Kathryn Osborne - Academia.edu (original) (raw)
Papers by Kathryn Osborne
Aims: The purpose of this study was to describe the care practices used by Certified Nurse-Midwiv... more Aims: The purpose of this study was to describe the care practices used by Certified Nurse-Midwives (CNMs) when providing second stage labor care, and to identify the facilitating factors and barriers to providing evidence-based care to women during this labor phase. Background: Most women who give birth in the U.S. are given arbitrary instructions concerning when and how to bear down. Therefore, birthing women do not receive second stage labor care that is based on the scientific evidence that indicates that support of women's spontaneous efforts contributes to more optimal maternal, fetal and neonatal outcomes. Methods: Prior to the focus group, a brief questionnaire was used to screen CNMs to identify potential participants who use evidence based second stage labor care practices such as support of maternal spontaneous pushing. A focus group of 7 CNMs was conducted in 2008 using a series of questions, audiotape recorded, transcribed and analyzed for themes. Results/Findings: Five major themes emerged from the analysis: 1) Recognition of second stage as physiologic (natural); 2) Midwifery care practices; 3) Direction as an intervention; 4) The fluid nature of supportive versus directive care practices; and 5) Barriers to supporting self-regulated pushing. Conclusion: The findings of this study suggested that second stage care tailored to the sensations and needs of individual women, versus routinized instructions,
Journal of Midwifery & Women's Health, Oct 1, 2015
The regulation of prescriptive authority for certified nurse-midwives (CNMs) and certified midwiv... more The regulation of prescriptive authority for certified nurse-midwives (CNMs) and certified midwives (CMs) is conducted by regulatory boards and individual state agencies. The purpose of this review was to update a previously conducted overview of the regulatory requirements relative to prescriptive authority for CNMs/CMs in the United States. State statutes and administrative rules relative to midwifery practice were reviewed for all 50 United States and the District of Columbia. As of June 14, 2015, the regulation of prescriptive authority for CNMs continues to vary widely across states, and CMs face substantial barriers to practice with prescriptive authority granted in just 2 states. Inconsistent regulatory requirements relative to prescriptive authority, which often impose barriers to full practice authority for midwives, continue to limit patients' access to necessary services in many states.
Nursing Education Perspectives
Journal of Pediatric Health Care, 2019
Background: Immunization-associated pain is the number one cause of pain in pediatric settings. U... more Background: Immunization-associated pain is the number one cause of pain in pediatric settings. Untreated pain has many shortand long-term detrimental effects. The purpose of this project was to implement a nonpharmaceutical immunization-associated−pain prevention program. Method: This project was implemented at a pediatric primary care clinic. Staff were educated about immunization-associated pain and techniques for decreasing/preventing pain. Families were educated about pain control, and the practitioner and parent/child picked interventions to decrease pain. Preimplementation and postimplementation data were collected using previously validated pain and satisfaction scales. Results: Pain prevention interventions decreased pain for children between 2 months and 7 years of age by 4.7 points on a Faces, Legs, Activity, Cry, Consolability (i.e., FLACC) scale. For children 7 years and older, pain during immunization decreased on average by 1.76 points on the visual analog scale. Conclusion: Non-pharmaceutical interventions are effective in decreasing immunization-associated pain. J Pediatr Health Care.
Journal of Midwifery & Women's Health, 2017
In addition to the regulation of prescriptive authority and prescribing practices conducted by in... more In addition to the regulation of prescriptive authority and prescribing practices conducted by individual states, the prescription of controlled substances is also regulated at the federal level by the US Drug Enforcement Administration (DEA). While there are variations in state laws relative to controlled substance prescribing, federal law is uniform across states as established by the Controlled Substances Act (21 United States Code § 801‐890) and the DEA Regulations (Title 21, Code of Federal Regulations). The only controlled substance for which states have authorized use that is outside the regulations set forth in the Controlled Substances Act is marijuana for the treatment of certain medical conditions. A review of statutes and administrative rules for all 50 states and the District of Columbia revealed that certified midwives (CMs) are authorized to prescribe controlled substances only in the state of New York, and there are variations across states in the regulation of contr...
