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Published on: August 19, 2020
Home phototherapy for neonatal hyperbilirubinemia: current practices and attitudes
Maryse C Cnossen1, Jessie Spaan2, Maria S Fleischmann3
1Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands. m.c.cnossen@hr.nl.
Insights
Home-based phototherapy for neonatal hyperbilirubinemia is well-received by healthcare professionals. Addressing knowledge gaps, guidelines, and financial concerns is key for successful implementation.
Area of Science:
- Neonatal care
- Public health
Background:
- Neonatal hyperbilirubinemia is a primary cause of infant hospitalization.
- Home-based phototherapy is emerging as a safe and effective alternative to hospital treatment.
- Broader implementation requires understanding healthcare professional perspectives.
Purpose of the Study:
- To assess the perspectives and needs of healthcare professionals regarding home-based phototherapy.
- To identify barriers and facilitators for implementing home-based phototherapy in the Netherlands.
Main Methods:
- A cross-sectional survey was conducted among pediatricians, midwives, and maternity care assistants.
- An 82-item questionnaire explored experiences, motivations, and readiness for home-based phototherapy.
- Respondents included those with and without prior experience in home phototherapy.
Main Results:
- A positive reception towards home-based phototherapy was observed across all respondent groups.
- Healthcare professionals recognized benefits and showed willingness to adopt the innovation.
- Identified challenges include a need for information, lack of guidelines, coordination issues, and financial concerns.
Conclusions:
- Home-based phototherapy is well-received by Dutch healthcare professionals.
- Addressing knowledge, guidelines, collaboration, and financial aspects is crucial for successful large-scale implementation.
- Successful implementation will benefit neonates, families, and healthcare systems.
Background:
Neonatal hyperbilirubinemia is a leading cause of hospitalization during the first week of life. Recent research suggest that phototherapy, the standard treatment, can be safely and effectively administered at home. Some Dutch hospitals have already adopted home-based phototherapy. The TREAT Jaundice@home study aims to contribute to its broader implementation across the Netherlands. Understanding the perspectives, perceptions, and needs of healthcare professionals is essential for facilitating this implementation.
Methods:
This cross-sectional survey targeted pediatricians, midwives, and maternity care assistants with and without prior experience with phototherapy at home. The 82-item questionnaire covered respondent background, experience, interests, motivation, responsibilities, logistics, collaboration, knowledge, indications and contraindications, financial aspects, and implementation readiness.
Results:
The study included responses from 16 pediatricians, 90 community midwives, and 514 maternity care assistants. Findings indicate a positive reception of phototherapy at home, regardless of prior experience. The majority expressed satisfaction, recognized potential benefits, and/or demonstrated a willingness to adopt this innovation. Key challenges identified include the need for information, the lack of guidelines, coordination and collaboration issues, and concerns about financial compensation.
Discussion:
Phototherapy at home is well-received by healthcare professionals. Addressing the identified challenges is imperative for successful implementation, ultimately benefiting neonates, their families, and healthcare systems.
Impact:
Phototherapy at home is well-received and perceived as beneficial by healthcare professionals with and without prior experience Key challenges include the need for better knowledge and guidelines, coordination and collaboration issues among healthcare professionals, and concerns about financial compensation Addressing these challenges through comprehensive information, standardized protocols, improved collaboration, and adequate financial compensation is essential to successfully implement phototherapy at home on a larger scale.
