Guideline-based educational intervention to decrease the risk for readmission of newborns with severe hyperbilirubinemia.
INTRODUCTION: The purpose of this study was to determine if educational intervention with medical providers in combination with a management tool to facilitate clinical guideline usage would (a) increase quality of care, (b) increase compliance with published guidelines, and (c) decrease hospital readmissions as a result of hyperbilirubinemia in the first week of life. METHOD: A quality improvement initiative was undertaken with a preintervention/postintervention design. INTERVENTION: An educational intervention was offered to persons who provide medical care to newborns. The charts of newborns were reviewed before and after the intervention in three samples: a care quality sample (N = 244), a compliance sample (N = 240), and a readmission sample. RESULTS: In the quality care sample, documentation of three quality care indicators improved significantly and one worsened significantly. In the compliance sample, the percentage of infants who were given appropriate follow-up appointments in primary care based on their hyperbilirubinemia risk at discharge improved (p = .03), and the readmission rate of newborns within the first week of life as a result of hyperbilirubinemia decreased by 50%. DISCUSSION: An educational intervention with a clinical tool may help change provider practice. Longer follow-up is needed to determine if the impact is sustainable.
Waldrop, JB; Anderson, CK; Brandon, DH
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