Journal of Midwifery & Women's Health, 2015
Aims: The purpose of this study was to describe the care practices used by Certified Nurse-Midwiv... more Aims: The purpose of this study was to describe the care practices used by Certified Nurse-Midwives (CNMs) when providing second stage labor care, and to identify the facilitating factors and barriers to providing evidence-based care to women during this labor phase. Background: Most women who give birth in the U.S. are given arbitrary instructions concerning when and how to bear down. Therefore, birthing women do not receive second stage labor care that is based on the scientific evidence that indicates that support of women's spontaneous efforts contributes to more optimal maternal, fetal and neonatal outcomes. Methods: Prior to the focus group, a brief questionnaire was used to screen CNMs to identify potential participants who use evidence based second stage labor care practices such as support of maternal spontaneous pushing. A focus group of 7 CNMs was conducted in 2008 using a series of questions, audiotape recorded, transcribed and analyzed for themes. Results/Findings: Five major themes emerged from the analysis: 1) Recognition of second stage as physiologic (natural); 2) Midwifery care practices; 3) Direction as an intervention; 4) The fluid nature of supportive versus directive care practices; and 5) Barriers to supporting self-regulated pushing. Conclusion: The findings of this study suggested that second stage care tailored to the sensations and needs of individual women, versus routinized instructions,
Journal of Midwifery & Women's Health, 2015
The Journal of Perinatal & Neonatal Nursing, 2001
Court-ordered detention and prosecution of a pregnant woman for substance abuse is an unusual but... more Court-ordered detention and prosecution of a pregnant woman for substance abuse is an unusual but increasing occurrence in the United States. At least 24 states have attempted to prosecute a pregnant woman on a variety of charges for suspected harm to the fetus. This article reviews the issues involved including personal autonomy duty of caregivers to women and fetuses, and ethical frameworks for discussion.
The Journal of Perinatal & Neonatal Nursing, 2014
Scientific evidence supports spontaneous physiologic approaches to second-stage labor care; howev... more Scientific evidence supports spontaneous physiologic approaches to second-stage labor care; however, most women in US hospitals continue to receive direction from nurses and birth attendants to use prolonged Valsalva bearing-down efforts as soon as the cervix is completely dilated. Delaying maternal bearing-down efforts during second-stage labor until a woman feels an urge to push (laboring down) results in optimal use of maternal energy, has no detrimental maternal effects, and results in improved fetal oxygenation. Although most commonly used with women who are undergoing epidural anesthesia, laboring down is just one component of physiologic second-stage labor care that can be used to achieve optimal maternal and neonatal outcomes for women with or without an epidural. Prior efforts to translate evidence regarding second-stage labor care to practice have not been successful. In this article, the scientific evidence for second-stage labor care and previous efforts at clinical translation are reviewed. The Ottawa Hospital Second Stage Protocol is presented as a model with potential to allow translation of evidence to practice. Recommendations to enhance widespread adoption of evidence-based practice are provided, including improved collaboration between nurses and birth attendants.
Journal of Midwifery & Women's Health, 2011
Introduction: Certified nurse‐midwives (CNMs) and certified midwives (CMs) provide primary care t... more Introduction: Certified nurse‐midwives (CNMs) and certified midwives (CMs) provide primary care to women across the lifespan. Yet these primary care providers face barriers to practice that include restrictive state laws and regulations regarding prescriptive authority. The purpose of this review is to critically examine and report the regulatory requirements relative to prescriptive authority for CNMs/CMs in the United States.Methods: State statutes and rules relative to midwifery practice were reviewed for all 50 United States and the District of Columbia.Results: CNMs have been granted the authority to write prescriptions in all 50 United States and the District of Columbia, while CMs have been granted prescriptive authority only in the state of New York. Prescriptive authority for CNMs and CMs is regulated by individual state agencies and regulatory boards. Regulations regarding prescriptive authority for CNMs and CMs vary widely from state to state and are described, with a sum...
Journal of Midwifery & Women's Health, 2002
ABSTRACTDomestic violence affects many women and their families. Although estimates of the preval... more ABSTRACTDomestic violence affects many women and their families. Although estimates of the prevalence of domestic violence during pregnancy vary, it is likely that most providers of women's health care will encounter pregnant women who experience domestic violence. The purpose of this article is to review research that has investigated associations between domestic violence during pregnancy and other demographic and lifestyle variables, as well as the literature regarding clinical assessment and intervention strategies.
