DEVELOPMENT OF A CLINICAL PATHWAY FOR NEAR-TERM AND CONVALESCING PREMATURE INFANTS IN A LEVEL II NURSERY

Abstract

A subcategory of premature infants, those born near term at 34 to 36 and 6/7 weeks gestation, may represent a previously unrecognized at-risk neonatal population. Evidence-based practice guidelines, crafted specifically for this population, are needed to effectively manage their care. In an effort to meet the needs of the near-term infant (NTI) population, and concurrently address the needs of the convalescing premature infants reverse transported to a Level II nursery setting, a multidisciplinary team of clinicians designed tools to provide a more consistent approach to care for and discharge these infants. This article describes the design, implementation, and evaluation of an evidence-based multidisciplinary clinical pathway specific to the needs of the NTI, including care plans, a standardized physician admission and discharge order set, evidence-based interventions, parent education, and recommendations for follow-up after hospital discharge that were developed for use in a Level II nursery. The use of the premature and near-term infant pathway has now been expanded to NTIs cared for in the newborn nursery, thereby ensuring safe, consistent, quality care for this population, regardless of their setting.