Does family-centred neonatal discharge planning reduce healthcare usage? A before and after study in South West England.
BMJ Open
; 6(3): e010752, 2016 Mar 10.
Article
em En
| MEDLINE
| ID: mdl-26966062
ABSTRACT
OBJECTIVE:
To implement parent-oriented discharge planning (Train-to-Home) for preterm infants in neonatal care.DESIGN:
Before and after study, investigating the effects of the intervention during two 11-month periods before and after implementation.SETTING:
Four local neonatal units (LNUs) in South West England.PARTICIPANTS:
Infants without major anomalies born at 27-33 weeks' gestation admitted to participating units, and their parents. TRAIN-TO-HOME INTERVENTION A family-centred discharge package to increase parents' involvement and understanding of their baby's needs, comprising a train graphic and supporting care pathways to facilitate parents' understanding of their baby's progress and physiological maturation, combined with improved estimation of the likely discharge date. MAIN OUTCOMEMEASURES:
Perceived Maternal Parenting Self-Efficacy (PMP S-E) scores, infant length of stay (LOS) and healthcare utilisation for 8 weeks following discharge.RESULTS:
Parents reported that the Train-to-Home improved understanding of their baby's progress and their preparedness for discharge. Despite a lack of change in PMP S-E scores with the intervention, the number of post-discharge visits to emergency departments (EDs) fell from 31 to 20 (p<0.05), with a significant reduction in associated healthcare costs (£3400 to £2200; p<0.05) after discharge. In both study phases, over 50% of infants went home more than 3 weeks before their estimated date of delivery (EDD), though no reduction in LOS occurred.CONCLUSIONS:
Despite the lack of measurable effect on the parental self-efficacy scores, the reduction in ED attendances and associated costs supports the potential value of this approach.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pais
/
Alta do Paciente
/
Recém-Nascido Prematuro
/
Unidades de Terapia Intensiva Neonatal
/
Instituições de Assistência Ambulatorial
/
Tempo de Internação
Tipo de estudo:
Clinical_trials
/
Guideline
Limite:
Adult
/
Female
/
Humans
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Infant
/
Male
/
Newborn
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article