Predict, Prevent and Manage Severe Hyperbilirubinemia in Term and Late Preterm Newborns

- Implementation Considerations

·       It has been demonstrated in a variety of settings that patient care consistent with recommendations in evidence- based guidelines leads to improved outcomes. Guidelines are designed to ensure that all members of a patient’s health care team are aware of the goals of treatment and of the different ways of achieving these goals. They help set standards of clinical care, may serve as a basis for audit, and act as a starting point for the education of health professionals and patients.

·       However, in order to effect changes in medical practice and consequent improvements in patient outcomes, evidence-based guidelines must be implemented and disseminated at national and local levels. Dissemination involves educating healthcare providers to improve their awareness, knowledge, and understanding of guideline recommendations. It is a part of implementation, which involves the translation of evidence-based guidelines into real-life practice with improvement of health outcomes for the patient. Implementation remains a difficult problem worldwide. Barriers to implementation range from poor infrastructure that hampers delivery of care to remote parts of a country, to cultural factors that make patients reluctant to use recommended medications and lack of use of guidelines

Guideline Implementation Strategies:

·        Implementing guidelines in practice that result in successful practice changes and positive clinical impact is a complex undertaking.  There are many strategies that can be helpful during implementation, which include the following:

- Identifying an individual to lead the project who is able to provide dedicated time to implementation. This leader will provide support, clinical expertise and should have strong interpersonal, facilitation and project management skills.

- Utilizing a systematic approach to planning, implementation and evaluation of the guideline initiative. A work plan is helpful to keep track of activities and timelines.

- Before a change in practice that can be expected and guideline recommendations implemented, the attitudes, values and beliefs of staff about NNJ must be addressed through a preliminary questionnaire.