Journal of Midwifery & Women's Health, 2005
Since the inception of nurse-midwifery education 80 years ago, educators have looked for ways in ... more Since the inception of nurse-midwifery education 80 years ago, educators have looked for ways in which to educate enough nurse-midwives. The application of distance learning to nurse-midwifery education expanded opportunities for a greater number of students to have access to an education in nurse midwifery. The story of the Community-based Nurse-midwifery Education Program is presented as an exemplar.
Journal of Midwifery & Women's Health, 2013
Journal of Midwifery & Women's Health, 2012
Introduction: Although the risks associated with using sustained and forceful maternal bearing‐do... more Introduction: Although the risks associated with using sustained and forceful maternal bearing‐down efforts during the second stage of labor have been well documented, most women who give birth in the United States bear down in response to direction from care providers about when and how to push rather than in response to their own physiologic urges. The purpose of this study was to describe the practices used by certified nurse‐midwives/certified midwives (CNMs/CMs) in response to maternal bearing‐down efforts when caring for women in second‐stage labor and to identify factors associated with the use of supportive approaches to second‐stage labor care.Methods: A national survey of 705 CNMs/CMs was conducted using mailed questionnaires. The instrument was an 84‐item, fixed‐choice questionnaire using Likert type scales that had been validated. A 72.6% response rate was achieved, and 375 of the respondents cared for women during the second stage of labor.Results: Most CNMs/CMs (82.4%)...
Journal of Midwifery & Women's Health, 2010
... 2003 9. Willard Gayheart, Appalachian Artist. Willard Gayheart and Donia S. Eley. ... My brot... more ... 2003 9. Willard Gayheart, Appalachian Artist. Willard Gayheart and Donia S. Eley. ... My brother Paul Sluder, research assistant extraordinaire, and his wife, Betty Jo, spent untold hours screening files and documents so my debt to them is greater than I can ever repay. ...
Aims: The purpose of this study was to describe the care practices used by Certified Nurse-Midwiv... more Aims: The purpose of this study was to describe the care practices used by Certified Nurse-Midwives (CNMs) when providing second stage labor care, and to identify the facilitating factors and barriers to providing evidence-based care to women during this labor phase. Background: Most women who give birth in the U.S. are given arbitrary instructions concerning when and how to bear down. Therefore, birthing women do not receive second stage labor care that is based on the scientific evidence that indicates that support of women's spontaneous efforts contributes to more optimal maternal, fetal and neonatal outcomes. Methods: Prior to the focus group, a brief questionnaire was used to screen CNMs to identify potential participants who use evidence based second stage labor care practices such as support of maternal spontaneous pushing. A focus group of 7 CNMs was conducted in 2008 using a series of questions, audiotape recorded, transcribed and analyzed for themes. Results/Findings: Five major themes emerged from the analysis: 1) Recognition of second stage as physiologic (natural); 2) Midwifery care practices; 3) Direction as an intervention; 4) The fluid nature of supportive versus directive care practices; and 5) Barriers to supporting self-regulated pushing. Conclusion: The findings of this study suggested that second stage care tailored to the sensations and needs of individual women, versus routinized instructions,
Journal of Midwifery & Women's Health, Oct 1, 2015
The regulation of prescriptive authority for certified nurse-midwives (CNMs) and certified midwiv... more The regulation of prescriptive authority for certified nurse-midwives (CNMs) and certified midwives (CMs) is conducted by regulatory boards and individual state agencies. The purpose of this review was to update a previously conducted overview of the regulatory requirements relative to prescriptive authority for CNMs/CMs in the United States. State statutes and administrative rules relative to midwifery practice were reviewed for all 50 United States and the District of Columbia. As of June 14, 2015, the regulation of prescriptive authority for CNMs continues to vary widely across states, and CMs face substantial barriers to practice with prescriptive authority granted in just 2 states. Inconsistent regulatory requirements relative to prescriptive authority, which often impose barriers to full practice authority for midwives, continue to limit patients' access to necessary services in many states.
