Discharge planning and guidance for preterm newborns: a best practice implementation project
Karina Faria de Souza, Denise Gomes Miyazato, Bárbara Barros Pereira Lobo, Silvia Maria Ibidi, Luiza Campos Carneiro, Patricia Tereza Cardoso de Camargo Severa, Ana Paula Almeida Brito, Kelli Borges dos Santos, Vilanice Alves de Araújo PüschelABSTRACT
Introduction:
Prematurity, affecting approximately 10% of births, is a leading cause of neonatal morbidity and mortality. It is associated with neurological, respiratory, feeding, visual, and auditory problems; developmental delays; and chronic disease risks. The earlier the birth, the greater the risks. Lack of proper discharge planning can impair the health care team's assessment of a family's readiness, increasing morbidity. Although guidelines have been developed to support clinical discharge practices for preterm infants, gaps remain between evidence and practice.
Aim:
This project aimed to improve discharge planning and guidance for families or legal guardians of preterm newborns; assess compliance with evidence-based discharge criteria; standardize documentation; and unify discharge guidance provided to families of preterm infants admitted to the neonatal unit of a teaching hospital in São Paulo, Brazil.
Methods:
A quasi-experimental before-and-after study was conducted using the JBI Evidence Implementation Framework, which combines clinical audits with a structured process to address barriers and enablers to evidence-based practice. The methodology includes identifying the practice area, engaging change agents, assessing context and readiness, baseline audits, implementing changes, follow-up audits, and evaluating sustainability.
Results:
No statistically significant differences were found between the baseline and follow-up audits. Two criteria were already fully met. Four of the nine audited criteria showed improved compliance. Changes were supported by multimodal strategies, including an Institutional Care Guideline, an illustrated booklet with clear language for families, flowcharts to guide discharge planning, dissemination via AI-powered video and social media.
Conclusions:
The project enhanced discharge practices and guidance for families through multidisciplinary collaboration. Sustaining improvements will require ongoing attention.
Spanish abstract:
http://links.lww.com/IJEBH/A645