This review emphasized the importance of appropriate metabolic screening, breastfeeding education, and postdischarge follow-up. Hospital discharge planning is a process that involves determining the appropriate post-hospital discharge destination for a patient; identifying what the patient requires for a smooth and safe All discharge criteria identified in Section 2 of the CLD form must be met prior to discharge from hospital. Hospital discharge service guidance Guidance on how health and care systems should support the safe and timely discharge of people who no longer need to stay in hospital… Glazener CM, Ramsay CR, Campbell MK et al. The American Academy of Pediatrics specifies that this assessment should take place 48 h to 72 h after discharge when a newborn has been discharged <48 h postdelivery [52][53]. Bhutani VK, Vilms RJ, Hamerman-Johnson L. Universal bilirubin screening for severe neonatal hyperbilirubinemia. J Perinatol 2010;30(Suppl):S6–15. Some infants are candidates for vaccination before discharge. Paediatr Child Health 2007;12(7):583–9. Unreadiness for postpartum discharge following healthy term pregnancy: Impact on health care use and outcomes. The objective should be to achieve a safe and early discharge. Because the risk of hemorrhagic disease of the newborn is higher when vitamin K is not given intra-muscularly, it is crucial that follow-up doses are given. Brigitte Lemyre, Ann L. Jefferies, Pat O’Flaherty; Canadian Paediatric Society, Fetus and Newborn Committee, Paediatr Child Health 2018, 23(8):515–522. endobj Similarly, ‘mother’ refers to any parent giving birth or, in the case of surrogacy, to the adult(s) adopting an infant. Pan-Canadian inventory of public health early child home visiting: Key facts and glossary. Pediatrics 2004;114(3):708–13. Brown S, Small R, Faber B, Krastev A, Davis P. Early postnatal discharge from hospital for healthy mothers and term infants. Early postnatal hospital discharge: The consequences of reducing length of stay for women and newborns. Jackson GL, Kennedy KA, Sendelbach DM et al. Use of a discharge readiness checklist (Table 1) can improve consistency and ensure thoroughness. Family psychosocial and environmental concerns should be assessed during the hospital stay and appropriate referrals or interventions arranged. Mothers are more likely to perceive themselves as unready to take their newborn home compared with HCPs, particularly if they are first-time parents, did not receive adequate prenatal care, gave birth during nonroutine hours and did not receive adequate in-hospital education [41]. Findings that may be missed include cleft palate and imperforate anus [27][28]. Discharge plans can help prevent future readmissions, and they should make your move from the hospital to your home or another facility as safe as possible. Many of these complications can be attributed to discharge planning problems, such as: • Changes or discrepancies in medications before and after discharge. Relevant publications from Health Canada, the Public Health Agency of Canada and Statistics Canada were obtained. This statement was also reviewed by members of the Society of Obstetricians and Gynaecologists of Canada Family Physicians Advisory (FPAC) and Clinical Practice Obstetrics and Maternal Fetal Medicine (MFM) Committees. What is best practice for Criteria Led Discharge? Each infant must have an appropriate discharge plan, including identification of the infant’s primary health care provider and assessment by a health care provider 24 h to 72 h after discharge. Because some newborn problems may not be apparent early on, it is prudent to re-examine infants assessed during the first 6 h of age. Vertical transmission of the hepatitis C virus: Current knowledge and issues. A dedicated discharge nurse position has been shown to enhance workflow and improve satisfaction levels among parents and nursing staff [51]. Martens PJ, Derksen S, Gupta S. Predictors of hospital readmission of Manitoba newborns within six weeks postbirth discharge: A population-based study. The Rourke Baby Record provides guidance on specific items to include with the physical assessment during the first week of life [29]. Common post-discharge complications include adverse drug events, hospital -acquired infections, and procedural complications. For permission to reprint or reproduce multiple copies, please see our copyright policy. A randomized comparison of home visits and hospital-based group follow-up visits after early postpartum