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Early discharge and home care after unplanned cesarean birth: nursing care time
D Brooten1, H Knapp, L Borucki
1Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106-4904, USA.
Objective:
This study examined the mean nursing time spent providing discharge planning and home care to women who delivered by unplanned cesarean birth and examined differences in nursing time required by women with and without morbidity.
Design:
A secondary analysis of nursing time from a randomized trial of transitional care (discharge planning and home follow-up) provided to women after cesarean delivery.
Setting:
An urban tertiary-care hospital.
Patients:
The sample (N = 61) of black and white women who had unplanned cesarean births and their full-term newborn was selected randomly. Forty-four percent of the women had experienced pregnancy complications.
Interventions:
Advanced practice nurses provided discharge planning and 8-week home follow-up consisting of home visits, telephone outreach, and daily telephone availability.
Outcome Measure:
Nursing time required was dictated by patient need and provider judgment rather than by reimbursement plan.
Results:
More than half of the women required more than two home visits; mean home visit time was 1 hour. For women who experienced morbidity mean discharge planning time was 20 minutes more and mean home visit time 40 minutes more.
Conclusions:
Current health care services that provide one or two 1-hour home visits to childbearing women at high risk may not be meeting the education and resource needs of this group.