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Rehospitalization of preterm infants according to the discharge risk level
Burcu Aykanat Girgin1, Güler Cimete2
1Assistant Professor in Pediatric Nursing, Faculty of Health Sciences, Çankırı Karatekin University, Çankırı, Turkey.
Insights
Nearly 40% of preterm infants were readmitted within 8 weeks of discharge. Higher risk assessments at discharge significantly predicted infant rehospitalization, highlighting the need for targeted interventions.
Area of Science:
- Neonatal care
- Pediatric health outcomes
- Healthcare risk assessment
Background:
- High rehospitalization rates (22-52%) in preterm infants within the first year post-discharge present a significant challenge.
- Understanding early rehospitalization risks is crucial for improving infant outcomes.
Purpose of the Study:
- To investigate the rehospitalization of preterm infants within two months of discharge.
- To identify risk factors associated with infant, parental, and social factors.
Main Methods:
- A cohort of 238 preterm infants and their parents was studied.
- The Neonatal Discharge Assessment Tool (N-DAT) assessed discharge risk (low, moderate, high) based on medical, competency, risk, resource, and parenting factors.
- Rehospitalization within 8 weeks post-discharge was recorded and analyzed using statistical tests.
Main Results:
- 39.9% of preterm infants were rehospitalized within 8 weeks, primarily due to medical issues like pneumonia and bronchiolitis.
- Infants discharged at moderate and high-risk levels (N-DAT scores) had significantly higher rehospitalization rates (p < .001).
- N-DAT subscale scores were significantly higher for rehospitalized infants (p < .001).
Conclusions:
- Preterm infant rehospitalization within two months is substantial and linked to discharge risk assessment.
- Targeted interventions and support based on N-DAT risk stratification can potentially reduce early rehospitalizations.
- Nurses play a vital role in minimizing rehospitalization through education, counseling, and home care.
Purpose:
The rehospitalization rate of preterm infants is between 22 and 52% within the first year after discharge. The purpose of this study was to investigate the rehospitalization of preterm infants within 2 months following discharge, considering the level of risks originating from the infant, parents, and the social factors.
Design And Methods:
The sample was composed of 238 preterm infants and their parents. The data were collected with a Descriptive Information Form, the Post-Discharge Infant Follow-up Form, and the Neonatal Discharge Assessment Tool (N-DAT). Before discharge, the preterm infants were evaluated in terms of risky discharge via N-DAT consisting of the subscales Medical, Competencies, Risk factors, Resources, and Parenting. Discharge was determined as low, moderate, and high risk according to N-DAT total score. Two months after the discharge, rehospitalization of the infants was assessed. The data were evaluated via chi-square, Mann-Whitney U-test, and Fisher's exact test.
Results:
In the study, 39.9% of the preterm infants were rehospitalized within the 8 weeks following the discharge, with medical and/or surgical reasons. Medical problems such as pneumonia and acute bronchiolitis were ranked as the first cause for rehospitalization. As expected, according to the N-DAT scores, the rates of rehospitalization of infants who had been discharged with intermediate and high risk levels were found to be higher (p < .001) than the rates of those with low risk levels. Also, N-DAT Medical, Competencies, Risk factors, Resources, and Parenting subscale scores of the infants who were rehospitalized with medical problems were found to be higher at a statistically significant level than infants who were not rehospitalized (p < .001).
Practice Implications:
Nurses can help to minimize rehospitalization of infants by parental education, telephonic counseling, frequent observation, and home care support.
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