Neonatal individualized predictive pathway (NIPP): a discharge planning tool for parents

The development of clinical pathways has paralleled the national movement to control health care dollars. This movement is particularly intense in states with extensive managed care plans, such as Arizona. Early infant discharge with minimal home nursing support is a reality that forces parents to anticipate their discharge needs well in advance of the actual discharge date. The 59-bed NICU at Phoenix Children's Hospital uses neonatal individualized predictive pathways (NIPPs) as a discharge planning tool with parents of premature infants less than 32-weeks gestation. The NIPPs were developed after an extensive retrospective record review identified time frames for a variety of medical therapies and clinical milestones. Parent and nursing staff expectations are specified on a weekly basis opposite the medical therapies. This article discusses the positive parental response to the NIPP and identifies future areas for development.