Wednesday, July 30, 2014
FAIRFIELD-SUISUN, CALIFORNIA
99 CENTS

Nurses take initiative to improve patient care

By
From page WMD14 | March 16, 2014 |

FAIRFIELD — Does listening to music make it easier for an intensive care patient to be weaned from a mechanical ventilator? Does having a mom hold her newborn when he or she receives injections reduce the baby’s stress and pain?

The answer is “yes” to both questions, proven by evidence-based practice studies completed by three NorthBay Medical Center registered nurses who have made a difference in the hospital’s care practices.

The nurses, Maureen Allain, Barbara Abeling and Autumn Thacker, did their research through the Evidence-Based Practice Fellowship Program sponsored by NorthBay Healthcare.

Allain, a nurse in the Intensive Care Unit, knew that music could have a positive healing influence on patients’ lives. Brain function physically changes in response to music and studies show that music with steady, slow and repetitive low-pitched rhythms exerts a hypnotic effect that can reduce anxiety and aid relaxation. Music can also reduce the patient’s need for sedative drugs, leading to a quicker recovery.

Allain planned an evidence-based practice project to discover whether music could also help patients relax when they are being weaned from mechanical ventilation – one of the most frequently used treatments in the ICU. Despite the lifesaving nature of mechanical ventilation, it is stressful for patients and they are often sedated while intubated. Studies have demonstrated that the continuous use of sedation can delay weaning the patient from mechanical ventilation, which in turn increases hospital stays and hospital care costs.

“Currently our practice to remove patients from ventilators is to perform a ‘sedation vacation,’ ” Allain said. “We wake the patient and have them perform breathing exercises in an attempt to wean and remove them from the ventilator. This process can lead to anxiety for the patient, which ultimately contributes to the patient failing the weaning process and remaining on the ventilator for a longer period of time.”

Allain’s project included all mechanically intubated patients that met the criteria for weaning. Half of the group – the intervention group – listened to music through disposable headphones, while the other half – the control group – were weaned in the usual manner with no music. The number of patient’s extubated without music was 33 percent, while 58 percent were extubated with music.

“The study proved that the use of music therapy during the weaning process can lead to decreased ICU days and a decreased incidence of ventilator-acquired pneumonia,” Allain said. “The use of music also increases patient satisfaction during the ventilator weaning process.”

Labor and Delivery nurses Barbara Abeling and Autumn Thacker set out to study Kangaroo Care, or skin-to-skin contact, between mother and baby when treating mild to moderate pain in the newborn.

They narrowed their study to full-term, well newborns receiving injections in the first two hours of life. Hospital practice was for infants to receive their routine injections while under a radiant warmer with no pain management provided. Since research indicates that untreated pain in newborns can have long-lasting detrimental effects, they decided to determine if babies held skin-to-skin by their moms when they received injections showed less pain and recovered quicker than babies placed alone under a warmer.

“This may seem obvious, but we use evidence to prove a new practice works,” Abeling said. “And our research evidence proved that babies held skin-to-skin experience less pain overall, and they also appear to recover from the painful stimuli more quickly.”

Their research helped change the practice for how newborns receive injections at NorthBay Medical Center.

The nurses earned an Excellence in Research Award when they presented their research study at the Association of Women’s Health and Neonatal Nurses national conference last June.

“Everyone at the conference loved our study because they are all struggling with the same practice changes,” Abeling said. “Since the conference we have heard from other nurses who want to change the practice at their hospitals.”

Marilyn Ranson is a public relations specialist with NorthBay Healthcare.

Marilyn Ranson

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