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Effectiveness of Parent Education on Late Preterm Infants' Readmission Rates

Sunday, June 26, 2011
Lisa Klein, MSN, RNC-OB, RNC-LRN, CNS , Malek School of Health Professions, Marymount University, Reston, VA

Discipline: Newborn Care (NB)

Learning Objectives:
  1. State three reasons late preterm infants are readmitted to a hospital after initial discharge
  2. Describe any impact of focused family education on readmission of late preterm infants
  3. Identify barriers to successful implementation of an educational intervention

Submission Description:
Objective: Evidence has shown that infants who are still premature, but close to term, are at significant risk for morbidity.  The objective of this research study was to determine the effect of a Late Preterm Infant family education program on infant readmissions rates. 

Design: Retrospective chart review

Setting: Suburban Community Hospital

Patients/Participants: Infants delivered at gestational age of 34-0/7 weeks to 37-6/7 weeks and readmitted to the study hospital’s Pediatric Unit in the first 28 days after birth discharge were included in this analysis.  A review of 231 charts before the education program identified 55 Late Preterm Infants and 217 charts after education was started yielded 41 Late Preterm Infants.   

Methods: Starting May 1, 2007, parents of late preterm infants received education, using the handout AWHONN developed.  The control population is comprised of Late Preterm Infants born September 1, 2005 to April 30, 2007.  The study population is comprised of Late Preterm Infants born May 1, 2007 to December 31, 2008.  As there is no specific diagnostic code for Late Preterm Infants, potential patients were determined by chart review of all readmissions to the Pediatric Unit during the specified time.  Data was collected on all patients who met eligibility criteria.

Results: Analysis of descriptive statistics indicated that the pre- and post education groups are sufficiently similar for comparative purposes.  Readmission length of stay was affected by readmission diagnosis (r = .391, p<.01).  Readmission length of stay was not related to birth weight (r =.050, p>.05). Birth gestation was not a predictor of readmission length of stay (F (1,93) = 3.053, p>.05).  The data did not support the intervention predicting length of stay at readmission to the hospital (r=.067, F(,93) = .423, p>.05).  Similarly, the intervention did not predict the amount of time for infant readmission after initial discharge after birth (r= .142, F(1,93) = 1.927, p>.05).

Conclusion/Implications for nursing practice: This study does not support a significant effect from the intervention of a focused education program on outcomes of late preterm infants readmitted in the first 28 days after birth discharge.   One possible reason is that a certain number of infants will need to return to the hospital despite all efforts for them to transition safely to home.  It would make sense that the most vulnerable infants would comprise a large number of them. 

Keywords: Late Preterm Infant, readmission