A nurse-initiated jaundice management protocol improves quality of care in the paediatric emergency department

Paediatrics & Child Health
Michelle LongSarah Reid

Abstract

Hyperbilirubinemia is a common neonatal condition requiring timely management to prevent acute bilirubin encephalopathy. Management protocols allow nonphysicians to initiate designated actions prior to physician assessment. To assess the effectiveness of a nurse-initiated neonatal jaundice management protocol for serum bilirubin sampling and phototherapy for neonates presenting with hyperbilirubinemia to the Paediatric Emergency Department (PED). A health records review was performed for jaundiced neonates 12 months prior to the introduction of the management protocol (control period) and 12 months after (intervention period). Randomly selected charts were evaluated for time to serum bilirubin sampling, phototherapy initiation, ED length of stay, admission rate, completion of direct antiglobulin test and nursing documentation. Two hundred and sixty-six neonates (131 control and 135 intervention) were included. Median time to serum bilirubin sampling was reduced by 22% (36 min versus 28 min; P<0.001) with 34 min difference at the 90th percentile (94 min [95% confidence interval (CI) 63.7 to 116.9] versus 60 min [95% CI 49.0 to 78.2]). Statistically significant improvements were found in time to phototherapy initiation (127 min [...Continue Reading

References

Mar 15, 2002·Journal of Quality in Clinical Practice·G J BrowneL T Lam
Jul 3, 2004·Pediatrics·UNKNOWN American Academy of Pediatrics Subcommittee on Hyperbilirubinemia
Nov 18, 2005·The Journal of Pediatrics·Joyce CheneyClaire Wainwright
Aug 6, 2010·Journal of Pediatric Hematology/oncology·Archana JayaramRama Jasty
Sep 15, 2010·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Khajista QaziKhandee Serrano
Mar 26, 2014·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Andrew DixonAmy C Plint

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Citations

Mar 18, 2021·Australasian Emergency Care·Luke BurgessSamantha Keogh

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