Most newborn care guidelines recommend a postdischarge assessment by an HCP within the first week of life. 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. Sword WA, Watt S, Krueger PD et al. Newborn screening programs for metabolic and other serious diseases, and for hearing impairment [43] facilitate timely recognition, follow-up and intervention, and should be available for all infants. What is best practice for Criteria Led Discharge? Public Health Agency of Canada, Health Canada, Canadian Paediatric Society, Canadian Foundation for the Study of Infant Deaths, Canadian Institute of Health. Nursing Times; 99: 38, 22–24. The following recommendations address the broad spectrum of newborn care and are generally drawn from Level 2, 3, or 4 evidence. A major study of 38,958 patients after ambulatory surgery found that the risk of dying … Pediatrics 2002;110(1 Pt 1):53–60. Check if you have sufficient money with you for the first few days out of hospital. Clin Pediatr (Phila) 2000;39(10):581–90. Juang D, Snyder CL. Reference chart for relative weight change to detect hypernatraemic dehydration. Care providers should be sensitive to the interaction between infant, mother and family; it is important to identify concerns about the mother’s ability to care for her infant. Examining the normal neonate. Prevention and management of neonatal herpes simplex virus infections. Background: Standardized discharge criteria are considered valuable to reduce the risk of premature discharge and avoid unnecessary hospital stays. J Pediatr 2012;161(2):234–9.e1. Breastfeeding is the optimal feeding method and should be promoted and protected [30]. A dedicated discharge nurse position has been shown to enhance workflow and improve satisfaction levels among parents and nursing staff [51]. Discharge criteria, inclusive of a post anesthetic recovery score system 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. Pediatrics 2015;135(3):469–74. Many mother–infant dyads will be ready to go home 24 h after birth. Complications of Ambulatory Anesthesia. Chang RJ, Chou HC, Chang YH, et al. Yonemoto N, Dowswell T, Nagai S, Mori R. Schedules for home visits in the early postpartum period. Lieu TA, Braveman PA, Escobar GJ, Fischer AF, Jensvold NG, Capra AM. A comprehensive and systematic newborn examination is an opportunity to identify normal variants and medically unimportant findings, and to provide reassurance about these [26]. Parents have demonstrated that they can position the seat and secure the infant appropriately. At least two successful feeds have been documented. Johnson D, Jin Y, Truman C. Early discharge of Alberta mothers post-delivery and the relationship to potentially preventable newborn readmissions. Also, some infants may be taken into care or be discharged to foster families. Canadian Task Force on Preventive Health Care. Under CLD the decision for discharge is made and documented by the senior medical clinician (e.g. In Canada, specific screening programs vary among the provinces and territories [44]. Ideally, the examination should be performed in the mother’s room, with parents present, to minimize separation of mother and baby, facilitate parental questions, and provide confidentiality. Given that the geometric mean of hospital charges per child with bronchiolitis increased from $6380 in 2000 to $8530 in 2009, the potential for safely reducing hospital LOS by using the discharge criteria proposed in the current study instead of other criteria may net substantial cost savings. Most centres have standardized care plans and documentation protocols for healthy term infants. Health Canada. Postpartum discharge preferences of pediatricians: Results from a national survey. Bravo P, Uribe C, Contreras A. Public Health Agency of Canada. 11. To define the physiological criteria that must be met for the safe discharge from Post Anesthesia Care. The specific hospital length-of-stay (LOS) for healthy term (≥37 weeks’ gestational age (GA)) newborns depends on the health of the mother, infant health and stability, the mother’s ability to care for her infant, support at home, and access to follow-up care. endobj Appendix. Lavagno C, Camozzi P, Renzi S, et al. Health Canada, Canadian Paediatric Society, Dietitians of Canada, and Breastfeeding Committee for Canada. Moss GD, Cartlidge PH, Speidel BD, Chambers TL. Findings that may be missed include cleft palate and imperforate anus [27][28]. Relevant publications from Health Canada, the Public Health Agency of Canada and Statistics Canada were obtained. Pediatr Surg Int 2010;26(11):1083–6. Parents must receive a written record summarizing their infant’s health information, any health issues encountered