Nursing Education Perspectives
Journal of Pediatric Health Care, 2019
Background: Immunization-associated pain is the number one cause of pain in pediatric settings. U... more Background: Immunization-associated pain is the number one cause of pain in pediatric settings. Untreated pain has many shortand long-term detrimental effects. The purpose of this project was to implement a nonpharmaceutical immunization-associated−pain prevention program. Method: This project was implemented at a pediatric primary care clinic. Staff were educated about immunization-associated pain and techniques for decreasing/preventing pain. Families were educated about pain control, and the practitioner and parent/child picked interventions to decrease pain. Preimplementation and postimplementation data were collected using previously validated pain and satisfaction scales. Results: Pain prevention interventions decreased pain for children between 2 months and 7 years of age by 4.7 points on a Faces, Legs, Activity, Cry, Consolability (i.e., FLACC) scale. For children 7 years and older, pain during immunization decreased on average by 1.76 points on the visual analog scale. Conclusion: Non-pharmaceutical interventions are effective in decreasing immunization-associated pain. J Pediatr Health Care.
Journal of Midwifery & Women's Health, 2017
In addition to the regulation of prescriptive authority and prescribing practices conducted by in... more In addition to the regulation of prescriptive authority and prescribing practices conducted by individual states, the prescription of controlled substances is also regulated at the federal level by the US Drug Enforcement Administration (DEA). While there are variations in state laws relative to controlled substance prescribing, federal law is uniform across states as established by the Controlled Substances Act (21 United States Code § 801‐890) and the DEA Regulations (Title 21, Code of Federal Regulations). The only controlled substance for which states have authorized use that is outside the regulations set forth in the Controlled Substances Act is marijuana for the treatment of certain medical conditions. A review of statutes and administrative rules for all 50 states and the District of Columbia revealed that certified midwives (CMs) are authorized to prescribe controlled substances only in the state of New York, and there are variations across states in the regulation of contr...
Journal of Midwifery & Women's Health, 2015
Aims: The purpose of this study was to describe the care practices used by Certified Nurse-Midwiv... more Aims: The purpose of this study was to describe the care practices used by Certified Nurse-Midwives (CNMs) when providing second stage labor care, and to identify the facilitating factors and barriers to providing evidence-based care to women during this labor phase. Background: Most women who give birth in the U.S. are given arbitrary instructions concerning when and how to bear down. Therefore, birthing women do not receive second stage labor care that is based on the scientific evidence that indicates that support of women's spontaneous efforts contributes to more optimal maternal, fetal and neonatal outcomes. Methods: Prior to the focus group, a brief questionnaire was used to screen CNMs to identify potential participants who use evidence based second stage labor care practices such as support of maternal spontaneous pushing. A focus group of 7 CNMs was conducted in 2008 using a series of questions, audiotape recorded, transcribed and analyzed for themes. Results/Findings: Five major themes emerged from the analysis: 1) Recognition of second stage as physiologic (natural); 2) Midwifery care practices; 3) Direction as an intervention; 4) The fluid nature of supportive versus directive care practices; and 5) Barriers to supporting self-regulated pushing. Conclusion: The findings of this study suggested that second stage care tailored to the sensations and needs of individual women, versus routinized instructions,
Journal of Midwifery & Women's Health, 2015
The Journal of Perinatal & Neonatal Nursing, 2001
Court-ordered detention and prosecution of a pregnant woman for substance abuse is an unusual but... more Court-ordered detention and prosecution of a pregnant woman for substance abuse is an unusual but increasing occurrence in the United States. At least 24 states have attempted to prosecute a pregnant woman on a variety of charges for suspected harm to the fetus. This article reviews the issues involved including personal autonomy duty of caregivers to women and fetuses, and ethical frameworks for discussion.
