Homecare and Healthcare Utilization Errors Post-Neonatal Intensive Care Unit Discharge.
Rupalee Patel, Matthew Nudelman, Adebola Olarewaju and 4 others
PMID 28252522WHAT IT FOUND
Most high-risk NICU graduates had at least one homecare or follow-up error after discharge; home visits found 63.1% of infants affected, and most errors appeared at the first visit.
Key findings
01At least one homecare or healthcare utilization error was found in 152 of 241 high-risk infants after NICU discharge, and 138 infants had an error during the first visit.
02Appointment errors were the most common of 363 errors, with 205 identified, and physical therapy appointment errors were the exception to the pattern that most errors did not recur.
03Infants with and without errors did not differ in birth weight, gestational age, length of stay, day of life at discharge, sex, or maternal demographic factors.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
Single-center study, so results may not apply to other populations or healthcare systems. Error identification was institution-specific, depending on local resources and systems. Infants who never received a home visit were excluded, including deaths within 2 weeks of discharge, moves, lost follow-up, or declined visits, so the sample may miss families with the greatest problems. There was no comparison group without home visits, so the study cannot show that the visits caused errors to resolve. Some maternal demographic data were missing because mothers chose not to disclose marital status, education, race, or language. Attrition occurred in later visits because visits were scheduled based on medical need, so follow-up data are incomplete for some infants. The study did not measure infant health outcomes such as rehospitalization, development, or safety.
The easy way to misread this
Do not conclude that home visits reduced errors or improved infant outcomes. The study had no comparison group and only describes errors found during visits, so it cannot show that the visits caused the errors to stop.