Photo by Edgar Estrada
From left to right: Danielle Altares Sarik, Ph.D., APRN; Evelyn Terrell, O.T.D.; Yui Matsuda, Ph.D., PHNA-BC; Flor Tena, R.N., C.C.R.N.-K; Melody Hernandez, Ph.D., M.D., B.S.N.; Mirtha Gonzalez
Fourth-Place Team
Nicklaus Children’s Hospital Leaders at Nicklaus Children’s Hospital in Miami successfully launched a program for infants cared for in the NICU to address gaps in care after discharge through a nurse-led telehealth program dubbed ‘Baby Steps’ By Janette Wider
C
linician leaders in hospitals have known for a long time that there is an expected gap in care from neonatal
intensive care unit (NICU) to community and home. Now, leaders at Nicklaus Children’s Hospital have addressed that program through their “Baby Steps” pro- gram. The Baby Steps program, a nurse-led telehealth transition of care intervention for infants cared for in the NICU and their caregivers, was developed to address a gap in care after discharge at Miami-based Nicklaus Children’s Hospital. Baby Steps is focused on providing integral support during the discharge process and after the infant returned to home and community.
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Led by an interprofessional team com- posed of researchers, NICU professionals, and telehealth specialists, the program was guided by the Theory of Transition Model to support the situational, developmental, and health transitions that occur during this time period. Central to the interven- tion was nurse-led telehealth follow-up within 24-48 hours after discharge, coupled with on-demand services available for two weeks. During these encounters, a trained NICU nurse offered clinical sup- port, addressed concerns, and provided anticipatory guidance. Within the first 24 months of the pro- gram, a total of 450 infants were enrolled,
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hcinnovationgroup.com | MARCH/APRIL 2023
and 492 total encounters were completed. Significant decreases in readmissions were noted (57 percent). Within 30 days of discharge 14 percent of patients enrolled in the program sought care at an emer- gency care setting (n=63), compared to 23 percent of NICU patients not enrolled in the program during the same time frame. Additionally, caregivers reported a high level of satisfaction, with 99.2 percent reporting they were satisfied or highly sat- isfied with the telehealth service (n=141). In conclusion, Nicklaus Children’s Hospital found that nurses effectively counselled caregivers, and that the use of telehealth intervention after discharge was feasible.
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