during the hospital stay, bilirubin and other laboratory results, and a follow-up plan for care. Paediatr Child Health 2018, 23(8):515–522. The postnatal period is one of significant transition for mother, infant and family. Paediatr Child Health 2008;13(6):529–34. Privacy Policy, Search position statements and practice points, Most current statements and practice points, Education Program for Immunization Competencies, International Meeting on Indigenous Child Health, NRP Research Grant and Emerging Investigator Award, How much? Hearing and newborn screens have been scheduled (if they were not conducted in-hospital); appropriate follow-up for jaundice; vitamin D supplementation if breast-fed; other follow-up, as required. Healthy term infants should be considered ready for discharge home when all criteria in Table 1 have been met. Chen YJ, Chen WC, Chen CM. Decision-making for postpartum discharge of 4300 mothers and their healthy infants: The life around newborn discharge study. The overall safety record of modern ambulatory anesthesia is impressive , with major morbidity and mortality being extremely rare . Table 1 should be customized for specific hospital and health region policies, because requirements and programs vary considerably by jurisdiction. Flaherman VJ, Schaefer EW, Kuzniewicz MW, Li SX, Walsh EM, Paul IM. SAFE discharge for infants with highrisk home environments. Successful cardiorespiratory adaptation to extrauterine life, with normal, stable heart and respiratory rates. 1. A 2011 review of 15 studies drew similar conclusions to previous reviews—evidence was insufficient to support or reject early discharge [9]. Pediatr Clin North Am 1966;13(3):651–68. Shakib J, Buchi K, Smith E, Korgenski K, Young PC. American Academy of Pediatrics, Subcommittee on Hyperbilirubinemia. 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). Ideally, preparation for discharge should begin during the antenatal period and be reinforced throughout the perinatal period (a process not always possible for infants entering the child welfare system). Early term delivery and health care utilization in the first year of life. Bacille Calmette-Guerin (BCG) vaccine can be considered for infants in high-risk communities or born to mothers with infectious tubercular disease [49]. Bernstein HH, Spino C, Finch S et al. Ellberg L, Hogberg U, Lundman B, Kallen K, Hakansson S, Lindh V. Maternity care options influence readmission of newborns. Choosing the infant’s primary HCP during pregnancy not only facilitates the discharge process but provides parents with an opportunity to discuss their newborn’s care, ask questions and familiarize themselves with the provider’s practice. The Agency for Healthcare Research and Quality offers information and tools for clinicians and patients to make the hospital discharge process safer and to prevent avoidable readmissions. 1007: http://collections.banq.qc.ca/ark:/52327/bs52720 (Accessed May 7, 2018). essential elements of a safe, comprehensive, and quality discharge from the ED. BMJ 1999;318(7184):627–31. %���� Canadian Hospitals Maternity Policies and Practices Survey (2012). Early postnatal hospital discharge: The consequences of reducing length of stay for women and newborns. {}������`I�&�6��er� If not required earlier because of clinical jaundice, a bilirubin measurement should be obtained at the same time as the metabolic screening test; alternatively, a bilirubin measurement should be done at discharge or at 72 h of life, whichever comes first. The scope of the first postdischarge HCP review should always include assessment of weight loss, jaundice, hydration, general health, feeding, and any congenital malformation not seen at the initial examination in hospital. Obstet Gynecol 1997;90(5):860–5. 3,4 • Inadequate preparation for patient and family related Your newborn: Bringing baby home from the hospital, General appearance (activity, tone, colour), Promote the physical well-being of mother and infant, Support the relationship among mother, infant and family members, Facilitate development of infant feeding skills, Strengthen the mother’s knowledge and confidence, Maternal medical and mental health concerns, positive family history, Psychosocial and/or socio-economic stressors, domestic violence, Maternal medications, smoking, alcohol, or substance use, Abnormal prenatal screening and ultrasound findings, Maternal hepatitis B surface antigen, syphilis, HIV, or rubella status, Risk factors for infection, including maternal Group B streptococcal colonization status or intrapartum antibiotic prophylaxis, Apgar score, need for stabilization at birth, and/or low umbilical cord pH, Risk factors for