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Nordic survey showed wide variation in discharge practices for very preterm infants
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Perinatal, Neonatal and Pediatric Cardiology Research.ORCID iD: 0000-0002-5802-3147
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, SWEDESD - Sustainability Learning and Research Centre. Department of Nursing Science University of Turku, Turku, Finland.ORCID iD: 0000-0003-2743-3589
Department of Clinical Sciences, Lund, Paediatrics Lund University and Skåne University Hospital Lund Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Perinatal, Neonatal and Pediatric Cardiology Research.ORCID iD: 0000-0001-5955-1278
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2023 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim

We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units.

Methods

Medical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-text comments.

Results

We received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post-discharge home visits and video-consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay.

Conclusion

Discharge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023.
Keywords [en]
early discharge, length of stay, neonatal home care, preterm infant, telemedicine
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-512706DOI: 10.1111/apa.16934ISI: 001047084900001PubMedID: 37540833OAI: oai:DiVA.org:uu-512706DiVA, id: diva2:1800859
Available from: 2023-09-28 Created: 2023-09-28 Last updated: 2023-09-28Bibliographically approved

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Arwehed, SofiaAxelin, AnnaThernström Blomqvist, YlvaÅgren, Johan

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