Increasing capacity for evidence-based practice through the evidence-based practice academy.

Although mentoring is an important aspect of implementing evidence-based practice (EBP), few models exist for EBP education. The EBP Academy is an innovative, 6-month educational program designed to develop clinical staff as EBP nurse mentors. Sessions provide protected time for participants to work on their EBP projects with assigned mentors who have EBP expertise and similar clinical or research interests. Participants develop EBP projects focused on improving care in their clinical areas. Evaluation of the EBP Academy is based on a four-level model, including participant feedback about the program, perception of meeting program objectives, ability to apply knowledge to practice through EBP projects, and outcome data measured as a result of implementing the EBP changes. By developing EBP mentors, capacity to move nursing practice to a stronger evidence-based foundation can be enhanced. Positive, professional nursing and patient outcomes have been demonstrated when structured EBP education is provided.

Oral feeding readiness in the neonatal intensive care unit.

Oral feeding is a complex sensorimotor process that is influenced by many variables, making the introduction and management of oral feeding a challenge for many health care providers. Feeding practice guided by tradition or a trial-and-error approach may be inconsistent and has the potential to delay the progression of oral feeding skills. Oral feeding initiation and management should be based on careful, individualized assessment of the NICU infant and requires an understanding of neonatal physiology and neurodevelopment. The purpose of this article is to help the health care provider with this complex process by (a) defining oral feeding readiness, (b) describing the importance of oral feeding in the NICU and the physiology of feeding, and (c) providing a review of the literature regarding the transition from gavage to oral feeding in the NICU.

A neonate with microphthalmia and median clefting of the lower lip and mandible.

Median clefts of the lower lip and mandible are very rare congenital anomalies. We report a female infant born to nonconsanguineous parents with unilateral microphthalmia and complete median clefting of the lower lip and mandible. This uncommon constellation of congenital malformations has never been reported in a liveborn infant.

Developing a strategic plan for a neonatal nurse practitioner service.

Neonatal nurse practitioners (NNPs) have been in practice for over 3 decades. More recently, NNPs have begun to take ownership for building their group practice models. The purpose of this article is to present a detailed case study demonstrating how one NNP group used a 4-phase strategic planning process to turn a crisis into an opportunity. The article describes data obtained during the strategic planning process from an informal national survey of NNP managers that focused on key benchmarks, such as role definition, responsibilities, protected nonclinical time, NNP salary and benefits, and educational and professional development support. Using the strategic planning process, the group defined mutually agreed upon minimum safe staffing levels for NNPs, interns, residents and neonatologists in their setting. Based on the data generated, the group successfully justified additional NNP positions and organizational support for 10% protected nonclinical time. A sample operational budget, comparison of 3 staffing scenarios, and a timeline are also provided.