scholarly journals Establishing an alternative accommodation for stable hospitalised antepartum patients: barriers and challenges

2022 ◽  
Vol 11 (1) ◽  
pp. e001625
Author(s):  
M Brad Sullivan ◽  
Abby Rentz ◽  
Pamela Mathura ◽  
Megan Gleddie ◽  
Tania Luthra ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Swot Analysis ◽  
Tertiary Care ◽  
Physical Space ◽  
Patient Discharge ◽  
Cost Effective ◽  
Premature Delivery ◽  
Care Centre ◽  
Outpatient Management ◽  
Tertiary Care Centre

BackgroundPatients in remote communities who risk premature delivery require transfer to a tertiary care centre for obstetric and neonatal care. Following stabilisation, many patients are candidates for outpatient management but cannot be discharged to their home communities due to lack of neonatal intensive care unit (ICU) support.ProblemWithout outpatient accommodation proximal to neonatal ICU, these patients face prolonged hospitalisation—an expensive option with medical, social and psychological consequences. Therefore, we sought to establish an alternative accommodation for out-of-town stable antepartum patients.MethodsQuality Improvement approaches were used to identify process strengths and opportunities for improvement on the antepartum ward in a tertiary care centre. Physician and patient surveys informed outpatient accommodation programme development by a multidisciplinary team. The intervention was implemented using a plan–do–study–act cycle. Barriers to patient discharge and enrolment in the programme were analysed by completing thematic and strengths–weaknesses–opportunities–threats (SWOT) analysis.ResultsPhysicians broadly supported safe outpatient management, whereas patients were hesitant to leave the hospital even when physicians assured safety. Our alternative accommodation was pre-existing and cost-effective, however, we encountered significant barriers. The physical space limited family visits and social interaction, lacked desired amenities,and the programme proved inconvenient to patients. The thematic and SWOT analysis identified aspects of the intervention which can be optimised to develop future actionable strategies.ConclusionThe utilisation of acute care beds is costly for the healthcare system and must be allocated judiciously. Patient needs, experience and health system barriers need to be considered when establishing alternative outpatient accommodations and strategies for stable antepartum patients.

Hearing screening outcome in neonatal intensive care unit graduates from a tertiary care centre in Singapore

2019 ◽  
Vol 46 (1) ◽  
pp. 104-110 ◽  
Author(s):  
Pooja Agarwal Jayagobi ◽  
Annie Yeoh ◽  
Karen Y.M. Hee ◽  
Lim Sok Bee Lim ◽  
Khoo Poh Choo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Hearing Screening ◽  
Care Centre ◽  
Tertiary Care Centre

scholarly journals Morbidity and mortality profile of preterm neonates admitted in neonatal intensive care unit of a tertiary care centre in Western Uttar Pradesh, India

2019 ◽  
Vol 6 (5) ◽  
pp. 1859
Author(s):  
Najia Hassan ◽  
Sujaya Mukhopadhyay ◽  
Sneha Mohan
Keyword(s):  
Risk Factors ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
Pregnancy Induced Hypertension ◽  
Care Centre ◽  
Maternal Risk Factors ◽  
Tertiary Care Centre ◽  
Maternal Risk ◽  
Induced Hypertension

Background: Preterm birth is a major cause of mortality and morbidity for newborns. Complications of prematurity are becoming more common as more survivors are spending time in Neonatal intensive care unit.Methods: A retrospective hospital based clinical observational study was conducted in NICU in Sharda hospital, a tertiary care centre in Greater Noida. Data regarding neonates′ age, sex, clinical presentation, maternal risk factors, complications and outcome were recorded.Results: A total of 133 preterm neonates were enrolled in the study. Maternal risk factors like Pregnancy induced hypertension (PIH) was seen in 19.5% cases, Urinary tract infection in 15% and Antepartum haemorrhage in 14.2% cases. Among the complications of prematurity, RDS was noted in 38.3% cases, Hyperbilirubinemia in 16.5% and feed intolerance in 15% cases. Sepsis was present in 3% of the preterm. Mortality rate was 7.5%. Most common cause of death was RDS.Conclusions: Pregnancy induced hypertension and Antepartum haemorrhage were important maternal risk factors for prematurity. Respiratory distress syndrome and perinatal asphyxia were the important causes of mortality in the present study.

scholarly journals Risk factor and perinatal outcome of preterm delivery in a tertiary care centre in rural Haryana

2020 ◽  
Vol 9 (10) ◽  
pp. 4187
Author(s):  
Sunaina Singla ◽  
Banashree Das
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Preterm Delivery ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Preterm Births ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
History Of

Background: Aim of the study was to identify risk factors and to assess neonatal mortality and morbidity associated with preterm delivery in patient attending a tertiary care centre in rural Haryana.Methods: This retrospective cohort study was conducted in Shree Guru Gobind Singh Tricentenary Medical College, over a period of one year (January to December). All pre-term deliveries were included in the study. They were followed up from admission till delivery and till discharge from hospital. Various, parameters like maternal age, associated medical disorder, obstetric complications, gestational age, neonatal mortality, need of neonatal intensive care and condition of baby at discharge were analyzed.Results: In the present study, incidence of preterm deliveries was 16.1%. The most common risk factor found to be history of previous abortion (23.6%), preterm premature rupture of membrane (17.1%), Intra-uterine growth restriction (IUGR) with oligohydramnios (10.5%), hypertensive disorder during pregnancy (5.9%), and antepartum hemorrhage (4.6%). But majority of the patient (56.5%) no cause could be identify. Out of total 160 preterm births 3 were still born and 157 live preterm births, and out of which total Neonatal intensive care (NICU) admission were 60. Mortality rate was 100% in neonate weighing less than 1000 gm and 18% in babies weighing less than 2000 gm.Conclusions: The commonest risk factor for preterm delivery is previous history of abortion and adverse perinatal outcome is inversely proportionate to the period of gestation at the time of delivery. All efforts should be made to prolong the pregnancy beyond 34 weeks by identifying and actively managing the risk factors for better neonatal outcome.

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