Most Proposed Topic :
Healthcare Advances, Research and Innovations (new projects / technology)
Proposed Topic (Second preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patient and improve patient communication)
Authors: (including presenting author): :
So HY(1), Kwok LY(1), Choi SP(1)
Affiliation: :
(1) Department of Paediatrics and Adolescent Medicine, Kwong Wah Hospital
Introduction: :
There are many complicating factors affecting the high risk infant discharge, such as parental readiness, availability of care for ongoing needs at home and community support. The discharge process should start at the time of admission to NICU and with a plan for physiological assessing and family support. Physiological support including thermoregulation, control of breathing, respiratory stability, and adequate weight gain with indication of feeding skills. Infant’s family is an important part of the care team and their involvement in NICU will increase their confidence and resilience, decrease anxiety and help ensure a safe discharge environment.
A discharge planning program should be provided a framework and practical guidance for multidisciplinary team, and help to ensure smooth transition from the NICU to home and shorten their length of stay in hospital.
Objectives: :
To provide a framework and practical guidance in discharge planning to shorten their length of stay in hospital
Methodology: :
This study period from 1/8/2021 to 30/11/2023.
The intervention group with pre-discharge program was started from 1/10/2022 to 30/11/2023 who admission in KWH NICU with the following criteria.
Inclusion Criteria:
1. Preterm infant: < 32 weeks or ≤ 1.5 kg
2. Home Care Technology Dependent infant
3. Complex case and high risk case referred by doctor
Assigned a nurse case manager when patient admission and recruited in this program. Nurse case manager need to follow the discharge planning stage to follow up the preparation of patient discharge and assessed the competence of parents to take care of baby at home. Data about the length of stay in hospital and parent confidence to care baby before discharge were retrieved.
In the control group, patient without this pre-discharge program from 1/8/2021 to 30/9/2022 with same criteria admission patient. Both groups received some routine medical and nursing care in NICU. These two group patient length of stay mean value data was compared.
Result & Outcome: :
During the program period, total 47 cases were met inclusion criteria and recruited in this study. The intervention group with recruited into the pre-discharge program were identified in 22 infants, whereas 25 infants were without started this pre-discharge program were identified in control group.
The mean value length of stay in intervention group were significantly lower than those in the control group. 98.54 days vs 109.12 days (P < 0.5, paired 2 tails t-test). This program helps to shorten the length of stay in hospital 10.58 days. Parent has been assessed with fully competency (100%), fully confidence (68.4%) and confidence (31.6%) to care baby at home.
Case manager in Transit to Home pre-discharge program can help to assess patient needs, coordinate with the care team, educate the patient and family, monitor and support the parents, evaluate and improve the transit to home process, promote inter-professional education and collaboration and shorten these high risk infant length of stay in hospital.
