Vecchi C J, Vasquez L, Radin T, Johnson P
Neonatal Netw. 1996 Jun;15(4):7-13.
The development of clinical pathways has paralleled the national movement to control health care dollars. This movement is particularly intense in states with extensive managed care plans, such as Arizona. Early infant discharge with minimal home nursing support is a reality that forces parents to anticipate their discharge needs well in advance of the actual discharge date. The 59-bed NICU at Phoenix Children's Hospital uses neonatal individualized predictive pathways (NIPPs) as a discharge planning tool with parents of premature infants less than 32-weeks gestation. The NIPPs were developed after an extensive retrospective record review identified time frames for a variety of medical therapies and clinical milestones. Parent and nursing staff expectations are specified on a weekly basis opposite the medical therapies. This article discusses the positive parental response to the NIPP and identifies future areas for development.
临床路径的发展与全国控制医疗费用的行动同步。在有广泛管理式医疗计划的州，如亚利桑那州，这种行动尤为激烈。在极少家庭护理支持的情况下早期婴儿出院已成为现实，这迫使父母在实际出院日期之前很早就开始预期出院需求。凤凰城儿童医院拥有59张床位的新生儿重症监护病房（NICU）将新生儿个体化预测路径（NIPPs）用作与孕周小于32周的早产儿父母进行出院计划的工具。NIPPs是在广泛的回顾性记录审查确定了各种医学治疗和临床里程碑的时间框架后制定的。每周都会在医学治疗的对面明确列出父母和护理人员的期望。本文讨论了父母对NIPP的积极反应，并确定了未来的发展领域。
