2.50
Hdl Handle:
http://hdl.handle.net/10755/183166
Category:
Abstract
Type:
Presentation
Title:
Hyperbilirubinemia: Eliminating the Incidence of Kernicterus
Author(s):
Ortega, Elena; Gonzalez, M.
Author Details:
Elena Ortega, MSN, ARNP, CCRN, Miami Children's Hospital, Miami, FL, email: elena.ortega@mch.com; M. Gonzalez
Abstract:
Purpose: Recently, there has been an increase in readmission of newborns due to hyperbilirubinemia. There are several risk factors that contribute to this issue: (a) early discharge of mothers and babies less than 48 hours after birth, (b) lack of timely follow-up on bilirubin levels, (c) inadequate education of the parents on the importance of follow-up bilirubin levels, and (d) not insuring that the breastfeeding mothers are providing adequate intake to newborn. It is estimated that approximately 20-30 newborns develop kernicterus every year. At our institution, a multidisciplinary team, which included physicians, nursing directors, clinical specialists, managers, bedside nurses, the laboratory department and the clinical engineering department, came together to evaluate our current practice regarding the management of patients who came to the Emergency Department with the symptoms of hyperbilirubinemia. Method: The primary goal was to create a rapid response and intervene immediately with newborns experiencing hyperbilirubinemia symptoms in the Emergency Department, prior to the admission to the Neonatal Intensive Care Unit. Initial evaluation included an assessment of our current practices, and equipment needs as well as the knowledge level of the staff. As a result of this evaluation, several strategies were implemented. Hands-on-training was done with the emergency department nurses and included content on hyperbilirubinemia, potential complications and proper usage of hyperbilirubinemia treatment equipment. To improve efficiency, the turn around time of the bilirubin level through the laboratory was evaluated and new equipment (transcutaneous bilirubin meter) for immediate bilirubin level reading was researched and obtained. Further teaching on new equipment was done with the emergency department staff. Also, an algorithm was created to serve as a guide for the Emergency Department staff in order to give prompt care. Findings: After the implementation of the new algorithm and practice changes regarding hyperbilirubinemia treatment in the emergency department, there has been an increase in rapid initiation of treatment for the newborns with hyperbilirubinemia. There has been no incidence of significant increase in bilirubin levels from the moment patients arrived in the Emergency Department and when they were admitted into the Neonatal Intensive Care Unit. Discussion: The collaboration of several departments including the Neonatal Intensive Care Unit, Emergency Department, Laboratory Department and Clinical Engineering Department led to this significant change in our practice and improved patient care with a prompt response in assessment and evaluation of all newborns with hyperbilirubinemia. The implications led to an increased awareness and education about hyperbilirubinemia and the treatment needed in the Emergency Department to improve patient outcomes.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2010
Conference Name:
7th Annual Florida Magnet Research Conference
Conference Host:
University of South Florida College of Nursing; Sigma Theta Tau International; Florida Organization of Nurse Executives
Conference Location:
Naples, Florida, USA
Description:
7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, 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.titleHyperbilirubinemia: Eliminating the Incidence of Kernicterusen_GB
dc.contributor.authorOrtega, Elenaen_US
dc.contributor.authorGonzalez, M.en_US
dc.author.detailsElena Ortega, MSN, ARNP, CCRN, Miami Children's Hospital, Miami, FL, email: elena.ortega@mch.com; M. Gonzalezen_US
dc.identifier.urihttp://hdl.handle.net/10755/183166-
dc.description.abstractPurpose: Recently, there has been an increase in readmission of newborns due to hyperbilirubinemia. There are several risk factors that contribute to this issue: (a) early discharge of mothers and babies less than 48 hours after birth, (b) lack of timely follow-up on bilirubin levels, (c) inadequate education of the parents on the importance of follow-up bilirubin levels, and (d) not insuring that the breastfeeding mothers are providing adequate intake to newborn. It is estimated that approximately 20-30 newborns develop kernicterus every year. At our institution, a multidisciplinary team, which included physicians, nursing directors, clinical specialists, managers, bedside nurses, the laboratory department and the clinical engineering department, came together to evaluate our current practice regarding the management of patients who came to the Emergency Department with the symptoms of hyperbilirubinemia. Method: The primary goal was to create a rapid response and intervene immediately with newborns experiencing hyperbilirubinemia symptoms in the Emergency Department, prior to the admission to the Neonatal Intensive Care Unit. Initial evaluation included an assessment of our current practices, and equipment needs as well as the knowledge level of the staff. As a result of this evaluation, several strategies were implemented. Hands-on-training was done with the emergency department nurses and included content on hyperbilirubinemia, potential complications and proper usage of hyperbilirubinemia treatment equipment. To improve efficiency, the turn around time of the bilirubin level through the laboratory was evaluated and new equipment (transcutaneous bilirubin meter) for immediate bilirubin level reading was researched and obtained. Further teaching on new equipment was done with the emergency department staff. Also, an algorithm was created to serve as a guide for the Emergency Department staff in order to give prompt care. Findings: After the implementation of the new algorithm and practice changes regarding hyperbilirubinemia treatment in the emergency department, there has been an increase in rapid initiation of treatment for the newborns with hyperbilirubinemia. There has been no incidence of significant increase in bilirubin levels from the moment patients arrived in the Emergency Department and when they were admitted into the Neonatal Intensive Care Unit. Discussion: The collaboration of several departments including the Neonatal Intensive Care Unit, Emergency Department, Laboratory Department and Clinical Engineering Department led to this significant change in our practice and improved patient care with a prompt response in assessment and evaluation of all newborns with hyperbilirubinemia. The implications led to an increased awareness and education about hyperbilirubinemia and the treatment needed in the Emergency Department to improve patient outcomes.en_GB
dc.date.available2011-10-28T16:17:23Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T16:17:23Z-
dc.conference.date2010en_US
dc.conference.name7th Annual Florida Magnet Research Conferenceen_US
dc.conference.hostUniversity of South Florida College of Nursingen_US
dc.conference.hostSigma Theta Tau Internationalen_US
dc.conference.hostFlorida Organization of Nurse Executivesen_US
dc.conference.locationNaples, Florida, USAen_US
dc.description7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.en_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.-
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