Schuler Rahel, Eiben Carola, Waitz Markus, Neubauer Bernd A, Hahn Andreas, Mihatsch Walter A
Department of General Pediatrics and Neonatology, Justus-Liebig-University, Feulgenstrasse 12, D-35392 Giessen, Germany.
Department of Pediatric Neurology, Justus-Liebig-University, Feulgenstrasse 12, D-35392 Giessen, Germany.
Children (Basel). 2024 Oct 29;11(11):1316. doi: 10.3390/children11111316.
BACKGROUND/OBJECTIVES: Long hospitalisation has been recognized as an independent risk factor for poor neurodevelopmental outcomes of preterm infants. Systematic training and early inclusion of parents in their preterm infant's care is a strategy to shorten the length of hospital stay. We implemented an enhanced stepwise family-centred care program and assessed its effects on postmenstrual age (PMA) at discharge and parental satisfaction.
This prospective single-centre longitudinal cohort study was carried out in a German level III neonatal unit from October 2020 to May 2023. Five consecutive 6-month cohorts (1 baseline and 4 intervention cohorts, 169 infants and their caregivers) were analysed.
Mean PMA at discharge did not change in the total cohort but declined significantly in patients without neonatal morbidities from baseline to cohort 4 (37.2 ± 1.4 to 36.1 ± 1.6 weeks; = 0.036). Concomitantly, discharge with tube feeding raised from 2.4% to 74.1% ( < 0.001) and discharge with home monitoring raised from 9.8% to 74.1% ( < 0.001), while unplanned readmissions remained unchanged ( = 0.44). Parental satisfaction with time point of discharge increased non-significantly from baseline to cohort 4 (75.8% vs. 95.7%; Chi 0.22).
Discharge of preterm infants at a significantly lower PMA is feasible through enhancement of family-centred care and is very well accepted by parents.
背景/目的：长期住院已被认为是早产儿神经发育不良结局的独立危险因素。系统培训并让父母早期参与早产儿护理是缩短住院时间的一项策略。我们实施了一项强化的逐步家庭中心护理计划，并评估了其对出院时的孕龄（PMA）和父母满意度的影响。
这项前瞻性单中心纵向队列研究于2020年10月至2023年5月在德国一家三级新生儿重症监护病房进行。分析了连续五个6个月的队列（1个基线队列和4个干预队列，共169名婴儿及其照料者）。
整个队列出院时的平均PMA没有变化，但在无新生儿疾病的患者中，从基线到队列4显著下降（从37.2±1.4周降至36.1±1.6周；P = 0.036）。与此同时，出院时带管饲喂养的比例从2.4%升至74.1%（P < 0.001），出院时带家庭监测的比例从9.8%升至74.1%（P < 0.001），而计划外再入院率保持不变（P = 0.44）。从基线到队列4，父母对出院时间点的满意度非显著增加（75.8%对95.7%；卡方检验P = 0.22）。
通过加强以家庭为中心的护理，以显著更低的PMA让早产儿出院是可行的，并且父母对此接受度很高。
