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Barbara Morrison Wilford Biography and Abstract
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Barbara Morrison Wilford, DNP, MBA/HCA, CKC, RN

 Associate Professor of Nursing, Associate Degree Nursing, Lorain County Community College, Elyria, Ohio

 

 

 

 

 

Biography

Barbara Morrison Wilford, DNP, MBA/HCA, CKC, RN is Associate Professor of Nursing, Associate Degree Nursing, Lorain County Community College, Elyria, Ohio where she has been Lead Faculty for Maternal Newborn Faculty from 2000 to the present. She was also Lead faculty for the capstone course, Concepts of Professional Practice 2003- 2013.


She earned a BSN (St. John College of Cleveland). She earned a MSN in Maternity Nursing as a Clinical Nurse Specialist (Case Western Reserve University), a MBA in Health Care Administration (Baldwin –Wallace College). She has been Lamaze Certified Childbirth Educator since 1978 to present.  She is currently a doctoral student at Case Western Reserve University in nursing educational leadership, with a projected completion date of 2016. 

 

She has received numerous honors and awards; served as Faculty Mentor and Service Learning Project Associate 2006 - 2010 and was recognized for her contributions by American Association of Community Colleges and Campus Compact. Professor Wilford has been nominated a faculty of the year by students and was recognized as an Outstanding Educator in Ohio, by Ohio Magazine, which recognizes outstanding teachers at colleges and universities throughout the state in 2009. Professor Wilford is a content expert course reviewer for Quality Matters and is a program reviewer for Accreditation Commission for Education in Nursing.  She is an active member of Association of Women’s Health, Obstetric and Neonatal Nurses, Ohio League for Nursing, United States Institute for Kangaroo Care, Ohio Lactation Consultants Association and the American Nurses Association. She has served on the OLN Board. She had served on community organization boards in health care and is a volunteer for the American Cancer Society and the National Multiple Sclerosis Association.

 

Professor Wilford has taught in all areas of nursing education from Nursing Assistant to graduate level. Her practice in maternal newborn nursing has included level 1 and level 2 maternity units. She has held prominent leadership positions as Chief Operating Officer for a multi-specialty group physician practice, Director of Clinical Nursing for Medical Surgical Nursing and Specialties at EMH Regional Health System, Elyria Ohio 1990-1996. Director of Utilization and Case Management for SummaCare Insurance Company 1996-2000. She and her team designed and implemented the first LDRP in North East Ohio at St. John Medical Center, Westlake, Ohio.  She has been a national consultant on single room maternity care, family centered care and staff cross-training for hospitals throughout the United States.  Her career had been focused on nursing care delivery redesign in maternal newborn nursing, family centered care, quality care in a cost driven environment. She has served as a nursing textbook reviewer for publications on nursing leadership and management and maternal newborn along with writing NCLEX questions and nursing leadership and maternal newborn scenarios for case studies and simulation.

 

Professor Wilford’s current research is focused on family centered nursing care, safe transition of the newborn at delivery, skin to skin care effects on Apgar score and initiation of breastfeeding, baby friendly hospital initiatives and best practices in newborn care.  Her publications on sibling preparation for childbirth have been cited in other publications. She is currently writing a Maternal Child textbook using case studies and simulation using QSEN standards.

 

 

Abstract

The American Academy of Pediatrics (AAP) guidelines for resuscitation recommend that newborns be placed in skin-to-skin contact (SSC) immediately after birth. Newborn physical and behavioral responses to SSC during extrauterine transition may be different from those of newborns separated from the mother and placed in a warming unit during extrauterine transition. Because newborn physiology and behavior may change during SSC (i.e. cardiorespiratory stability and motoric calm ensue with SSC), so may Apgar scores, resulting in scores of 7 or less. However, little is known about newborn physiological and behavioral signs when in SSC during the first two hours post-birth, and about Apgar scores when in SSC at 1, 5, and 10 minutes post-birth. Sudden Unexpected Postnatal Collapse (SUPC), an emerging complication of skin-to-skin contact and breastfeeding in which an infant with a 5-minute Apgar of 8 or more requires resuscitation the first hours and days post-birth, can be assessed and possibly prevented when nurses conduct the Respiratory, Activity, Perfusion, Position, and Tone (RAPPT™) assessment during SSC and breastfeeding. But, the RAPPT™ is still new (first edition published in 2014), and use of the RAPPT™ has not been studied, nor has the number of SUPCs in infants assessed by the RAPPT™. The purposes of the observational descriptive study are to describe the 1) physiological and behavioral signs of 30 healthy term newborns in SSC every five minutes over the first two hours of life, 2) 1-, 5-, and 10- minute Apgar scores during SSC, 3) RAPPT™ scores every fifteen minutes, and 4) number of SUPC occurrences over the first two hours post-birth. The method will be continuous personal observation, confirmed by video, of the infant over the first two hours post-birth following University Hospitals IRB approval and signed maternal consent. Nurses will conduct routine newborn care (attach pulse oximeter, do Apgar and RAPPT scores, support breastfeeding, diaper and position infant) while the research nurse videotapes and records observations.. The outcome variables are physiological and behavioral signs, Apgar and RAPPT™ scores, and the number of SUPC occurrences. Tools used are Maternal Data and Photography Release Form, Newborn Observation Data Collection Sheet, and the RAPPT™ Scoring System. The Apgar has established validity and moderate reliability. The RAPPT has content validity, but no reliability yet. All descriptive data will be analyzed using descriptive statistics. The results will provide absolute number and percent of newborn signs in SSC and Apgar and RAPPT scores at various times, and the number of SUPC events during the first two hours post-birth.

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