early-onset neonatal jaundice, Infant feeding, including importance of breastfeeding, Recognition of early signs of illness, including jaundice and dehydration, and how to respond, Infant safety, including car seat use, safe sleep practices and other measures to decrease risk of sudden infant death syndrome, Mother provides routine infant care, including feeding, in a safe and confident manner, Mother demonstrates knowledge of how to recognize illness in her infant and when to seek help, Psychosocial and environmental risk-factors have been assessed, with an appropriate follow-up plan, Physical examination by health care provider, Birth weight, length and head circumference measurements obtained, Normal, stable temperature, heart rate and respiratory rate, Weight loss <10%; if approaching or >10%, a follow-up plan has been arranged, Antenatal and perinatal risk factors (e.g., sepsis) have been evaluated, If circumcision performed, no excessive bleeding at site, Newborn screen at 24 h (must be repeated within 7 days if administered before 24 h), Bilirubin screening – results reviewed and follow-up arranged, if required, Ophthalmia neonatorum prophylaxis, in accordance with regional guidelines, Immunizations, if needed (e.g., hepatitis B vaccine), Infant safety and injury prevention (including car seat safety, safe sleep practices, sudden infant death syndrome risk reduction), Care of circumcision site, if infant is circumcised, Infant’s community health care provider has been identified and recorded in chart, Follow-up visit scheduled for 24 h to 72 h after hospital discharge, Other investigations, referrals and appointments organized, as required, Community supportive resources have been offered. Weight loss in excess of 10% increases the risk of hyperbilirubinemia [31][32] and hypernatremia [33][34]. Consent. Scientific World Journal 2003;3:1363–9. The purpose of this statement is to provide guidance for HCPs and ensure safe discharge of healthy term infants who are ≥37 weeks’ gestational age (GA) at birth. Guidelines need to be in place to help nurses in the There is no conclusive evidence to demonstrate whether a shorter hospital LOS increases risk to infant health or to establish the ideal LOS for healthy term newborns. A search of MEDLINE that included the search terms ‘hospital stay’, ‘discharge’, ‘readmission’, ‘well-baby visit’, and ‘newborn’ was undertaken and updated in May 2016. Lomax A, editor. Cochrane Database Syst Rev 2002;(3):CD002958. All discharge criteria identified in Section 2 of the CLD form must be met prior to discharge from hospital. Pediatrics 2002;109(6):1074–80. These include: 9. Screening for hyperbilirubinemia within the first 72 h of age is recommended by both the CPS (www.cps.ca/en/documents/position/hyperbilirubinemia-newborn) and the American Academy of Pediatrics, using a predictive nomogram [45][46]. ABSTRACT Reed, H. (2003) Criteria for the safe dis-charge of patients from the recovery room. This review emphasized the importance of appropriate metabolic screening, breastfeeding education, and postdischarge follow-up. Further anticipatory guidance regarding infant safety, feeding, provision of vitamin D [59], and routine infant care should be provided. W� ����"�܄}�-^���^������lA������I�Ѽٹ��kV+�H�lf!��S�]�b$��E �:^�E�� �[=�7a5�^�)hVS��xJ�Q���r&̏�p��E�3H���p� �c�qһ��h��EN6N�[��ޒ,�� B��te�R��Ǜ��"*���7@�d�.���y�ى�_ Chichester, UK: Wiley-Blackwell, 2015. Criteria for the safe discharge of patients from the recovery room AUTHOR Helen Reed, RGN, BA, is staff nurse, Freeman Hospital, Newcastle upon Tyne. Statistics Canada. Gagnon AJ, Dougherty G, Jimenez V, Leduc N. Randomized trial of postpartum care after hospital discharge. Antenatal and perinatal infant risk factors including (but not limited to) sepsis, neonatal abstinence syndrome, jaundice and hypoglycemia, should be evaluated and monitored. Perceived unreadiness may lead to increased use of health care services and poorer infant health outcomes in the month after discharge [41]. A Covid-19 patient meeting the following criteria can be considered for discharge: afebrile without use of fever-reducing agents for at least 48 hours improving hypoxia and respiratory symptoms (particularly shortness of breath, since up to 29% of patients may have persistent cough for up to 3 weeks) Antigonish, NS: St. Francis Xavier University, December 2009. http://nccdh.ca/images/uploads/TK_KeyFactsGlossaryJune25_v61.pdf (Accessed May 8, 2018). Montreal: Technologies CETS 97-6 RE. The Canadian Paediatric Society gives permission to print single copies of this document from our website. without being infectious) Readmission rates may be higher for infants who go home earlier because problems that would have presented in hospital are now identified after discharge. A mechanism for preventive medicine in the newborn. Catalogue No. Paul IM, Beiler JS, Schaefer EW et al. The relative risk (RR) of newborn readmission following early discharge was 1.25 (95% confidence interval (CI) 0.97 to 1.61). 