Date of Conferral

2023

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Trinity Ingram-Jones

Abstract

AbstractProviders at a community-based pediatric hospital in the southern region of the United States have traditionally transferred otherwise healthy neonates with hyperbilirubinemia requiring inpatient treatment to a tertiary care facility. The question addressed was whether the implementation of an evidence-based, organizational protocol increases the quality and decreases the cost of caring for neonates with hyperbilirubinemia in the community-based, pediatric acute care hospital. The main goal of the organization’s quality improvement (QI) project was to facilitate the provision of high-quality, cost-effective care to neonates with hyperbilirubinemia using an evidence-based approach as evidenced by a reduction in the number of neonates with hyperbilirubinemia transferred to the tertiary care facility, decreased cost to the organization, and increased level IV Neonatal Intensive Care Unit (NICU) bed availability at the tertiary care facility. The evaluation of the existing QI initiative was based on 12 months of pre-implementation data compared to 60 days post-project implementation. The data points collected included the number of neonates with hyperbilirubinemia transferred from the community-based facility to the tertiary care facility, the cost of the transport, and the number of NICU beds occupied by these neonates. The short evaluation period and staff non-compliance to the protocol were the main barriers to project goal attainment. Staff re-education to ensure adherence to the protocol and a longer evaluation period to provide sufficient data for analysis were recommended to facility leadership. The use of evidence-based principles and practices to inform processes, guide clinical practice, and solve clinical problems is anticipated to promote positive social change in the local and extended community.

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