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Related Sites Journal of the American Medical Association National Association of Pediatric Nurses and Practitioners
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Early discharge appears safe for newborns
Posted
10-4-99 Cincinnati. Discharging newborns early from the hospital appears to be safe-as long as they get early follow-up care from a primary care physician or home health nurse, according to a study of 102,000 Ohio infants insured by Medicaid. The study, published in the Sept. 22/29 issue of The Journal of the American Medical Association, found that early discharge of newborns did not result in an increase in rehospitalization during the following two weeks. "We expected to find an increase in readmissions, but what we actually found, surprisingly, was a fall in readmissions. The data also showed that there was more of an effort to connect babies with primary care doctors and more home visits, so children get seen earlier," said Uma Kotagal, MD, author of the study and director of health policy and clinical effectiveness at Cincinnati Children's Hospital Medical Center. Researchers looked at healthy, full-term neonates born in Ohio between July 1, 1991, and June 15, 1995, to women receiving Medicaid. The mean length of stay decreased 27 percent during that period, from 2.2 days in 1991 to 1.6 days in 1995. In 1991, 20 percent of newborns were discharged one day after birth, and 76 percent within two days after birth. By 1995, 54 percent of newborns were discharged one day after birth, and 88 within percent two days after birth. Kotagal believes nurses should be involved in deciding the right time to discharge the mother and baby. "It's really very individualized," she said. Barbara Kelley, EdD, MPH, PNP, RN, president of the National Association of Pediatric Nurse Associates and Practitioners, isn't surprised by the study's findings. "Mothers and babies can do well at home as long as they have the advantage of a good support system," she said. "Nurses need to be on top of who needs to be discharged, and this study can give support to nurses, who I believe should be the gatekeepers."
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