Factors Influencing Failure to Comply with Follow-up Care for High-Risk Newborns

Mullins-Thompson, Jane

Saturday, 16 November 2013

Jane Mullins-Thompson, BSN
Newborn Intensive Care, Methodist LeBonheur Children's Hospital, Memphis, TN

Learning Objective 1: The learner will be able to identify two barriers linked to reasons for low rate of return for scheduled appointments with the Newborn Follow-up Clinic.

Learning Objective 2: The learner will be able to list two opportunities to improve high-risk newborn follow-up care to enhance growth and development outcomes.

At a large academic children’s hospital in the South over 50% of the NICU babies were not returning Newborn Follow-up clinic for their appointments. Failure to attend follow-up appointments for a high-risk neonate can jeopardize early interventions to promote optimal growth and development. The purpose of this investigation was to examine why NICU babies were not returning to their appointments at the Newborn Follow-up clinic.

A retrospective chart review was conducted of NICU patients (N = 527) discharged from January 1, 2011 to June 30, 2012. The chart review focused on variables that might potentially impact the ability of parents to bring their baby in for a follow-up appointment. Variables that were explored in the chart review included: Infant diagnosis, gestational age, severity of infant health status and demographic data. Data were dichotomized for analysis using logistic regression.

Analysis of data revealed only 27% of NICU patients discharged from January1, 2011 to June 30, 2012 had an appointment made for the follow-up clinic. Yet, eighty percent of the total patients discharged during this time frame returned to a specialty clinic. Factors influencing compliance with the Newborn Follow-up include: other clinic referrals, maternal age 13-24; gestational age less than 37 weeks and a discharge diagnosis of hydrocephalus.

The limited number of follow-up appointments that were made is suggested as one explanation for the low return rate to the Newborn Follow-up clinic. The findings also support the need to re-evaluate discharge appointment criteria that have been established for the clinic.

See more of: 2012-2013 Maternal-Child Health Nurse Leadership Academy Invited Posters
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