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Arch Pediatr Adolesc Med. 1998 Oct;152(10):972-5.

Nursery practices and detection of jaundice after newborn discharge.

Author information

1
Division of General Pediatrics, Connecticut Children's Medical Center, Hartford 06106, USA. CWiley@CCMCkids.org

Abstract

OBJECTIVE:

To investigate nursery practices regarding outpatient recognition of neonatal jaundice.

DESIGN:

Descriptive survey.

PARTICIPANTS:

Random sample of nursery head nurses and pediatricians from national lists.

SETTING:

Nurseries with more than 100 births per year and pediatricians responsible for newborn discharges.

RESULTS:

Head nurses from 204 nurseries and 200 pediatricians were surveyed, with 62% of head nurses and 55% of pediatricians responding. Almost half of the head nurses (45%) reported lack of a written neonatal jaundice protocol. Twenty-seven percent of head nurses and pediatricians reported that no system is in place to track jaundiced newborns after discharge. Forty percent of head nurses and 26% of pediatricians reported from higher-risk nurseries, defined as nurseries where more than 25% of mothers did not have a high school diploma or more than 50% of infants were born to single-parent families. These nurseries were no more likely to have a protocol for jaundice management or to use a system to track newborns after discharge. Discharge of most newborns before 36 hours of age was common (70% of head nurses, 62% of pediatricians) and some respondents discharged most newborns before 24 hours of age (16% of head nurses, 12% of pediatricians). For newborns discharged before 24 hours of age, more than half of the nurseries surveyed scheduled follow-up within 2 to 3 days (53% of head nurses, 62% of pediatricians). The likelihood of such follow-up did not differ by type of health care insurance, level of maternal education, percentage of single-parent families, predominance of minority patients, or higher risk as defined above.

CONCLUSIONS:

In our sample, many nurseries lack parent education, neonatal jaundice protocols, and neonatal jaundice tracking systems. Newborns discharged before 48 hours of age are often not scheduled to be seen by a health care provider within 2 to 3 days, despite American Academy of Pediatrics guidelines recommending such follow-up.

PMID:
9790606
DOI:
10.1001/archpedi.152.10.972
[Indexed for MEDLINE]

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