FROM NEWBORN ITNENSIVE CARE UNIT (NICU) TO HOME DIRECT INVOLVEMENT OF PARENTS HOUSED WITH THEIR INFANTS IN A SPECIAL RECOVERY UNIT

Abstract

Discharge from NICU, especially after severe neonatal illness can represent a new family crisis, particularly if parents have not been prepared to resume full care of their infant, and if the link and interdependence with the follow-up (FU) clinic has not been appropriately established. To smooth the transition from hospital to home, to complete education of parents in health care maintenance and to ensure compliance with FU, a special Recovery Unit (RU) was designed to house infants and their parents in a homelike environment before discharge. Of the 703 infants admitted to NICU (20% with congenital heart disease, 25% with surgical conditions, 30% premature, 14% VLBW infants; 50% required assisted ventilation), 530 spent an average of 6 days (3-62 days) in the RU. During this stay nurses, physicians and social workers established the goals for the hospitalization, determined the requirements for discharge, taught parents on the care for some of their infant's special needs (feeding tubes, urinary catheters, ostomy bags, medications, etc.), helped them to establish a positive problem solving and decision making attitude, and established the initial link with the FU clinic. The iiipact of these activities were evaluated by means of special Questionnaire delivered to mothers; by determining the % of babies breastfed upon discharge and the caipliance with FU. Eighty two % of the families answered that the RU helped to increase their confidence in handling their infants; 10% of mothers felt that the additional stay in the RU was unnecessary; 17% of mothers answered that they still lacked confidence. Of the babies whose hospitalization exceeded 45 days, 60% were receiving human milk upon discharge. Drop out rate in FU was 8%. RU seems appropiate to wean parents from NICU making transition to home less traumatic, and helps improve compliance with FU.