Paper
Saturday, July 14, 2007
This presentation is part of : Stimulating Transdisciplinary Scholarship in Diverse Clinical Nursing Specialties
The use of the Bilibed for infants hospitalized for treatment of Hyperbilirubinemia
Patricia Decina, RN, BSN, CNP and Lisa Waraksa, RN, BSN, CNP. Pediatrics, Bryn Mawr Hospital, Bryn Mawr, PA, USA

Treatment of Hyperbilirubinemia in infants using quadruple phototherapy interferes with parent –infant bonding  by creating a barrier to sight, sound, and touch.   The lights can cause overheating associated with insensible fluid loss which frequently prompts evaluation for sepsis in infants. The evaluation can include  blood draws, lumbar puncture, and/or catheterization and can lead to initiating IV fluid replacement and prophylactic antibiotics.  Gathering the various pieces of equipment needed for phototherapy causes delays in treatment.

 All of this lead two pediatric nurses to seek a better way.  Following attendance at a national conference, they were determined to gain support for trialing the bilibed at this hospital.  In order to gain support, they knew they would need to gather data.  They contacted local hospitals using the bilibed and asked them to complete a survey about use of this product.  They were able to gain support for the trial from their nurse manager and the medical director of the unit.  

 

 Twenty infants were enrolled in a study to determine the effectiveness of the bilibed.
Bilirubin levels were recorded on admission and at discharge.  Infants were placed on the bilibed and parents are instructed on its use.  Irradiance, hours of phototherapy, and  length of hospital stay were noted.  Group means were calculated.  Healthcare providers were surveyed to assess their satisfaction with the bilibed.

 The means were as follows: admission bilirubin , 19.9 mg/dl;  discharge bilirubin 13.5 mg/dl, irradiance 65.8 microwatts/cm2/nm; hours on the bilibed 21.9, and length of hospital stay, 33.7 hours.  None of the patients on the bilibed had a febrile episode resulting in further testing and treatment.

 The bilibed is a safe, effective, and efficient treatment method for Hyperbilirubinemia that allows us to deliver patient centered care in a timely, cost effective manner.