Neonatal dicharge criteria

OBJECTIVES: Hospital discharge marks an important transition in care from the inpatient team to the family and primary care provider. Parents must know the hospital course and discharge plan to care for their child at home and provide background for future providers. Our study aimed to determine parental knowledge of key aspects of their child's hospital course and discharge plan and to identify markers of increased risk for incomplete or incorrect knowledge among participants. METHODS: We conducted a descriptive prospective cohort study of parents within 24 hours of hospital discharge...

OBJECTIVE: The delivery of anticipatory guidance regarding newborn care is a standard practice for pediatricians. The purpose of this prospective study was to analyze the preexisting knowledge of routine newborn care in postpartum mothers. METHODS: Inclusion criteria included all postpartum mothers of live-born infants at least two hours following delivery that had not yet received formal instruction in newborn care. Each eligible mother that agreed to the voluntary survey was asked four multiple-choice questions which evaluated her knowledge of newborn care...

OBJECTIVE: Children who require chronic mechanical ventilation via tracheostomy are medically complex and require prolonged hospitalization, placing a heavy burden on caregivers and hospital systems. We developed an interdisciplinary Ventilator Care Program to relieve this burden, through improved communication and standardized care. We hypothesized that a standardized team approach to the discharge of tracheostomy- and ventilator-dependent children would decrease length of stay (LOS), reduce patient costs, and improve safety...

BACKGROUND AND OBJECTIVES: Discharging patients from the NICU may be delayed for nonmedical reasons including the need for medical equipment, parental education, and children's services. We describe a method to predict which patients will be medically ready for discharge in the next 2 to 10 days, providing lead time to address nonmedical reasons for delayed discharge. METHODS: A retrospective study examined 26 features (17 extracted, 9 engineered) from daily progress notes of 4693 patients (103,206 patient-days) from the NICU of a large, academic children's hospital...

BACKGROUND: Early discharge of stable preterm infants still requiring gavage feeds offers the benefits of uniting families sooner and reducing healthcare and family costs compared with discharge home when on full sucking feeds. Potential disadvantages of early discharge include increased care burden for the family and risk of complications related to gavage feeding. OBJECTIVES: To determine the effects of a policy of early discharge of stable preterm infants with home support of gavage feeding compared with a policy of discharge of such infants when they have reached full sucking feeds...

OBJECTIVE: To compare the incidence of postpartum maternal and neonatal complications and hospital readmission in patients discharged 24 versus 72 h after cesarean section. METHODS: Using randomization, 1495 patients were discharged after 24 h and 1503 patients were discharged after 72 h. All patients fulfilled the discharge criteria. Patients were assessed 6 weeks after delivery, any maternal or neonatal problems or hospital readmissions during this time interval were reported...

BACKGROUND: Early discharge of mother/neonate dyad has become a common practice, and its effects are measured by readmission rates. We evaluated the safety of early discharge followed by an individualized Follow-up programme and the efficacy in promoting breastfeeding initiation and duration. METHODS: During a nine-month period early discharge followed by an early targeted Follow-up was carried out in term neonates in the absence of weight loss <10% or hyperbilirubinaemia at risk of treatment...

BACKGROUND: We have developed a Family Integrated Care (FIC) model for use in a neonatal intensive care unit (NICU) where parents provide most of the care for their infant, while nurses teach and counsel parents. The objective of this pilot prospective cohort analytic study was to explore the feasibility, safety, and potential outcomes of implementing this model in a Canadian NICU. METHODS: Infants born ≤ 35 weeks gestation, receiving continuous positive airway pressure or less respiratory support, with a primary caregiver willing and able to spend ≥ 8 hours a day with their infant were eligible...

OBJECTIVE: To evaluate trends in adherence to American Academy of Pediatrics recommendations for early discharge of late-preterm newborns and to test the association between hospital characteristics and early discharge. PATIENTS AND METHODS: This study was a population-based cohort study using statewide birth-certificate and hospital-discharge data for newborns in California, Missouri, and Pennsylvania from 1993 to 2005. A total of 282 601 late-preterm newborns at 611 hospitals were included...

This policy statement updates the guidelines on discharge of the high-risk neonate first published by the American Academy of Pediatrics in 1998. As with the earlier document, this statement is based, insofar as possible, on published, scientifically derived information. This updated statement incorporates new knowledge about risks and medical care of the high-risk neonate, the timing of discharge, and planning for care after discharge. It also refers to other American Academy of Pediatrics publications that are relevant to these issues...

