement. The closed-ended responses were summarized. Open-ended responses were analyzed using basic categorical and thematic coding. RESULTS: Perinatal health workers' responses prominently identified racism as a cause of Black maternal morbidity and mortality, and their recommendations ranged across levels of social determination of health. DISCUSSION: Results suggest that the views of perinatal health workers, the majority of whom were midwives, are complex and correspond to the problems and solutions identified in the research literature. Midwives and other perinatal health workers are well positioned to help center health equity in perinatal care, through both clinical practice and policy advocacy.

"We're Still Here": A Photovoice Study of Mothers' Perspectives 6 Years after the Flint Michigan Water Contamination Event.

Purpose: This study explored the lived experiences of pregnant and parenting women after the water contamination event in Flint, Michigan (Flint Water Contamination Event [FWCE]), by helping them visualize their everyday challenges, assets, and family health concerns. Methods: The photovoice methodology was utilized in this study. Individual participants met with researchers to discuss their photos using the SHOWeD method. Researchers analyzed the photographs, accompanying narratives, and discussion session transcripts using descriptive coding and thematic analysis. Results: Data analysis revealed five themes: (1) having a healthy pregnancy and well children is a central concern in everyday life, (2) children serve as social and practical resources for family, (3) meeting children's need for safe water is a significant concern, (4) the community and its households battle to get safe affordable water, and (5) there are resources available in the community to support mothers. Conclusion: While much information is still being collected and published in the aftermath of the FWCE, this study was the first to use the photovoice method to allow pregnant and parenting women to express their concerns about how the FWCE continues to affect the health and care of their families.

Using high fidelity simulation to increase nursing students' clinical postpartum and newborn assessment proficiency: A mixed-methods research study.

OBJECTIVE: The objective of this study was to explore the benefits of using High Fidelity Simulators (HFS) to teach maternal postpartum and newborn assessment skills to student nurses before they interacted with actual hospital patients. DESIGN: This descriptive, observational study employed a mixed-method design using a Qualtrics online survey instrument. SETTING: The study was set at a Midwestern university. PARTICIPANTS: The study used a convenience sample of third-year BSN nursing students (n = 132). METHODS: After participating in an HFS experience and completing a maternity clinical rotation, students took an online Qualtrics survey evaluating the benefits and drawbacks of the HFS experience. RESULTS: Students valued the HFS experience at an average score of 3.82 on a Likert Scale of 1-5. Open-ended questions identified three themes: psychomotor learning leading to skill acquisition, affective learning, and simulation restructuring to provide more time, better instructor preparation, and smaller groups. CONCLUSION: This study's data supports the use of HFS to enhance nursing care and education, with special attention given to instructional consistency. Practicing new assessment skills in a non-threatening, safe environment gives students expertise and confidence while promoting the development of critical thinking skills.

The Growing Impact of Legionella in the Flint Water Crisis.

The water crisis in Flint, Michigan raised national awareness about lead- tainted drinking water, particularly its harm to children and pregnant and lactating women. However, according to recent findings, there may be another by-product of this man-made crisis. Failure to use anticorrosive material in the water, a practice mandated by the 1978 Clean Water Act, is being linked to an outbreak of Legionnaires' disease, an illness detrimental primarily to adults over 65 years of age. While Legionnaires' disease is relatively rare, it is also likely to remain undiagnosed. Clinicians, therefore, are urged to consider this diagnosis in adults with pneumonia that does not respond to typical antibiotic treatment, and in newborns with respiratory distress along with other non-typical symptoms as well as those who have had water births or who were exposed to ultrasonic, cool-mist humidification.

New Careers in Nursing: An Effective Model for Increasing Nursing Workforce Diversity.

BACKGROUND: The Robert Wood Johnson Foundation and the American Association of Colleges of Nursing developed the New Careers in Nursing (NCIN) program to address the nursing shortage, increase workforce diversity, and raise the profession's educational level. The program provided scholarships to second-degree underrepresented or economically disadvantaged (UED) students attending an accelerated nursing program to earn a Bachelor of Science in Nursing degree. METHOD: A midwestern university received three academic-year cycles of NCIN funding. The program's model, resources, and functioning are described. RESULTS: The NCIN provided exceptional financial and program support that received high marks from participants. During the three award cycles, 20 UED scholars graduated with a Bachelor of Science in Nursing degree. Nineteen of the 20 scholars passed the NCLEX-RN on the first attempt. CONCLUSION: While the NCIN program has ended, nursing school administrators and faculty wishing to promote UED student success should consider using the program's model and resources as the basis for their own program. [J Nurs Educ. 2018;57(3):178-183.].

Lessons Learned From the Crisis in Flint, Michigan Regarding the Effects of Contaminated Water on Maternal and Child Health.

The Flint, Michigan water crisis raised awareness about the dangers of lead-tainted drinking water and the role of the nurse in addressing such a crisis. Although lead exposure is dangerous for all people, research indicates that pregnant and nursing women and their infants are especially vulnerable to prenatal and postnatal lead exposure. This information is of national importance because of the aging infrastructure of American cities and the likelihood of similar problems in other locations.

Urban African American women's explanations of recurrent chlamydia infections.

OBJECTIVE: To explore reasons for the high chlamydia recurrence rate among African American (AA) urban women. DESIGN: In this phenomenological qualitative study, young AA urban women with recurrent chlamydia were interviewed using open-ended questions guided by the conceptual framework of the health belief model (HBM). SETTING: The study was set in three urban health clinics in Michigan. PARTICIPANTS: Ten African American adolescents, age 15 to 19, participated. METHODS: In face-to-face recorded interviews, participants shared their personal experiences and viewpoints on what led to their recurrent chlamydia infections. The data were transcribed and analyzed through hand coding and NVivo 8 a qualitative software package. RESULTS: Overall, participants demonstrated significant knowledge deficits about the seriousness of chlamydia compared to other sexually transmitted infections (STIs). After reinfection, their perceived susceptibility changed: condom use was seen as beneficial and perceived barriers to condom use diminished as participants gained a new sense of empowerment. CONCLUSION: Chlamydia infection among African American urban adolescents is nearly 3 times that of the general population. Lack of education is still a barrier to STI prevention. Participants reported a desire to receive counseling and support from the health care staff. A STI care model that includes education, counseling, and regular screening of high-risk adolescents should be considered. Further research, using the HBM or similar theoretical models, are needed to gauge the success of any planned or implemented intervention.