Admission and Care Practices in United States Well Newborn Nurseries.

Autor:	Joshi NS; Department of Pediatrics, Stanford University, Stanford, California., Flaherman VJ; Department of Pediatrics, University of California San Francisco, San Francisco, California., Halpern-Felsher B; Department of Pediatrics, Stanford University, Stanford, California., Chung EK; Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington., Congdon JL; Department of Pediatrics, University of California San Francisco, San Francisco, California., Lee HC; Department of Pediatrics, Stanford University, Stanford, California.
Jazyk:	angličtina
Zdroj:	Hospital pediatrics [Hosp Pediatr] 2023 Mar 01; Vol. 13 (3), pp. 208-216.
DOI:	10.1542/hpeds.2022-006882
Abstrakt:	Objectives: Late preterm and term infants comprise 97.3% of annual births in the United States. Admission criteria and the availability of medical interventions in well newborn nurseries are key determinants of these infants remaining within a mother-infant dyad or requiring a NICU admission and resultant separation of the dyad. The objective of this study was to identify national patterns for well newborn nursery care practices. Methods: We surveyed a physician representative from each nursery in the Better Outcomes through Research for Newborns Network. We described the admission criteria and clinical management of common newborn morbidities and analyzed associations with nursery demographics. Results: Of 96 eligible nursery representatives, 69 (72%) completed surveys. Among respondents, 59 (86%) used a minimal birth weight criterion for admission to their well newborn nursery. The most commonly used criteria were 2000 g (n = 29, 49%) and 1800 g (n = 19, 32%), with a range between 1750 and 2500 g. All nurseries used a minimal gestational age criterion for admission; the most commonly used criterion was 35 weeks (n = 55, 80%). Eleven percent of sites required transfer to the NICU for phototherapy. Common interventions in the mother's room included dextrose gel (n = 56, 81%), intravenous antibiotics (n = 35, 51%), opiates for neonatal abstinence syndrome (n = 15, 22%), and an incubator for thermoregulation (n = 14, 20%). Conclusions: Wide variation in admission criteria and medical interventions exists in well newborn nurseries. Further studies may help identify evidence-based optimal admission criteria to maximize care within the mother-infant dyad. (Copyright © 2023 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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