OBJECTIVE: The timely discharge of moderately premature infants has important economic implications. The decision to discharge should occur independent of unit census. We evaluated the impact of unit census on the decision to discharge moderately preterm infants. DESIGN/METHODS: In a prospective multicenter cohort study, we enrolled 850 infants born between 30 and 34 weeks' gestation at 10 NICUs in Massachusetts and California. We divided the daily census from each hospital into quintiles and tested whether discharges were evenly distributed among them...

OBJECTIVES: To document whether medically stable infants can be transferred safely from incubators to unheated, open cots at 1500 g. METHODS: Four cohorts were recruited in a stepwise observational trial of transfer from incubators to unheated, open cots. We aimed to transfer the first 15 infants into cots on reaching a weight of 1800 g, the second at 1700 g, the third at 1600 g and the fourth at 1500 g. Nursery temperatures were set at 25 degrees C. The primary outcome measure was failure of transfer defined as the inability to maintain body temperatures in a cot despite additional coverings, with two consecutive axillary temperatures below 36...

Although early hospital discharge of infants can be both cost-effective and better for developmental care and parent-infant bonding, neonatal caregivers need to ensure infant safety. One of the concerns of early discharge is the risk that premature babies may continue to have apnea, bradycardia, and oxygen desaturation after discharge and that these events can be serious enough to increase morbidity and mortality. The discharging provider bears the responsibility of assessing each infant's risk for persistent apnea and providing the care and monitoring appropriate for his presumed risk level...

OBJECTIVE: To determine mortality and morbidity at discharge from the hospital of a large population-based cohort of infants who were born at <or=26 weeks' gestation. METHODS: Perinatal data were collected on extremely preterm infants who were alive at the onset of labor and born between January 1, 1999, and December 31, 2000, in all 19 Belgian perinatal centers. RESULTS: A total of 525 infants were recorded. Life-supporting care was provided to 322 liveborn infants, 303 of whom were admitted for intensive care...

OBJECTIVE: The purpose of this study was to evaluate the effects of an early postpartum discharge program and a subsequent legislative mandate for 48 hours of hospital coverage on incidence of newborn jaundice and feeding problems. We tested the hypothesis that heightened postdischarge ascertainment (rather than short stays) is responsible for apparent increases in these outcomes. METHODS: Interrupted time series analysis was conducted on retrospective data from the automated medical records of a large Massachusetts health maintenance organization (HMO)...

OBJECTIVE: To describe new parents' choice of the type of maternity care they wanted to receive, the family suite (FS) or an early discharge (ED), and to gain a better understanding of parents' experiences of different postnatal care alternatives. DESIGN: A qualitative study using semi-structured interviews. The interviews were analysed by content analysis. SETTING AND PARTICIPANTS: Eleven couples and one mother, including both first-time and experienced parents...

OBJECTIVE: Harmful effects of short postpartum hospital stays include dehydration and malnutrition of breastfed infants. These may be prevented by adequate breastfeeding frequency; however, rigorous research to determine the relative effectiveness of various follow-up strategies in supporting breastfeeding frequency is absent. This study addressed the question, "Is there a difference in breastfeeding frequency or infant weight gain for singleton infants discharged within 36 hours' postpartum who received either community nurse (home visit) or hospital nurse (clinic) follow-up?" METHODS: A randomized, controlled trial was conducted at a university teaching hospital (3700 births/y) and affiliated community health centers...

BACKGROUND: Few studies have examined earlier discharge in relation to Canadian guidelines for earlier discharge and infant feeding. We addressed differences in readmission (1 year post-discharge) and exclusive breastfeeding (4 months) for newborns and mothers discharged within 48 hours compared to those with a longer hospital stay. METHOD: A cohort of 1,357 vaginally delivered singleton normal newborns and their mothers (births between January 1, 1996 and March 31, 1997) were studied by linking five databases and a chart audit...

UNLABELLED: Discharge from an intensive care nursery should be dependent on the infant's clinical and social condition and independent of the day of the week. OBJECTIVE: To evaluate admission and discharge dates of 5272 neonates cared for in 5 major metropolitan regions in the United States and managed by a national disease management company for the distribution of the day of the week. STUDY DESIGN: All infants discharged to home between July 1, 1996 and September 30, 1998 are included...

CONTEXT: Hospital stays for newborns and their mothers after uncomplicated vaginal delivery have decreased from an average of 4 days in 1970 to 1.1 days in 1995. Despite the lack of population-based research on the quality-of-care implications of this trend, federal legislation passed in 1996 mandated coverage for 48-hour hospital stays after uncomplicated vaginal delivery. OBJECTIVE: To assess the impact of very early discharge (defined as discharge on the day of birth) on the risk of infant readmission during the neonatal period in a California healthy newborn population...