Decreasing the Risk for Severe Hyperbilirubinemia in Newborns

Abstract

(41st Biennial Convention) Objective: To determine if educational interventions with medical providers in combination with a management tool to facilitate clinical guideline implementation would 1) increase compliance with published guidelines and 2) decrease hospital readmissions secondary to hyperbilirubinemia in the first week of life. Design: This study uses a pre- post-intervention design over a 12 month period. Setting: The study took place at a major university hospital. Participants: Data was collected from patient records. Methods: Analysis of differences was done with t-tests for continuous variables and either X2 or Fisher's Exact tests for categorical variables. Results: Improvements in the documentation of three care quality indicators were observed; 1) jaundice on the discharge exam or discussion of jaundice risk with parents (p = 0.03), 2) written and oral counseling of parents (p < 0.01), and 3) exclusive breastfeeding (p = 0.02). Documentation of two observed breastfeedings decreased (p < 0.01). The percentage of infants given appropriate follow up appointments in primary care based on their hyperbilirubinemia risk at discharge improved (p = 0.03) and the re-admission rate of newborns within the first week of life secondary to hyperbilirubinemia decreased by 50%. Conclusions: This study demonstrates that an educational intervention with a clinical tool may help change provider practice. Longer follow up is needed to determine if impact is sustainable.