The Journal of Perinatal & Neonatal Nursing, 2014
Scientific evidence supports spontaneous physiologic approaches to second-stage labor care; howev... more Scientific evidence supports spontaneous physiologic approaches to second-stage labor care; however, most women in US hospitals continue to receive direction from nurses and birth attendants to use prolonged Valsalva bearing-down efforts as soon as the cervix is completely dilated. Delaying maternal bearing-down efforts during second-stage labor until a woman feels an urge to push (laboring down) results in optimal use of maternal energy, has no detrimental maternal effects, and results in improved fetal oxygenation. Although most commonly used with women who are undergoing epidural anesthesia, laboring down is just one component of physiologic second-stage labor care that can be used to achieve optimal maternal and neonatal outcomes for women with or without an epidural. Prior efforts to translate evidence regarding second-stage labor care to practice have not been successful. In this article, the scientific evidence for second-stage labor care and previous efforts at clinical translation are reviewed. The Ottawa Hospital Second Stage Protocol is presented as a model with potential to allow translation of evidence to practice. Recommendations to enhance widespread adoption of evidence-based practice are provided, including improved collaboration between nurses and birth attendants.
Journal of Midwifery & Women's Health, 2011
Introduction: Certified nurse‐midwives (CNMs) and certified midwives (CMs) provide primary care t... more Introduction: Certified nurse‐midwives (CNMs) and certified midwives (CMs) provide primary care to women across the lifespan. Yet these primary care providers face barriers to practice that include restrictive state laws and regulations regarding prescriptive authority. The purpose of this review is to critically examine and report the regulatory requirements relative to prescriptive authority for CNMs/CMs in the United States.Methods: State statutes and rules relative to midwifery practice were reviewed for all 50 United States and the District of Columbia.Results: CNMs have been granted the authority to write prescriptions in all 50 United States and the District of Columbia, while CMs have been granted prescriptive authority only in the state of New York. Prescriptive authority for CNMs and CMs is regulated by individual state agencies and regulatory boards. Regulations regarding prescriptive authority for CNMs and CMs vary widely from state to state and are described, with a sum...
Journal of Midwifery & Women's Health, 2002
ABSTRACTDomestic violence affects many women and their families. Although estimates of the preval... more ABSTRACTDomestic violence affects many women and their families. Although estimates of the prevalence of domestic violence during pregnancy vary, it is likely that most providers of women's health care will encounter pregnant women who experience domestic violence. The purpose of this article is to review research that has investigated associations between domestic violence during pregnancy and other demographic and lifestyle variables, as well as the literature regarding clinical assessment and intervention strategies.
Journal of Midwifery & Women's Health, 2005
Since the inception of nurse-midwifery education 80 years ago, educators have looked for ways in ... more Since the inception of nurse-midwifery education 80 years ago, educators have looked for ways in which to educate enough nurse-midwives. The application of distance learning to nurse-midwifery education expanded opportunities for a greater number of students to have access to an education in nurse midwifery. The story of the Community-based Nurse-midwifery Education Program is presented as an exemplar.
Journal of Midwifery & Women's Health, 2013
Journal of Midwifery & Women's Health, 2012
Introduction: Although the risks associated with using sustained and forceful maternal bearing‐do... more Introduction: Although the risks associated with using sustained and forceful maternal bearing‐down efforts during the second stage of labor have been well documented, most women who give birth in the United States bear down in response to direction from care providers about when and how to push rather than in response to their own physiologic urges. The purpose of this study was to describe the practices used by certified nurse‐midwives/certified midwives (CNMs/CMs) in response to maternal bearing‐down efforts when caring for women in second‐stage labor and to identify factors associated with the use of supportive approaches to second‐stage labor care.Methods: A national survey of 705 CNMs/CMs was conducted using mailed questionnaires. The instrument was an 84‐item, fixed‐choice questionnaire using Likert type scales that had been validated. A 72.6% response rate was achieved, and 375 of the respondents cared for women during the second stage of labor.Results: Most CNMs/CMs (82.4%)...
Journal of Midwifery & Women's Health, 2010
... 2003 9. Willard Gayheart, Appalachian Artist. Willard Gayheart and Donia S. Eley. ... My brot... more ... 2003 9. Willard Gayheart, Appalachian Artist. Willard Gayheart and Donia S. Eley. ... My brother Paul Sluder, research assistant extraordinaire, and his wife, Betty Jo, spent untold hours screening files and documents so my debt to them is greater than I can ever repay. ...