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Am J Perinatol 2014; 31(03): 203-208
DOI: 10.1055/s-0033-1343772
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Influence of Changes in the Evaluation of Neonatal Jaundice

Arieh Riskin
1   Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
,
Keren Cohen
1   Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
,
Amir Kugelman
1   Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
,
Marta Abend-Weinger
1   Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
,
Miri Hemo
1   Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
,
David Bader
1   Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
› Author Affiliations
Further Information

Publication History

16 January 2013

06 March 2013

Publication Date:
24 April 2013 (online)

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Abstract

Objective To study the influence of policy changes in the evaluation of neonatal hyperbilirubinemia on discharge process from the nursery. Changes included early assessment of risk factors by universal umbilical blood sampling for blood type, Coombs test, and glucose-6-phosphate dehydrogenase (G6PD) and universal noninvasive transcutaneous bilirubinometry at discharge.

Study Design The 1,569 newborns (≥ 36 weeks' gestation) admitted after the implementation of changes were compared with the 1,822 born before.

Results Policy changes improved the diagnosis of G6PD deficiency and ABO incompatibility and decreased the number of referrals from the community for jaundice follow-up. The average number of needlesticks per baby as well as the time required for the analysis of serum bilirubin levels on discharge day decreased. Changes did not significantly increase costs.

Conclusion Changes seem to have improved the quality of medical care, including early identification of risk factors and better follow-up of neonatal hyperbilirubinemia with reduction of pain and increased efficiency.

Keywords

policy changes - evaluation - neonatal jaundice - risk factors - quality measures
 

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