We have located links that may give you full text access.
EVALUATION STUDIES
JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
A systems approach for neonatal hyperbilirubinemia in term and near-term newborns.
OBJECTIVE: To propose and implement a family-centered systems approach to manage newborn jaundice for safer outcomes.
DESIGN: Observational study for known adverse outcomes.
SETTING: Semiprivate urban birthing hospital.
PATIENTS/PARTICIPANTS: 31,059 well babies discharged as healthy from a cohort of 41,961 live births (1990-2000).
INTERVENTIONS: Incremental implementation of a systems approach that incorporated a hospital policy to (a) authorize nurses to obtain a bilirubin (total serum/transcutaneous) measurement for clinical jaundice, (b) universal predischarge total serum bilirubin (at routine metabolic screening), and (c) targeted follow-up, using the bilirubin nomogram (hour-specific, percentile-based total serum bilirubin/transcutaneous bilirubin).
MAIN OUTCOME MEASURES: Known adverse outcomes assessed for early- and late-onset severe hyperbilirubinemia before, during, and after systems approach implementation.
RESULTS: Adverse outcomes decreased for well babies: exchange transfusion, intensive phototherapy, and readmission. During the study period, there were no "never events" (total serum bilirubin greater than or equal to 30 mg/dl), while "close calls" (total serum bilirubin greater than or equal to 25 mg/dl) were 1 in 15,000 as compared to a reported incidence of 1 in 625.
CONCLUSIONS: Reduced adverse events, significant reduction in close calls, and no never events met family expectations for safer experiences with this approach.
DESIGN: Observational study for known adverse outcomes.
SETTING: Semiprivate urban birthing hospital.
PATIENTS/PARTICIPANTS: 31,059 well babies discharged as healthy from a cohort of 41,961 live births (1990-2000).
INTERVENTIONS: Incremental implementation of a systems approach that incorporated a hospital policy to (a) authorize nurses to obtain a bilirubin (total serum/transcutaneous) measurement for clinical jaundice, (b) universal predischarge total serum bilirubin (at routine metabolic screening), and (c) targeted follow-up, using the bilirubin nomogram (hour-specific, percentile-based total serum bilirubin/transcutaneous bilirubin).
MAIN OUTCOME MEASURES: Known adverse outcomes assessed for early- and late-onset severe hyperbilirubinemia before, during, and after systems approach implementation.
RESULTS: Adverse outcomes decreased for well babies: exchange transfusion, intensive phototherapy, and readmission. During the study period, there were no "never events" (total serum bilirubin greater than or equal to 30 mg/dl), while "close calls" (total serum bilirubin greater than or equal to 25 mg/dl) were 1 in 15,000 as compared to a reported incidence of 1 in 625.
CONCLUSIONS: Reduced adverse events, significant reduction in close calls, and no never events met family expectations for safer experiences with this approach.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app