Healthcare Capstone Academy for Practical Nursing and Health Occupations
1Skin-to-skin contact has a multitude of researched benefits for an infant including, thermoregulation, cardiac regulation, neurostimulation, stabilization of blood glucose levels and encouraging the initiation on breastfeeding. Breastfeeding also has been proven to have extensive benefits such as a decreased risk of cancer, diabetes, childhood obesity, development of allergies and an increase in overall intelligence just to name a few. For my EBP I am suggesting that all maternity units should implement immediate skin-to-skin contact (SSC) between mother and infant (or father and infant if mother not stable to do so) as standard newborn care in order to promote breastfeeding along with the additional health benefits.
One obstacle of initiating SSC is lack of infant stabilization, especially in neonates. Many neonates are very unstable from minute to minute, hour to hour and day to day and due to this instability, it is hard to implement skin-to-skin contact at any point in their recovery because of the need to continuously monitor their vitals. Currently, “sensors that measure a premature newborn’s heart rate, breathing rate and other vital signs in the neonatal intensive care unit require electrodes whose glue can hurt and scar a preemie’s delicate skin, and wires that can prevent cuddles and other skin-to-skin contact babies need” (McCartney, N. & Pawlowski A., 2019).
Researchers at Northwestern University have recently “unveiled wireless soft, ultra-thin, flexible skin-like sensors” in hopes that this will be a suitable alternative for monitoring neonates’ vital signs. Wireless sensors are placed both on the baby’s chest and foot and then data is transmitted using near-field communication. Near-field communication is a technology that resembles that used to make a wireless payment from a smartphone. This technology could allow for infants to be placed skin-to-skin with their mothers, receiving the above-mentioned benefits of SSC and hopefully encouraging the process of breastfeeding or even mothers milk to come in (McCartney, N. & Pawlowski A., 2019).
While the article discusses the use of this technology within the NICU, there is no reason why it couldn’t be useful for full-term, healthy newborns within a maternity unit as well. When SSC is initiated for any newborn the nurse still needs to assess the infant’s vitals regularly to assure that their vitals remain stable. In order to complete this assessment, the RN needs to disrupt the independent SSC between mother and infant. While SSC isn’t discontinued, the manipulation required by the nurse in order to accurately assess the infant’s vitals does cause slight discontinuation of infant contentment on his/her mothers’ chest. There are also many instances when a nurse needs to disrupt an infant breastfeeding in order to get their assessment. This can all be avoided if there were an easier way to monitor the infant’s vitals independently from physical touch and intervention. Overall, I believe this would only enhance the mother/infant bonding and skin-to-skin experience and benefits!
2-Healthcare technology includes bedside physiologic monitors, pulse oximetry devices, electrocardiogram machines, bedside telemetry, infusion pumps, ventilators, and electronic medical records (EMRs) as well as electronic health records (EHRs). It is used to improve delivery of safe patient care by providing tools for early diagnosis, ongoing monitoring, and treatment of patients. Healthcare technology also plays an important role in projects’ implementation. In my capstone project, I am using cloud based/web based EMR that can improve the implementation process and the outcomes of the EBP.
Cloud-based software technology was introduced to replace the paper. The EMR technology “gives health care providers information in formats that were not possible with paper charts” (Manca, 2015). For instance, the EMR technology enables viewing and printing graphs of values such as weight, cholesterol levels, and blood pressure, tracking changes over time; improves attainment of chronic disease management, prevention, and screening targets (Manca, 2015). Also, EMRs can provide treatment goals or alerts to remind providers when certain prevention and screening maneuvers are due or out of date. For instance, as in case of CAUTIs prevention, which is the topic of my project, EMR system with physician order entry and nursing documentation builds charting modules that reinforce the appropriateness of catheter use, reducing CAUTIs incidences and hence improving patient outcomes. A physician order for a catheter requires criteria for catheter insertion “mapped to the nursing checklist, which triggers a “foley maintenance protocol” (Pharmacy OneSource Blog, 2014). A device-specific charting module provides for nursing documentation of patient
