GOLD Learning Speakers

Discharge teaching programs are typically established based on what we as health care providers think parents need to know. Reality sets in very quickly for families after taking home a premature newborn. Despite thorough discharge teaching and parent involvement in hospital, parents are surprised by the challenges they face post-discharge. Feeding, behavior, reflux, sleep, and parenting troubles top the list. Based on over twenty years’ experience working with premature infants and their families beyond discharge, the presenter will reveal common challenges encountered and discuss research-based and practical strategies for the NICU team to share with parents to smooth the transition home. A greater knowledge of post discharge sequelae and preventative strategies will aid the NICU team in optimizing the discharge process and ultimately improve outcomes for babies and parents.

Many preterm infants remain vulnerable following discharge from the neonatal intensive care unit (NICU). Health challenges persist beyond the NICU including respiratory illness, breastfeeding progression, bottle feeding incoordination, behavior and development issues, impaired growth, infrequent stooling, and gastroesophageal reflux. Preterm infants are up to two times more likely than full term infants to be hospitalized in the first year of life. Parents are challenged to transition their premature baby home and to keep them home! Community-based, specialized follow-up services following NICU discharge have a powerful impact. The Neonatal Transition Team in Calgary, Alberta, Canada provides post-NICU follow-up for very-low-birth-weight infants and their families. The team consists of community health registered nurses with advanced skill in premature infant outcomes, feeding and neurodevelopmental assessment, and a consultation partnership with nutritional and feeding specialists. While home visits have been the backbone of this service, the team questioned the feasibility and acceptance of virtual care and completed a three month quality improvement pilot. This virtual care pilot demonstrated optimization of health-care resources by providing safe, high-quality care at a reduced operational cost. The pilot was instrumental in the team’s management during the SARS-COVID-19 pandemic. Virtual care has been fully operationalized into the service delivery model and expanded to serve other newborns with feeding or growth challenges.