discharge. Can J Public Health 2002;93(4):276–80. Barrington KJ, Sankaran K; Canadian Paediatric Society, Fetus and Newborn Committee. Screening for issues of concern, behavior, and/or medical problems that may impact a safe discharge can be identified at ABSTRACT Reed, H. (2003) Criteria for the safe dis-charge of patients from the recovery room. Home visits are ideal. Check if you have adequate heating/cooling immediately you get home. OBJECTIVES: In 2015, the American Academy of Pediatrics (AAP) published an updated consensus statement containing 17 discharge recommendations for healthy term newborn infants. Ottawa: Minister of Public Works and Government Services Canada; 2000. Check if your home need to be cleaned before you get out of hospital. The definition of early discharge ranged from 6 h to 72 h after childbirth but was shorter than the standard LOS for the hospitals included in each trial. A 2011 review of 15 studies drew similar conclusions to previous reviews—evidence was insufficient to support or reject early discharge [9]. The HCP should assess and note parent–infant interaction, ask how the family is coping and inquire about any psychosocial or socio-economic stressors. Physicians tend to focus on infant clinical and physical factors, although maternal age, social risk factors, fatigue, and stress are important considerations [40]. 4 0 obj Discharge of late preterm infants (340/7 to 366/7 weeks’ GA) (www.cps.ca/en/documents/position/safe-discharge-late-preterm-infant) and preterm infants <34 weeks’ GA (www.cps.ca/en/documents/position/facilitating-discharge-of-the-preterm-infant) is reviewed in two other Canadian Paediatric Society (CPS) statements [3][4]. Hepatitis B vaccine can be considered for infants born to mothers with hepatitis C infection [50]. Pediatr Clin North Am 1966;13(3):651–68. Document first published: 19 March 2020 Page updated: 3 September 2020 Topic: Coronavirus, COVID-19 Publication type: Guidance. Nursing Times; 99: 38, 22–24. The clinical behavior of the newly born. In 1997, a review of 28 studies of early discharge (<48 h following vaginal birth and <96 h following CS birth) concluded that data neither supported nor refuted early postpartum discharge for the general population [6]. {}������`I�&�6��er� Several studies have shown that approximately 50% to 95% of problems necessitating transfer to a higher level of care or readmission after discharge were detected during the first 24 h of life [11]–[13]. Members: Heidi Budden MD (Board Representative), Mireille Guillot MD (Resident member), Leonora Hendson MD, Ann L. Jefferies MD (past Chair), Thierry Lacaze-Masmonteil MD (past Chair), Brigitte Lemyre MD, Michael Narvey MD (Chair), Leigh Anne Newhook MD (past Board Representative), Vibhuti Shah MD, Liaisons: Radha Chari MD, The Society of Obstetricians and Gynaecologists of Canada; James Cummings MD, Committee on Fetus and Newborn, American Academy of Pediatrics; William Ehman MD, College of Family Physicians of Canada; Roxanne Laforge RN, Canadian Perinatal Programs Coalition; Chantal Nelson PhD, Public Health Agency of Canada; Eugene H. Ng MD, CPS Neonatal-Perinatal Medicine Section; Doris Sawatzky-Dickson RN, Canadian Association of Neonatal Nurses; Kristi Watterberg MD, Committee on Fetus and Newborn, American Academy of Pediatrics (past representative), Principal authors: Brigitte Lemyre MD, Ann L. Jefferies MD, Pat O’Flaherty MEd, MN, RN-EC. Cochrane Database Syst Rev 2002;(3):CD002958. Catalogue No. §483.12(a)(7)). Infants born at 37 weeks’ GA tend to have a longer hospital LOS compared with infants ≥38 weeks’ GA [17]. Joint Statement on Safe Sleep: Preventing Sudden Infant Deaths in Canada, 2011. http://www.phac-aspc.gc.ca/hp-ps/dca-dea/stages-etapes/childhood-enfance_0-2/sids/pdf/jsss-ecss2011-eng.pdf (Accessed May 7, 2018). Reference chart for relative weight change to detect hypernatraemic dehydration. Surg Clin North Am 2012;92(3):685–711, ix–x. Bernstein HH, Spino C, Finch S et al. Ongoing assessment of the infant and mother–infant dyad throughout the hospital stay helps ensure safe discharge. Models for postdischarge newborn care include office or hospital visits with a physician or nurse, and home visits by nurses or midwives. satisfaction defined as preparedness to leave hospital … Hagan JF, Shaw JS, Duncan PM, editors. Zimmerman DR, Klinger G, Merlob P. Early discharge after delivery. Appendix. Sword WA, Watt S, Krueger PD et al. 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