|Ellise Adams Biography and Abstract|
Ellise D. Adams, PhD, CNM
Associate Professor, The University of Alabama in Huntsville
Dr. Adams has over 30 years’ experience in perinatal nursing and academic leadership. She has served as a Director of Nursing Honors and is currently the Director of the Doctorate of Nursing program. She is a member of AWHONN’s Research Advisory Panel, the American College of Nurse-Midwives’ Healthy Birth Initiatives Task force and is on the Editorial Board of the Journal of Perinatal and Neonatal Nursing.
Her primary research interests include the beliefs of intrapartum nurses related to birth practices, benefits of skin-to-skin care during cesarean birth, homebirth practices of American women, and the practice of newborn airway clearance for healthcare providers and parents. In all of her work she seeks to promote physiologic birth and to improve birth outcomes for women and infants.
Although there is no scientific evidence for the routine practice of airway clearance of the newborn at birth, this practice is frequently implemented among intrapartum nurses, midwives and obstetricians.Therefore this practice needs to be explored, described and clearly identified. There is scientific evidence that this routine practice causes newborn apnea, disturbances in heart rate and does not improve lung function or newborn oxygenation. There is also evidence that harmful microorganisms are found within suction devices and may infect the newborn. This proposed study will explore the practice of newborn suctioning, determine species specific bacteria associated with the practice, and correlate maternal and neonatal data with identified microorganisms.
This proposed research will be a feasibility, non-experimental, correlational study. Participants will be recruited from a teaching hospital in the southeastern United States. Consented participants will be grouped in the following groups according to suctioning actions: 1) no suctioning at birth; 2) wiping only; 3) bulb syringe suctioning; 4) other suctioning (OG, DeLee, etc.); or 5) combination. Four categories of data will be collected using an instrument developed for this proposed research: 1) observation data to describe suctioning practices at the time of delivery, 2) maternal data to identify microorganisms present and patient information for correlation, 3) newborn data to identify microorganisms present and patient information for correlation and 4) device data to identify microorganisms present. Specific aims of this proposed study related to the feasibility of the study are to determine the data collection process appropriate to obtain suction devices and patient swabs, and determine the laboratory process appropriate to identify species specific bacteria from patient swabs.
The convenience sample will be recruited at the clinical agency in the labor and delivery area. Subjects will include both mothers and newborns. Mothers will be term (38 weeks to 41 weeks gestation) without prenatal complications and expected to give birth to healthy, well, singleton newborns. The sample size for this proposed feasibility/pilot study will be 20-30 days.
The sample and observation data will be analyzed via descriptive statistics. Qualitative data recorded during observations will be subjected to narrative content analysis. To compare findings of bacterial analysis with patient data, both maternal and newborn, correlation and bivariate statistics will be used.
The information gleaned from this study will be used to identify the processes for a larger study with a sample size sufficient to identify causal relationships between suctioning practices and microorganism identification and patient information. Observational data related to the practice of newborn suctioning may be sufficient to identify elements of suction practices and assist the researchers in framing a nationwide study to identify beliefs, attitudes, knowledge and practices related to newborn suctioning at birth. In this manner, this study will contribute to the scientific basis of newborn suctioning by identifying practices of newborn suctioning, determine species specific bacteria associated with the practice, and correlate maternal and neonatal data with identified microorganisms to determine potential hazards associated this practice which could compromise newborn safety and health.