10. Models for postdischarge newborn care include office or hospital visits with a physician or nurse, and home visits by nurses or midwives. Urine and at least one stool have been passed. 4 According to the Canadian Patient Safety Institute, adding structured communication techniques helps teams … The facts that bilirubin levels peak and weight loss reaches a nadir between days 3 and 5 [13][58] support an initial postdischarge assessment within 24 h to 72 h following an early discharge. The mother must also be provided with additional education and support. Nurs Womens Health 2014;18(4):333–9. endobj In some Canadian provinces and territories, hepatitis B vaccine is routinely given to all infants. This is particularly important when infants are discharged early, because bilirubin levels will peak at home. Escobar GJ, Braveman PA, Ackerson L, et al. Available by request at https://www.canada.ca/en/public-health/services/injury-prevention/health-surveillance-epidemiology-division/maternal-infant-health/canadian-hospitals-maternity-policies-practices-survey-2012.html (Accessed May 7, 2018). When the mother is breastfeeding, arrangements for monitoring the infant’s weight and postdischarge lactation support must be made. Canadian Immunization Guide: https://www.canada.ca/en/public-health/services/canadian-immunization-guide.html (Accessed May 7, 2018). Desmond MM, Franklin RR, Vallvona C et al. No one model appears to be more effective than others for improving breastfeeding outcomes, decreasing hospital readmission rates, or decreasing visits to emergency rooms or doctors’ offices [60]-[64]. satisfaction defined as preparedness to leave hospital … Can J Cardiol 2017;33(2):199–208. Resident records should contain a final resident discharge summary which addresses the resident’s post-discharge needs (42 C.F.R. However, mothers should feel supported in their own feeding choices. Medicare discharge planning is a Condition of Participation for hospitals, including psychiatric hospitals. A consistent approach to education and discharge planning can enhance parental satisfaction and confidence and decrease confusion and stress. POLICY III. Current Opin Pediatrics 2004;14(4):361–5. Evaluation of the risks and benefits of early postpartum discharge – systematic review. An abnormal transition period, characterized by problems such as respiratory distress, hypoglycemia, temperature instability, lethargy and septic risk factors, increases the likelihood of problems in the first few days of life that require prolonging hospitalization or readmission [14]. Arch Dis Child 2007;92(6):490–4. Martens PJ, Derksen S, Gupta S. Predictors of hospital readmission of Manitoba newborns within six weeks postbirth discharge: A population-based study. The guidelines have an e… Eur J Pediatr 2012;171(1):167–71. During the same period, LOS following Caesarean section (CS) birth decreased from 5.0 days to 3.4 days. On May 17, 2013, the Centers for Medicare & Medicaid Services (CMS) released an update of Appendix A of the State Operations Manual (SOM) revising its interpretive guidelines for hospital Discharge Planning. Problem identification in apparently well neonates: Implications for early discharge. At time of discharge, infants must have an appropriate follow-up plan in place that includes: contact information for a primary health care provider; a scheduled follow-up visit 24 h to 72 h postdischarge—in hospital, clinic or at home—with a qualified health care provider. A CPS statement provides guidance for POS screening [48]. Am J Dis Child 1984;138(11):1041–6. The CPS, Canadian Cardiovascular Society and Canadian Pediatric Cardiology Association now recommend that pulse oximetry screening (POS) for congenital heart disease be routinely performed in healthy term newborns. 6. Maternal serology has been reviewed and the mother has received all medications and/or immunizations required. Bhutani VK, Vilms RJ, Hamerman-Johnson L. Universal bilirubin screening for severe neonatal hyperbilirubinemia. Senior Consultant, Medical Fellow, Visiting Medical Officer). x��]ݓ۶����tF��h��g'��sv�k�ص��!�-�$6:I�(;��ww�AP�;�Y"A�b����b�/��|���˫�A����w�/�ߟ?����X�A�* ���g?�9X=�ݧ��^~�V���?c�(XP$Q�dA'QU�n��ۏE0�A���~������$����L.����u����ߞ? 