Abstract
While there has been much progress advancing evidence-based practice in the hospital setting, challenges still exist in rural hospitals with limited resources and no evidence-based practice framework. Implementing evidence-based practice for the rural inpatient neonatal population is grossly underreported. Yet many rural hospitals are forced to provide care for these at-risk patients both in the short and long-term. Neonates are particularly vulnerable to out of date practices and lack of evidence-based management protocols. With the neonate at risk for a multitude of complications after birth, there remains a wide variation in management and nursing care. Often, medical and nursing care for these patients is guided by personal experience and training philosophy with little regard to best practice. The purpose of this project was to implement a model for change to evidence-based practice utilizing best scientific evidence, clinical expertise and patient advocacy to develop a neonatal nursing clinical protocol for the birth and infant care center of a rural inpatient hospital setting. All Birth and Infant Care Center nursing staff of a small rural Nebraska hospital were asked to voluntarily complete the Evidence-Based Nursing Practice Self Efficacy Scale at baseline and prior to any evidence-based practice education. The Rosswurm-Larrabee model was used as the framework for this project and to guide the incorporation of evidence-based nursing practice. Comparing data from pre and post scales showed that confidence about the importance, location, process, and use of evidence-based nursing practice all improved significantly (p < .01). Sixteen of the seventeen items of the Evidence-Based Nursing Practice Self Efficacy Scale demonstrated statistically significant improvement in nursing confidence in their evidence-based nursing practice with self-reported confidence levels over 80%. The findings of this project provided evidence that a systematic program using a model for change can engage neonatal nurses in the rural hospital setting in promoting evidence-based practice.