Principle investigators
Tamara Leal, Kathy Reitmeyer, Denise Howard, Emily Sebesta, Linda Jewell, Mary Sciuto, Sue Hurst, Tanya Rodriguez, Lottie Bills, Anne Marie Hagstedt, Monica Thompson, Chris Tussey, and Jennifer Mesnik..
Current practice

Every baby under 37 weeks receives a serum bilirubin (MBR) for screening of bilirubin levels prior to discharge. Only babies 37 weeks and over, receive a transcutaneous bilirubin (TCB) for screening of bilirubin prior to discharge. If the TCB reading is above the recommended acceptable range, an MBR is performed. Proposed practice

The proposed practice is to screen for bilirubin by utilizing the TCB on all infants prior to discharge. This practice would eliminate the unnecessary venipuncture of the late preterm infant. Babies whose levels are in the high risk category will receive an MBR.

Implementation Input was gathered, from bedside nursing staff, as to the PICO question of interest. Final question was accepted. Each attended a 3 day education conference on the process of EBP. Data gathering forms were developed and staff was educated as to the process. Each staff member  received one on one instruction as to the correct use of the Bilicheck machine. All babies 34-37 weeks, 24-72 hours old, would not only receive an MBR, but also a TCB, done either simultaneously or within 30 minutes. TCB’s were not performed on babies who had received or were currently receiving phototherapy.The MBR were sent to lab within 5 minutes for processing, results were available within 1 hour. The patient did not incur the charge of this non-invasive additional testing. The data was gathered between the dates March 17-August 7, 2008, with a sample size of 116.  
Analysis
SPSS 16.0 was used to analyze the data. There was a total sample size of 112 newborns with gestational ages ranging 33 to 37 weeks (M = 35.5, SD = .759) with both a MBR (M = 7.098, SD = 1.845) and TCB (M = 7.915, SD = 2.39) test result obtained.  A paired t-test demonstrated significant difference between the two tests (p = .000). 
Results and implications for practice
The results showed that there was a significant difference between the two test results. At this point, the MBR remains the gold standard for accuracy in determining bilirubin levels in newborns.  As prior research concludes, the TCB may not be accurate for newborns with darker pigmentation (Maisels et. al, 2004). Since approximately 40% of the population in this hospital is of Hispanic ethnicity,, this may have been a factor influencing results.
As well, tests were obtained from various subjects at one data point, instead of being obtained repeatedly. Future research should include repeated measures of both the TCB and MBR on subjects.  Perhaps the TCB can serve as a trigger at a certain level to warrant an MBR.
Education and research
Behavioral Objectives;
1) Assess staff knowledge of the EBP process.
2) Measure their understanding of the process following the dissemination of the EBP results and implications to their current practice.
3) Recognize the value in the results of this EBP project.