Brooten D, Roncoli M, Finkler S, Arnold L, Cohen A, Mennuti M
Center for Low Birthweight Research, University of Pennsylvania, School of Nursing.
Obstet Gynecol. 1994 Nov;84(5):832-8.
To determine the safety, efficacy, and cost savings of early hospital discharge of women delivered by unplanned cesarean delivery.
Using randomized assignment, 61 postpartum women were discharged from the hospital at the usual time, and 61 were discharged early and had nurse specialist home follow-up care. The latter group received comprehensive discharge planning, instruction, counseling, home visits, and daily on-call availability from the nurse specialists. Both groups were followed from delivery to 8 weeks postpartum.
Women who were discharged early and received transitional home care services by clinical nurse specialists were sent home a mean of 30.3 hours earlier than the control group (P < .001). They had significantly greater satisfaction with care, more of their infants had timely immunizations at the end of follow-up, and they had a 29% reduction in health care charges compared to the control group receiving routine care. Although there were no statistically significant differences in maternal and infant rehospitalizations and acute-care visits, there were more maternal rehospitalizations in the control group than in the nurse specialist-followed group (three versus zero). No statistically significant differences were found between the groups in the outcomes of maternal affect and overall functional status.
Early hospital discharge of women after unplanned cesarean birth, using the model of nurse specialist transitional home care, is safe, feasible, and cost-effective.
确定计划外剖宫产术后妇女早期出院的安全性、有效性及成本节约情况。
采用随机分组，61名产后妇女按常规时间出院，61名早期出院并接受护士专家家庭随访护理。后一组接受了全面的出院计划、指导、咨询、家访以及护士专家的每日随叫随到服务。两组均从分娩后随访至产后8周。
早期出院并接受临床护士专家过渡性家庭护理服务的妇女比对照组平均早30.3小时出院（P <.001）。她们对护理的满意度显著更高，更多婴儿在随访结束时及时接种了疫苗，与接受常规护理的对照组相比，她们的医疗费用降低了29%。尽管母婴再次住院和急诊就诊方面无统计学显著差异，但对照组的产妇再次住院人数多于护士专家随访组（3例对0例）。两组在产妇情绪和总体功能状态的结果方面未发现统计学显著差异。
采用护士专家过渡性家庭护理模式，计划外剖宫产术后妇女早期出院是安全、可行且具有成本效益的。