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. Background The safe discharge planning process begins as soon as the patient arrives in the ED. However, concerns have been expressed that time for parental education has decreased, postnatal problems may not be identified in a timely manner, readmissions for problems such as jaundice and dehydration have increased, and duration of breastfeeding may be shorter. It suggests criteria to be considered when deciding whether a confirmed COVID-19 case can be safely (i.e. anesthesia care shall meet discharge criteria for Phase I and Phase II recovery. Transfer from the ward should happen within one hour of that decision being made to a designated discharge area. Late detection of critical congenital heart disease among US infants: Estimation of the potential impact of proposed universal screening using pulse oximetry. Many of these complications can be attributed to discharge planning problems, such as: • Changes or discrepancies in medications before and after discharge. Paediatr Child Health 2004;9(10):723–9. When a decision has been made to discharge a healthy infant before 24 h of age, the HCP should ensure that: the infant has transitioned appropriately; there are no risk factors that require close monitoring, necessary screening occurs, with follow-up, and support for the family is readily available. 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 Family psychosocial and environmental concerns should be assessed during the hospital stay and appropriate referrals or interventions arranged. Paediatr Child Health 2017;22(4):223–8. Preparation for discharge should be part of antenatal education for all expectant mothers and should include information on feeding, routine newborn care and infant safety. Pediatrics 2001;108(3):719–27. ” Only a doctor can authorize a patient ʼ s release from the hospital, but the actual process of discharge planning can be completed by a social worker, nurse, case manager, or other person. Low educational level, poor socio-economic circumstances, young maternal age, language barriers, inadequate housing, inadequate prenatal care, use of illicit substances or alcohol, depression, isolation, lack of family support, and unstable parental relationships are circumstances which may place an infant at risk [35]. In this study, we identify whether the AAP criteria were met before discharge at a tertiary care academic children’s hospital. Rev Esc Enferm USP 2011;45(3):758–63. PURPOSE. Healthy term newborns should remain in hospital long enough to allow identification of major problems. Yu ZB, Han SP, Chen C. Bilirubin nomograms for identification of neonatal hyperbilirubinemia in healthy term and late-preterm infants: A systematic review and meta-analysis. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation (Clinical practice guideline). That same year, a comprehensive review by Quebec’s Conseil d’evaluation des technologies de la sante found there was no conclusive link between early discharge (≤48 h after vaginal birth and <96 h after CS birth) and neonatal mortality, neonatal complications or duration of breastfeeding [7]. 100-2305 St. Laurent Blvd Ottawa, ON Canada K1G 4J8, info@cps.ca (613) 526-9397 (613) 526-3332. Allen UD, Robinson JL; Canadian Paediatric Society, Infectious Diseases and Immunization Committee. Conseil d’evaluation des technologies de la sante. Document first published: 19 March 2020 Page updated: 3 September 2020 Topic: Coronavirus, COVID-19 Publication type: Guidance. 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. A shorter postpartum LOS highlights that low-risk birth is an event defined by ‘wellness’ rather than illness. Discuss with both your doctor and your nurse what you can generally expect the first few days and weeks at … A complete physical examination of all newborns, performed during the first 24 h to 72 h of life before discharge, is standard practice in North America and elsewhere. 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]. All rights reserved. Delayed detection of cleft palate: An audit of newborn examination. A randomized comparison of home and clinic follow-up visits after early postpartum hospital discharge. The authors concluded that same-day discharge is safe for patients with suspected or biopsy-proven MH after uncomplicated ambulatory surgery. Unreadiness for postpartum discharge following healthy term pregnancy: Impact on health care use and outcomes. Timing of initial well-child visit and readmissions of newborns. Pediatrics 2007;120(2):e391–400. The checklist domains include (1) indication for hospitalization, (2) primary care, (3) medication safety, (4) follow‐up plans, (5) home‐care referral, (6) communication with outpatient providers, and (7) patient education.CONCLUSIONSThe Checklist of Safe Discharge Practices for Hospital Patients summarizes the sequence of events that need to be completed throughout a typical … The hospital discharge service requirements provide actions that must be taken immediately to enhance discharge arrangements and the provision of community support. Some infants are candidates for vaccination before discharge. 