Abstract

(41st Biennial Convention) Objective: To determine if educational interventions with medical providers in combination with a management tool to facilitate clinical guideline implementation would 1) increase compliance with published guidelines and 2) decrease hospital readmissions secondary to hyperbilirubinemia in the first week of life. Design: This study uses a pre- post-intervention design over a 12 month period. Setting: The study took place at a major university hospital. Participants: Data was collected from patient records. Methods: Analysis of differences was done with t-tests for continuous variables and either X2 or Fisher's Exact tests for categorical variables. Results: Improvements in the documentation of three care quality indicators were observed; 1) jaundice on the discharge exam or discussion of jaundice risk with parents (p = 0.03), 2) written and oral counseling of parents (p < 0.01), and 3) exclusive breastfeeding (p = 0.02). Documentation of two observed breastfeedings decreased (p < 0.01). The percentage of infants given appropriate follow up appointments in primary care based on their hyperbilirubinemia risk at discharge improved (p = 0.03) and the re-admission rate of newborns within the first week of life secondary to hyperbilirubinemia decreased by 50%. Conclusions: This study demonstrates that an educational intervention with a clinical tool may help change provider practice. Longer follow up is needed to determine if impact is sustainable.

Description

41st Biennial Convention

Authors

Julee Waldrop

Author Details

Julee Waldrop, DNP

Sigma Membership

Unknown

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

newborns, quality improvement, hyperbilirubinemia

Conference Name

41st Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Grapevine, Texas, USA

Conference Year

2011

Rights Holder

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Decreasing the Risk for Severe Hyperbilirubinemia in Newborns

Grapevine, Texas, USA

(41st Biennial Convention) Objective: To determine if educational interventions with medical providers in combination with a management tool to facilitate clinical guideline implementation would 1) increase compliance with published guidelines and 2) decrease hospital readmissions secondary to hyperbilirubinemia in the first week of life. Design: This study uses a pre- post-intervention design over a 12 month period. Setting: The study took place at a major university hospital. Participants: Data was collected from patient records. Methods: Analysis of differences was done with t-tests for continuous variables and either X2 or Fisher's Exact tests for categorical variables. Results: Improvements in the documentation of three care quality indicators were observed; 1) jaundice on the discharge exam or discussion of jaundice risk with parents (p = 0.03), 2) written and oral counseling of parents (p < 0.01), and 3) exclusive breastfeeding (p = 0.02). Documentation of two observed breastfeedings decreased (p < 0.01). The percentage of infants given appropriate follow up appointments in primary care based on their hyperbilirubinemia risk at discharge improved (p = 0.03) and the re-admission rate of newborns within the first week of life secondary to hyperbilirubinemia decreased by 50%. Conclusions: This study demonstrates that an educational intervention with a clinical tool may help change provider practice. Longer follow up is needed to determine if impact is sustainable.