The Framework of NICU-discharge Plan System for Preterm Infants in Iran: Duties, Components and Capabilities

Abstract

Introduction:The development of comprehensive discharge plan system Not only, will facilitate the discharge process, increase staff and parent satisfaction, improve the care of preterm infants, also reduce the human error.Aim:to determine duties, components and capabilities of NICU discharge plan system as a multidimensional tool for facilitating the complex process of transition preterm infants to the home and support parents for post-discharge care.Method:The descriptive and qualitative study conducted in 2017. Firstly by literature review, components of framework were determined in 38 statements under 3 major themes: duties, components, and capabilities and then related questionnaire was provided. Cronbach’s alpha test was used to assess the reliability of the questionnaire. The result was more than 0.82 for all statements of questionnaire. The validity of the instrument was determined based on concepts in the valid scientific texts and comments of experts. The analysis was performed using SPSS software.Result:In overall, 29 experts participated in the consensus process. In the duties section, all of the statements reach more than 50% consensus. Among statements of the components and capabilities consensus was achieved in 12 out of 17, 12 out of 16 statements respectively.Conclusion:according to survey, checkout infant readiness determined as the main duty of the system. Alarm message for special examination before discharge and parent readiness checklist considered as the most important components. The ability to send alarm message, register and log in system were the key capabilities of the discharge system.

Understanding preparation for preterm infant discharge from parents’ and healthcare providers’ perspectives: Challenges and opportunities

“…Encouraging parents to prepare for discharge and look for available resources more proactively is the first and the essential step to promote discharge preparation of preterm infants currently (American Academy of Pediatrics Committee on & Newborn, 2008; Smith et al., 2013). A checklist or brochure could help parents learn about the importance of discharge preparation, their role during the process and what to prepare before discharge (American Academy of Pediatrics Committee on & Newborn, 2008; Seyedfarajollah, Nayeri, Kalhori, Ghazisaeedi, & Keikha, 2018).…”

Parental readiness for hospital discharge as a mediator between quality of discharge teaching and parental self‐efficacy in parents of preterm infants

“…High-quality discharge teaching conducted by nurses is an important component of this smooth transition and would help parents to prepare for their preterm infant's discharge (Jefferies, 2014;Raphael et al, 2018;Seyedfarajollah et al, 2018).…”

“…In some countries such as the USA, Canada and Iran, recommendations on how to prepare for the preterm infants' discharge with their families, including appropriate investigations and screening tests, resolved medical concerns, and individual follow-up plans, could effectively improve RHD of the parents. (Jefferies, 2014;Seyedfarajollah et al, 2018).…”

“…Fortunately, advances in neonatal technology and treatment have improved survival rates of preterm infants in the last few decades (Shah et al, 2016). These treatments often require preterm infants to remain in a neonatal intensive care unit (NICU) for a substantial period of time before they can be discharged (Seyedfarajollah, Nayeri, Sharareh, Ghazisaeedi, & Keikha, 2018).…”

Impact of Discharge Educational Program on Preterm Infants’ Mothers’ Knowledge and Practice

“…Parental discharge education usually begins while the infants are in NICUs, aiming at providing anticipatory guidance and information to help parents successfully care for the infant at home (8) . Meanwhile, many strategies have been established to improve the effectiveness of discharge education programs (9) , researchers found that education programs for parents of preterm infants during the hospitalization period contributed to higher levels of parental knowledge of parenting infants, more parental satisfaction with nursing service (10) , lower infant morbidity after discharge (11) and lower readmission rates (12) . Despite receiving training by neonatal nurses, mothers of preterm infants encounter difficulties at home, hospital readmission rates increase and family life is disrupted (13) .…”