[Early discharge and postpartum home visit during the COVID-19 pandemic at the HULP (Madrid).] / Alta precoz y visita domiciliaria puerperal durante la pandemia por la COVID-19 en el Hospital Universitario La Paz (Madrid).

ABSTRACT

OBJECTIVE: The COVID-19 pandemic caused that the Health Department of the Autonomous Region of Madrid redirected the Obstetrics, Gynecology and Neonatology emergency care. On March 24th 2020, the HULP launched a program of postpartum early discharge and home visit. The objective of this work was to detect if the care strategy "Voluntary early discharge and home visit by the midwife (2nd year EIR)" applied by the HULP during the COVID-19 pandemic had any adverse effect on the woman and/or the newborn. METHODS: Cross-sectional observational descriptive study using convenience sampling among women included in the early discharge-home visit program from March 24th to May 5th 2020. 222 medical records and telephone surveys to postpartum women who complied with the inclusion criteria were analyzed. The statistical analysis was performed using SAS 9.4. RESULTS: The average of inpatient time was 25 hours and 15 minutes. 8.6% of newborns were sent back to the HULP, and 2.2% were readmitted for hyperbilirubinemia. 2.3% of parents took their infants to the Emergency Care Unit, but only 0.46% needed readmission. 0.4% of postpartum women were readmitted. At the discharge, 84.2% of newborns exclusively breastfed. After one week of the birth, 73.4% of infants were exclusively breastfeeding, 18% were mixed breastfeeding, and 8.6% were bottle feeding. 89.6% of women believed early discharge was appropriate. Home visit was described as "very satisfactory" in 83.3% of cases, and the care provided, in 88.7% of cases. CONCLUSIONS: With the early discharge-home visit program, continuity of care is provided, health problems were detected and resolved and high maternal satisfaction levels were obtained.

RESUMEN

OBJETIVO: La pandemia por la COVID-19 motivó que la Consejería de Sanidad de la Comunidad de Madrid reorganizara la atención urgente de Obstetricia-Ginecología y Neonatología. El 24/03/2020 se inicia en el Hospital Universitario La Paz (HULP) un programa de alta precoz posparto y visita domiciliaria. El objetivo de este estudio fue detectar si la estrategia de "alta precoz voluntaria y visita domiciliaria por la residente de matrona" aplicada por el HULP durante la pandemia por la COVID-19 tuvo algún efecto adverso en puérpera y/o recién nacido (RN). METODOS: Estudio observacional descriptivo transversal, con muestreo de conveniencia en mujeres incluidas en el programa de alta precoz voluntaria-visita domiciliaria entre 24/03/2020 y 5/05/2020. Se analizaron 222 historias clínicas y cuestionarios telefónicos de puérperas que cumplieron los criterios de selección. El análisis estadístico se realizó con el programa SAS-9.4. RESULTADOS: La media de estancia hospitalaria fue de 25h 15min. Derivaron al HULP a 8,6% neonatos, ingresando un 2,2% por hiperbilirrubinemia. El 2,3% de padres con sus neonatos acudieron a urgencias, ingresando el 0,46%. El 0,4% de puérperas precisó reingreso. Al alta, el 84,2% de RN tomaban lactancia materna exclusiva (LME). A la semana, el 73,4% de RN estaban con LME, el 18% con lactancia mixta y el 8,6% con lactancia artificial. El 89,6% consideró adecuada el alta precoz. Percibieron como "muy satisfactoria" la visita domiciliaria un 83,3%, y la atención profesional recibida un 88,7%. CONCLUSIONES: Con el alta precoz-visita domiciliaria se ofrece continuidad de cuidados, detectando y resolviendo problemas, manteniendo un alto grado de satisfacción materna.