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Improving Evaluation and Treatment of Hyperbilirubinemia in Late Preterm Infants

Sheila A Brown1, Julee Waldrop, Jennifer D'Auria

  • 1University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina (Maj Brown and Drs Waldrop and D'Auria); and University of North Carolina Children's Hospital Newborn Nursery, Chapel Hill, North Carolina (Ms Haushalter).

The Journal of Perinatal & Neonatal Nursing
|October 20, 2020
PubMed

Insights

Changing the timing of bilirubin testing for late preterm (LPT) infants from 24 to 36 hours of life improved hyperbilirubinemia identification and treatment without increasing hospital stays. This practice change also reduced readmissions and blood draws.

Area of Science:

  • Neonatal Medicine
  • Pediatrics
  • Clinical Practice Improvement

Background:

  • Late preterm (LPT) infants face higher risks of hyperbilirubinemia.
  • Current protocols often delay treatment until predischarge, potentially increasing hospital stays.
  • Early identification and intervention are crucial for LPT infant health.

Purpose of the Study:

  • To evaluate a practice change in bilirubin testing timing for LPT infants.
  • To assess the impact of testing at 36 hours versus 24 hours of life.
  • To determine effects on hyperbilirubinemia treatment, length of stay, and readmissions.

Main Methods:

  • Retrospective medical record review at an academic medical center.
  • Implementation of a new protocol: serum bilirubin testing at 36 hours of life.
  • Comparison of outcomes before and after the practice change.

Main Results:

  • High compliance with the 36-hour testing protocol was achieved (P < .05).
  • More LPT infants were identified and treated for hyperbilirubinemia.
  • No increase in length of hospital stay was observed.
  • Readmissions for hyperbilirubinemia and blood draw rates decreased.

Conclusions:

  • Testing serum bilirubin levels at 36 hours of life is effective for LPT infants.
  • This practice change improves hyperbilirubinemia management and patient safety.
  • Further adherence to the policy may enhance outcomes in neonatal care.

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