Late-Preterm Infant-Who Am I? Using Evidence-Based Practice Model to Expedite Improvement of Care to Vulnerable Infants

2.50
Hdl Handle:
http://hdl.handle.net/10755/164062
Category:
Abstract
Type:
Presentation
Title:
Late-Preterm Infant-Who Am I? Using Evidence-Based Practice Model to Expedite Improvement of Care to Vulnerable Infants
Author(s):
Allen, Marianne
Author Details:
Marianne Allen, MN, RNC-OB, Pinnacle Health System, Harrisburg, Pennsylvania, USA, email: mallen@pinnaclehealth.org
Abstract:
PURPOSE/OBJECTIVES: To describe the role of the Clinical Nurse Specialist (CNS) in applying an evidence-based practice model to implement standards addressing the unique physiological and developmental needs of vulnerable late-preterm infants. SIGNIFICANCE: In 2005, the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) launched initiatives addressing the unique needs of late-preterm infants of 34 and 37 weeks gestation, accounting for 71% of preterm births. The standards focused on neonatal functional status, nursing care practices, care environment, and role of families in the hospital and after discharge. Prematurity is one of the most significant threats to infants. Although late-preterm infants may appear to be smaller versions of term infants, they are at high risk for problems related to immaturity of each body system, thermoregulation, hypoglycemia, jaundice and feeding. Prematurity may negatively impact on outcomes, provide challenges to families and result in increased costs to both the parents and the organization. DESIGN: The Iowa Model of Evidence Based Practice to Promote Quality Care is used to demonstrate the processes of implementing evidence-based practice changes for care of the late-preterm infant. Practice changes were accomplished during a 4-year period of time, contrasted to 17-24 years typically cited for implementation of research into practice. Methods: Lead by the maternity CNS, the unit-based nursing committees reviewed literature, assessed current practices, and implemented practice changes. The CNS collaborated with Maternity Center, Labor and Delivery, NICU and pediatricians. Practice changes included: Late-preterm infant order sets; parent education materials; car seat challenge testing; gestational age assessment tool; skin-to skin contact; sleepers for thermoregulation; hyperbilirubinemia assessment/management; staff education. FINDINGS: Improved nursing practice based on gestational age rather than routine care; parent education specific to needs of late-preterm infants; early breastfeeding initiation/follow-up; increased staff awareness of vulnerability of late-preterm infant; increased collaboration between nurses and physicians; timely post-discharge follow-up. CONCLUSIONS: A model of evidence-based practice guided the processes that indicated a sufficient research base for practice change. The development of tools to promote gestational-age appropriate standards has enhanced care and reduced risks to the late-preterm population. IMPLICATIONS FOR PRACTICE: Using a model of evidence-based practice can expedite application of research to practice to improve patient outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2010
Conference Name:
CNS as Interal Consultant: Influencing Local to Global Systems
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Portland, Oregon, USA
Description:
Conference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleLate-Preterm Infant-Who Am I? Using Evidence-Based Practice Model to Expedite Improvement of Care to Vulnerable Infantsen_GB
dc.contributor.authorAllen, Marianneen_US
dc.author.detailsMarianne Allen, MN, RNC-OB, Pinnacle Health System, Harrisburg, Pennsylvania, USA, email: mallen@pinnaclehealth.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164062-
dc.description.abstractPURPOSE/OBJECTIVES: To describe the role of the Clinical Nurse Specialist (CNS) in applying an evidence-based practice model to implement standards addressing the unique physiological and developmental needs of vulnerable late-preterm infants. SIGNIFICANCE: In 2005, the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) launched initiatives addressing the unique needs of late-preterm infants of 34 and 37 weeks gestation, accounting for 71% of preterm births. The standards focused on neonatal functional status, nursing care practices, care environment, and role of families in the hospital and after discharge. Prematurity is one of the most significant threats to infants. Although late-preterm infants may appear to be smaller versions of term infants, they are at high risk for problems related to immaturity of each body system, thermoregulation, hypoglycemia, jaundice and feeding. Prematurity may negatively impact on outcomes, provide challenges to families and result in increased costs to both the parents and the organization. DESIGN: The Iowa Model of Evidence Based Practice to Promote Quality Care is used to demonstrate the processes of implementing evidence-based practice changes for care of the late-preterm infant. Practice changes were accomplished during a 4-year period of time, contrasted to 17-24 years typically cited for implementation of research into practice. Methods: Lead by the maternity CNS, the unit-based nursing committees reviewed literature, assessed current practices, and implemented practice changes. The CNS collaborated with Maternity Center, Labor and Delivery, NICU and pediatricians. Practice changes included: Late-preterm infant order sets; parent education materials; car seat challenge testing; gestational age assessment tool; skin-to skin contact; sleepers for thermoregulation; hyperbilirubinemia assessment/management; staff education. FINDINGS: Improved nursing practice based on gestational age rather than routine care; parent education specific to needs of late-preterm infants; early breastfeeding initiation/follow-up; increased staff awareness of vulnerability of late-preterm infant; increased collaboration between nurses and physicians; timely post-discharge follow-up. CONCLUSIONS: A model of evidence-based practice guided the processes that indicated a sufficient research base for practice change. The development of tools to promote gestational-age appropriate standards has enhanced care and reduced risks to the late-preterm population. IMPLICATIONS FOR PRACTICE: Using a model of evidence-based practice can expedite application of research to practice to improve patient outcomes.en_GB
dc.date.available2011-10-27T11:41:17Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:41:17Z-
dc.conference.date2010en_US
dc.conference.nameCNS as Interal Consultant: Influencing Local to Global Systemsen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPortland, Oregon, USAen_US
dc.descriptionConference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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