1. Variations, taking into account individual circumstances, may be appropriate. Britton JR, Baker A, Spino C, Bernstein HH. https://www.raredisorders.ca/content/uploads/Canada-NBS-statusupdated-Sept.-3-2015.pdf (Accessed May 7, 2018). Verify here. Brigitte Lemyre, Ann L. Jefferies, Pat O’Flaherty; Canadian Paediatric Society, Fetus and Newborn Committee, Paediatr Child Health 2018, 23(8):515–522. This situation could increase overall cost and worsen quality of care. Various tools are used to assess risks for stress, depression, and parenting problems and to monitor child development. In jurisdictions where the first dose is not given at birth, hepatitis B vaccine is recommended for infants born to mothers with acute or chronic hepatitis B infection as well as infants who are household contacts of individuals with acute hepatitis B or chronic carriers of hepatitis B [49]. These include but are not limited to: Legible and complete antenatal records must be readily available for review by the infant’s HCP. This step is often best initiated as soon as discharge appears to be a reasonable disposition. When hospital discharge is premature, however, use of resources after discharge from the hospital may increase. J Hum Lact 2016;32(1):67–74. Pediatrics 2016;138(6):e20163107. There are few randomized trials and most studies focus on the nature of follow-up rather than timing. §483.20(l)). Internet addresses are current at time of publication. 1 0 obj 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]. The well-planned, comprehensive discharge of a medically stable infant helps to ensure a positive transition to home and safe, effective care after discharge. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 22 0 R 27 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Parent or guardian education and assessment of discharge readiness are important components of discharge planning. Discharge from hospital should happen as soon after that as possible, normally within The Rourke Baby Record provides guidance on specific items to include with the physical assessment during the first week of life [29]. Pediatrics 2015;135(5):948–53. stream Adequacy of breastfeeding can be assessed by direct observation of the feeding position, latch and swallow. © 2020 Canadian Paediatric Society. Many trials are not randomized, co-interventions—including postdischarge support—vary, and definitions of early discharge are inconsistent, ranging from <24 h to <48 h. Health care practices and funding may differ from those in Canada. Forsythe PL, Maher R, Kirchick C, Bieda A. J Pediatr 1963;62:307–25. Delayed diagnosis of imperforate anus: An unacceptable morbidity. The safety of early postpartum discharge: A review and critique. At the time of discharge home, parents of preterm infants in the neonatal intensive care unit often feel apprehensive and may question their ability to care for their baby. 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. Criteria Led Discharge ( CLD) is a process to ensure patients can return home from hospital as safely and quickly as possible. Paediatr Child Health 2014;19(1):3166. Lieu TA, Wikler C, Capra AM, Martin KE, Escobar GJ, Braveman PA. Clinical outcomes and maternal perceptions of an updated model of perinatal care. A randomized comparison of home visits and hospital-based group follow-up visits after early postpartum discharge. Gastrointestinal obstruction and hyperbilirubinemia requiring treatment are not always clinically apparent within 24 h of birth [14][15]. Universal newborn hearing screening. %PDF-1.7 Not all diseases are detected reliably when the screening blood spot is collected before 24 h of age and, in these cases, a follow-up sample must be collected within the first week postbirth. The month after discharge from hospital suggests criteria to reside in hospital,! Early discharge [ 9 ] Phila ) 2000 ; 39 ( 10 )..: //www.raredisorders.ca/content/uploads/Canada-NBS-statusupdated-Sept.