Implementation of a Late Preterm Infant Protocol
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Authors
Beck, Carol
Baas Rubarth, Lori
Beckvermit Prine, Kelli
Smith, Debra
Trower, Martha
Issue Date
2014-07-30
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Abstract
Problem: Late preterm infants are often considered and treated as functionally mature at birth. Research has proven the late preterm infant has a higher risk of morbidity and mortality in comparison to infants born at term (completion of 37 weeks gestation). The aim of this study was to compare complications of late preterm infants prior and following the implementation of the late preterm care guideline. Methods: A retrospective chart review was conducted of infants born at The Medical Center of Aurora to identify specific complications following birth of the late preterm infant (infants born at 35 0/7 to 36 6/7 weeks gestation). Comparisons of complications by frequency distribution were examined for a 6‐month period before and again after institution of the late preterm care guideline. Results: In a sample of 85 late preterm infants (52 pre/33 post‐implementation) variables included gender, gestational age, weight, ethnicity, weight for gestational age, hypoglycemia, hyperbilirubinemia, hypothermia, respiratory distress (oxygen requirement), feeding difficulty, length of stay, and admission to the Neonatal Intensive Care Unit (NICU). Frequency distributions of morbidity values revealed a 4% improvement in normoglycemia, an 18% decline in hyperbilirubinemia as well as an 8% decrease in oxygen need. There was a minimal increase (0.6, 2.5%) of hypothermia and feeding difficulties that may have been due to enhanced monitoring and subsequent early intervention. The post implementation group also revealed a significant decrease in length of stay and NICU admission by 7‐9% respectively. Conclusions: Early and enhanced interventions by implementation of the late preterm guideline have generally proven to benefit care of the late preterm infant. The minimal increase in hypothermia and feeding difficulty may have been due to enhanced monitoring and intervention. Further studies to refine late preterm care protocols will help to increase quality of care as well as decrease in overall costs of the late preterm infant population.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University
Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University