Certain factors can help prepare families to bring infants home from neonatal intensive care units

Child/Adolescent Health
Certain factors can help prepare families to bring infants home from neonatal intensive care units

A new study of neonatal intensive care unit (NICU) nurses and families with newborns treated in the NICU has uncovered factors likely to make the infant's transition home a success. Specifically, the researchers found a correlation between preparedness for infant discharge from the NICU and the parents' confidence in their choice of a pediatrician, their readiness for the infant to come home, and their confidence in their infant's health and physiological maturity. This type of maturity means that infants can coordinate their breathing and taking in food by mouth, ingest adequate amounts of food to gain weight, maintain normal body temperature outside of an incubator, and maintain stable heart rate and breathing.

The researchers analyzed data from 867 discharge nurse–family pairs, out of 1,492 eligible discharges from a medical center NICU between November 2003 and April 2007. Both the discharge nurses and the families rated the family's emotional or technical preparedness for discharge. At discharge time, 9 percent of the families were deemed unprepared for discharge by the responding nurse, 3 percent of the families reported feeling less than prepared (although the nurse found them to be prepared), and less than 1 percent of the families were both self-rated as unprepared and rated as unprepared by the nurse. Factors that correlated with preparedness for discharge were heavier infant weight and the presence of medical problems requiring special teaching for proper parental care.

Future studies need to assess the impact of discharge preparedness on long-term outcomes for preterm infants and their families, such as infant development and growth, readmission to the hospital, receipt of recommended immunizations, and continued parental confidence, the researchers suggest. Their study was funded in part by the Agency for Healthcare Research and Quality (T32 HS00063).

More details are in "Are families prepared for discharge from the NICU?" by Vincent C. Smith, M.D., Steven Young, Ph.D., DeWayne M. Pursley, M.D., M.P.H., and others in the Journal of Perinatology 29(9), pp. 623-629, 2009.