Guideline-based educational intervention to decrease the risk for readmission of newborns with severe hyperbilirubinemia.

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.A quality improvement initiative was undertaken with a preintervention/postintervention design.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.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%.An educational intervention with a clinical tool may help change provider practice. Longer follow-up is needed to determine if the impact is sustainable.

Duke Scholars

Author Julee Briscoe Waldrop School of Nursing

Author Debra Huffman Brandon School of Nursing