Preparing for home: A before-and-after study to investigate the effects of a neonatal discharge package aimed at increasing parental knowledge, understanding and confidence in caring for their preterm infant before and after discharge from hospital

Ingram, Jenny; Blair, Peter; Powell, Jane; Manns, Sarah; Burden, Heather; Pontin, David; Redshaw, Margaret; Beasant, Lucy; Rose, Claire; Johnson, Deborah; Gaunt, Daisy; Fleming, Peter

Abstract

Background
Improved survival and shorter length of stay (LOS) for preterm infants, together with poorly organised discharge planning in some neonatal units, leaves many parents ill prepared to take their babies home, with increased use of out-of-hours services. Despite the importance accorded to family-orientated neonatal care by the Department of Health and the National Institute for Health and Care Excellence, few neonatal units offer structured, family-orientated discharge planning.

Objectives

To implement a parent-orientated discharge planning approach (Train-to-Home package) for preterm infants and investigate the effects on parental self-efficacy scores, infants’ LOS and change in costs associated with use of health-care resources in the 8 weeks after discharge, before and after implementation.

Design
A before-and-after study, investigating the effects of Train-to-Home package during two 11-month periods, immediately before and after its implementation.

Setting
Four local neonatal units in South West England.

Participants
Infants without major anomalies, born at 27–33 weeks’ gestation, admitted to the participating units, and their parents.

Train-to-Home intervention
A parent-orientated package that incorporated approaches to improving parents’ involvement in, and understanding of, their baby’s needs. It comprised a train graphic and supporting care pathways to facilitate parents’ understanding of their baby’s progress through the neonatal unit, combined with improved estimation, soon after hospital admission, of the baby’s likely discharge date.

• Report Type: Project Report
• Publication Date: Jan 1, 2016
• Deposit Date: Mar 16, 2016
• Publicly Available Date: Mar 16, 2016
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.3310/hsdr04100
• Keywords: neonatal unit, scbu or special care baby unit, nicu, neonatal intensive care unit, premature, neonate, infant, discharge
• Public URL: https://uwe-repository.worktribe.com/output/920022
• Publisher URL: http://dx.doi.org/10.3310/hsdr04100
• Contract Date: Mar 16, 2016