Wednesday, May 02, 2007

Victoria's Research Corner

As evidence based projects (EBP) and research studies are being done, I wanted to let you know about projects as they are happening. Every newsletter, I will be interviewing someone who is doing either an EBP or a research study. For this newsletter I had the wonderful opportunity of interviewing Terry Zeilinger, Manager of the Mother-Baby Unit, regarding her research study, “Determination of whether 36-hour screening transcutaneous bilirubin adds to knowledge gained from 24-hour screening”.

Q. What is your study about?
A. “We are looking at transcutaneous bilirubins at 36 hours in babies who are born here at St. Joseph’s Hospital during a 3-month period who are not discharged before 36 hours post delivery. The standard of care has been 24-hour bilirubins and then on a PRN (as needed) basis if a baby looks jaundiced. Most babies’ average length of stay is 2 days for a vaginal delivery and three days for a C-section. We are trying to catch babies who are in trouble with abnormal (high) bilirubins to try to avoid complications such as increased dehydration, poor feeding, and ultimately kernicterus.”

Q. Is it an EBP/Research Study?
A. “This is a quantitative research study.”

Q. What made you interested in this project?
A. “We had a baby whose bilirubin was normal at 24 hours. At 40 hours the nurse noticed the baby looked jaundice and took a transcutaneous bilirubin, the level was high. The baby went home and was then readmitted to CHOC for still increased bilirubin. A few other babies were also readmitted post discharge from the Mother/Baby Outpatient Center due to high bilirubins.”

Q. How did you go about doing your research?
A. “I decided to look into the research already available and realized there weren’t any other studies that looked at bilirubins greater than 24 hours. After discussing with a colleague, she suggested I make this a research study. I then went to Dana Rutledge, the Nurse Research Facilitator, and we organized the information. I then had to go the Institutional Review Board (IRB) for approval of my study. Now I am doing chart reviews looking at trending in 24 and 36-hour bilirubins of babies.”

Q. What are your expected outcomes?
A. “We have already started the practice change and the study in the units looking at 36-hour bilirubins and so far, empirically, there are more babies already requiring phototherapy. Hopefully, we will be able to find these “high risk” babies and give intervention, supplementation, and closer follow-up.”

Q. Have you done research before? If so what did you learn?
A. “I did a small project for my Master’s, which looked at finger feeding preterm infants versus bottle-feeding. I learned that although research is interesting there is some frustration with the amount of time it takes. There can be a lot of limitations. You must review policy and procedures, look at articles, go to councils for approval, and possibly change a practice.”

Q. Will you do an EBP/research project again?
A. “I would like to. I definitely have an interest. The mother baby unit based council and myself are looking at alcohol application versus natural cord drying in infants, this may lead to another study.”

1 comment:

Judy Rousch, RN, BSN said...

I love this interview format. But I'm curious what newsletter you are referencing?