Imprint 2021 November/December November/December 2021 | Page 21

Nurses As Innovators in Patient Care By Anna Staiger

Nursing students often do not consider themselves scientists , researchers , or innovators . The intensity of a curriculum focused on healthcare content and clinical skills leaves little time to think creatively . Nevertheless , the profession of nursing is rooted in innovation . The most common example being Florence Nightingale ’ s implementation of hygiene practices that dramatically improved the outcomes for British troops during the Crimean war in the 1800s ( Sheingold , 2014 ). Since then , nurses have continuously been innovating solutions in patient care , and we have seen many examples during the COVID-19 pandemic such as the development of new face shields and implementation of virtual roundings in hospitals ( Johnson & Johnson Nursing , 2020 ).

COVID-19 has imposed unanticipated challenges related to maternal-infant care . In the early days of the pandemic , there was little evidence to reassure healthcare providers and mothers that it was safe to be together ( CDC , 2021 ). The hospital was the last place you wanted to be if you were having a baby , yet obstetrics is the most common reason for hospitalization with more than 4 million hospitalized births every year ( Brown , 2017 ).
Imagine an infant born to a first-time mother who had an uneventful pregnancy and delivered the infant at 36 6 / 7 weeks gestation by spontaneous vaginal delivery at 2650g without the need for oxygen or hemolytic concerns . The infant ’ s low intermediate bilirubin allowed for him to be discharged two days after his birth .
At home , the baby was breastfeeding 8-12 times a day , but parents reported they had not changed a wet diaper since they arrived home from the hospital , and the baby appears to have a yellow hue . You are a nurse in the Neonatal Intensive Care Unit ( NICU ) when the parents receive the devastating news that they need to leave their son in the NICU for phototherapy to treat his high bilirubin levels and jaundice diagnosis .
Despite being otherwise healthy , and in the absence of any other serious risk factors , 91 % of newborns are readmitted to the hospital due to jaundice within their first 14 days of life . These readmitted infants use limited time and resources of hospital staff while being separated from their families , disrupting newborn attachment and critical development of feeding skills ( Lain , 2015 ).
It was the innovation spurred by the clinical observations of British nurse Sister Jean Ward who noted that infants placed in the sunlight were less jaundiced , leading to the development of phototherapy . Phototherapy treats jaundice by allowing blue light within the 430-490 nm light spectrum to enter the infant ’ s superficial capillaries and convert bilirubin to water-soluble isomers that can be excreted in the infant ’ s urine and stool . The light must be bright enough (> 30-35 µ W / cm 2 / nm ) to effectively treat jaundice ( Stokowski , 2011 ; American Academy of Pediatrcs , 2004 ).
Meet the Blue Blanket Team
During COVID-19 , the stress of maternal-infant separation was exacerbated by strict hospital visitation policies . Critical maternal-newborn behaviors such as breastfeeding were disrupted due to this level of separation . Given our mutual clinical interests in newborn health , I approached Dr . Sunny Hallowell , a pediatric nurse practitioner , researcher , and assistant professor at the M . Louise Fitzpatrick College of Nursing at Villanova University to explore research opportunities in nursing . Serendipitously , she was working on a project with engineering students to develop a solution for newborn jaundice ; she asked me if I was interested in participating in this project .
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