Barriers to Evidence-based Nursing Practice

Barriers to Evidence-based Nursing Practice

This paper consists of two section and each section should have its own reference list at the end
of that section. In section A an article is attached that will be used to complete that section. It is
critical to respond to all questions detail and properly address the facts in each section without
the omission of any point.
Gennaro, S., & Reiser, D. (2006) Hyperbilirubinemia: identification and management in the
healthy term and near-term newborn (2nd Ed) Washington, DC: AWHONN.

A literature review was conducted to identify the best methods that can be used in the delivery of
photo therapeutic treatment. It was discovered that no standard method was in place and a way of
delivering these treatments. The only guidance that was provided regarding these treatments was
the AAP policy statement on jaundice. It states that the light source for an infant has a rather
dramatic effect on the special irradiance and as a result affects the treatments. The change
therefore required that the fluorescent tubes be put closer to the infants as much as possible while
the infant is placed in a bassinet and not an incubator. The reason for the bassinet as a better baby
holder was the fact a fluorescent tube placed in it can be adjusted up to ten centimeters above the
baby. The effect of the change was that the delivering of phototherapy treatment to the full term
for a healthy infant in an isolette would not be so much as effective as it would be if
phototherapy was given to an infant in an open crib. The change therefore did not lead to
improved patient outcomes (Gennaro & Reiser, 2006).

The barriers to change that were met in this case study resulted in the fact that the
children services nursing quality improvement committee and the unit based practice council
were formed which resulted in the slowing of decision making processes. There was enough
evidence to support the provision of phototherapy by the use of an open crib instead of providing
external heat and light sources. Another barrier was that the pediatricians were very skeptical
about initiating the new modalities but after a few deliberations approved it with several
conditions that would have made the entire exercise tasking. These conditions included the
hourly recording of infant temperature. The outcome of these particular condition was that it
raised the nurses concerns that these hourly intervention would have an effect on the quality of
nursing care and the quality of rest that these infants and there new mothers required. The fact
that the pediatricians were sympathetic to the nurses concerns did not sway them in any way and
they remained completely adamant (Walker,Vroman, & Becker,2007).
This article will be important to me in my advancement of my nursing practice in the
sense that it will help in the improvement of my personal nursing quality of infants. The results
of the project will also be helpful to me in the fostering of camaraderie. It will also help me learn
the open crib phototherapy policy and procedure as the standard of care for infants. Evidence
from other studies indicate that improvements in nursing sensitive patient outcomes can be
improved if nurses become cognizant with the information and knowledge that has already been
published and to improve their competency and knowledge about nursing care. Increased and
proactive use of evidence based practices in the clinical setting is particularly important in
improving nursing care quality (Goolsby, 2000).



Gennaro, S., & Reiser, D. (2006) Hyperbilirubinemia: identification and management in the
healthy term and near-term newborn (2nd Ed) Washington, DC: AWHONN.
Goolsby, M. (2000) Clinical practice guidelines of the American Academy of Pediatrics: a
compilation of evidence-based guidelines for pediatric practice. (3rd Ed) Elk Grove
Village, IL: American Academy of Pediatrics.
Walker, L., Vroman, L., & Becker, J. (2007). Using Evidence to change Practise. Open Filed
Phototherapy , 402-404.

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