Sharma Yograj, Pathak Om Krishna, Sharma Asmita, Khanal Suvekhsya, Baral Niruta, Shrestha Sagar, Adhikari Pradeep
Department of Paediatrics, Bharatpur Hospital, Bharatpur, Chitwan, Nepal.
Bharatpur Hospital Nursing Program, Bharatpur Hospital, Bharatpur, Chitwan, Nepal.
JNMA J Nepal Med Assoc. 2023 Jul;61(263):571-575. doi: 10.31729/jnma.8212. Epub 2023 Jul 30.
Leave against medical advice is a condition in which a patient leaves the hospital against the treating physician's recommendation and is a sensitive issue occurring frequently in neonatal intensive care units across the developing world. Investigating the causes of newborn deaths is essential as there is high neonatal mortality rate in context of Nepal and a huge gap between that rate and desired outcomes. Self-discharge of sick neonates from hospitals further increases the chance of death. Hence, this study aimed to find out the prevalence of leave against medical advice among neonates admitted to the neonatal intensive care unit in a tertiary care centre.
This descriptive cross-sectional study was conducted among patients admitted to the Neonatal Intensive Care Unit from 14 April 2021 to 13 April 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 077/78-021). The patient's demographic and clinical characteristics and reasons for self-discharge were recorded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated.
Among 1352 neonates, the prevalence of leave against medical advice was 119 (8.80%) (7.29-10.31, 95% Confidence Interval).
The prevalence of leave against medical advice from the neonatal intensive care unit was lower than in other studies done in similar settings.
违反医嘱出院是指患者违背主治医生的建议离开医院,这是一个敏感问题,在发展中世界的新生儿重症监护病房中经常出现。鉴于尼泊尔新生儿死亡率很高,且该死亡率与预期结果之间存在巨大差距,调查新生儿死亡原因至关重要。患病新生儿自行出院会进一步增加死亡几率。因此,本研究旨在查明一家三级护理中心新生儿重症监护病房中违反医嘱出院的发生率。
本描述性横断面研究在获得机构审查委员会伦理批准(参考编号:077/78 - 021)后,于2021年4月14日至2023年4月13日对入住新生儿重症监护病房的患者进行。记录患者的人口统计学和临床特征以及自行出院的原因。采用方便抽样法。计算点估计值和95%置信区间。
在1352名新生儿中,违反医嘱出院的发生率为119例(8.80%)(7.29 - 10.31,95%置信区间)。
新生儿重症监护病房违反医嘱出院的发生率低于在类似环境中进行的其他研究。