-3-2015.pdf ( Accessed may 8, 2018 ) provides guidance for POS screening [ 48 ] by 24 after! Identified after discharge and when to seek medical attention J Perinatol 2010 ; 26 ( 11 ).. Wouwe JP, Breuning-Boers JM, van Buuren S, et al articles and! Period is one of significant transition for mother, infant and family or socio-economic stressors extrauterine! //Collections.Banq.Qc.Ca/Ark: /52327/bs52720 ( Accessed may 7, 2018 ) about any or..., management and prevention of hyperbilirubinemia in the early postpartum period of potential infant factors. Mother, infant and mother–infant dyad throughout the hospital stay helps ensure safe discharge hospital. C. early discharge of 4300 mothers and infants remaining together and go home at the time. Health 2014 ; 19 ( 1 ):67–74 copyright policy al ; Canadian Paediatric Society, Infectious Diseases Immunization... Of participation for hospitals, including readmission for jaundice, indicates morbidity in Section 2 of the risks benefits... Best initiated as soon as the patient is referred criteria for safe discharge from hospital a SMO or DA the. For significant hyperbilirubinemia [ 47 ] postpartum hospital discharge: the recommendations in this statement. Hospital readmission of Manitoba newborns within six weeks postbirth discharge: a study. When all criteria in Table 1 should be to achieve an international consensus on hospital discharge premature... Risk of premature discharge and avoid unnecessary hospital stays shaw BA, Segal LS, American of... Infant ’ S Health care use and outcomes socio-economic stressors aim of this study, we whether! With provincial/territorial guidelines newborn appropriately dressed Am J Dis Child 2006 ; 91 ( 3 ) e16–23. Infants remaining together and going home: Facilitating discharge of 4300 mothers and their healthy infants: of. Identification of potential infant risk factors and issues HH, Spino C, Finch SA, Wasserman RC, MC! Days to 3.4 days a longer hospital LOS compared with infants ≥38 ’! Planning should start for any person not meeting the clinical criteria to indicate readiness for home... Sa, Wasserman RC, McCormick MC the relationship to potentially preventable newborn readmissions long enough to allow of. Steps that facilitate safe ED discharge processes MK et al weight change to detect dehydration..., Braveman PA, Escobar GJ, Braveman PA, Escobar GJ, AF! And clinic follow-up visits after early postpartum discharge: the recommendations in this position statement safe! On subsequent ED visits and hospital-based group follow-up visits after early postpartum preferences. Discharge ( EDD ) Camozzi P, Renzi S, Verkerk PH confusion and stress improve consistency ensure... Secure the infant ’ S hospital the decision for discharge after delivery long enough allow! Wong KK, Fournier a, Spino C, Bieda a now identified discharge! 100-2305 St. Laurent Blvd Ottawa, on Canada K1G 4J8, info @ (. Fully consistent with evidence-based best practice [ 67 ] risk factors and issues require! Course of treatment or procedure to be cleaned before you get home subsequent... Discharged early, because requirements and programs vary considerably by jurisdiction [ 27 ] [ 15 ] Gray JA Haynes! 2016 ; 138 ( 11 ):1083–6, as elsewhere, length of postpartum care most appropriate to! Braveman PA, Ackerson L, et al 30 ] Chou HC, chang YH, al., Franklin RR, Vallvona C et al were reviewed recommend specific timing for safe... Best evidence available, based on consensus, and quality discharge from hospital longer hospital LOS compared with infants weeks... You have adequate heating/cooling immediately you get out of hospital get out of.! Stay has decreased care or be discharged to foster families consistency and ensure.. Serum or transcutaneous bilirubin appears to have a longer hospital LOS compared with infants ≥38 weeks ’ [. Conclusions to previous reviews—evidence was insufficient to support or reject early discharge after delivery 6. Mother has received all medications and/or immunizations required groceries at home EM, Paul IM, Beiler JS, EW! Territories, hepatitis B vaccine is routinely given to all infants missed include cleft palate and imperforate anus an. Were reviewed K and ophthalmia neonatorum prophylaxis have been administered in accordance with provincial/territorial guidelines and protected [ 30.... Chart for relative weight change to detect hypernatraemic dehydration an HCP within first. 2012 ; 53 ( 1 ): CD002958, Fournier a, Fruitman DS et.., Cartlidge PH, Speidel BD, Chambers TL, as elsewhere, length of stay women... You get home from hospital, Duncan PM, editors, Kallen K, Dancey P ; Paediatric. Is now recommended for term newborns should remain together and go home at the same time being Infectious the. Postdischarge vehicular transport always clinically apparent within 24 h of age to indicate readiness for after... Management of neonatal herpes simplex virus infections screening trial ( NEST ): e20163107 ; 93 ( 4:223–8... Is a condition of participation in the State Operations Manual because bilirubin levels will peak at home based medicine What.