reduced length of stay through teamwork and communication
TRANSCRIPT
Disclosure
• I have nothing to disclose
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Len
gth
of
stay
(d
ays)
Date of admission
Length of NICU stay by individual substance-exposed infant
Median
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# In
fan
t-d
ays
Date of Admission
NICU occupancy by substance-exposed infants per month January 2010 to October 2013
Median
The Team
Sponsor
Neonatologist
Neonatal Nurse Educator
Perinatal Nurse Educator
Family physician
Pediatricians
Pharmacist
Hospital social worker
Midwife
Postpartum nurse educator
Postpartum bedside nurse
Neonatal bedside nurse
Labour-delivery clinical nurse leader
Neonatal clinical nurse leader
Aboriginal liaison nurse
Child Safety Consultant
Public Health clinical coordinator
Youth and family substance use manager
Collaborative maternity care manager
HerWay Home Program coordinator
Principles of Care:
1. Promote safe care of baby with mother
2. Medical instability requires NICU admission
3. Promote breast feeding
4. Normalize care for infant and mother
5. Encourage skin-skin
6. Involve parents in assessment (care-by-parent model)
7. Simplify assessment of withdrawal (consider “no score” tool)
8. Promote healthcare providers training in assessment and management
9. Identify resources to support maternal length of stay
10. Follow established models (literature/grey literature review)
11. Promote culture of safety
12. Practice trauma-informed care
13. Practice culturally safe care
14. Promote family supports to mother and infant
15. Optimize community supports while in acute care environment
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11/02/2010 11/02/2011 11/02/2012 11/02/2013 11/02/2014 11/02/2015
Len
gth
of
stay
(d
ays)
Date of admission
Length of NICU stay by individual substance exposed infant
Median
Project start
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90Ja
n-1
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Mar
-10
May
-10
Jul-
10
Sep
-10
No
v-1
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Jan
-11
Mar
-11
May
-11
Jul-
11
Sep
-11
No
v-1
1
Jan
-12
Mar
-12
May
-12
Jul-
12
Sep
-12
No
v-1
2
Jan
-13
Mar
-13
May
-13
Jul-
13
Sep
-13
No
v-1
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Jan
-14
Mar
-14
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-14
Jul-
14
Sep
-14
No
v-1
4
Jan
-15
Mar
-15
May
-15
Jul-
15
Sep
-15
# In
fan
t-d
ays
Date of Admission
Monthy NICU occupancy by substance-exposed infants
Median
We did a bunch of stuff…
• Principles of care to guide development and implementation of the desired Model of Care
• Guideline development to support care of the mother-infant dyad outside of the NICU setting
• Parent education and discharge planning resources
• Developed tools for consistent, evidence-based & safe practice
• Staff Education requirements identified
Reduced Length of Stay through Teamwork and
Communication
