Discharging complex babies

AliRae · Jul 9, 2007

I'm a PICU girl, but with our NICU bursting at the seams right now, we've been getting the older NICU grads. These are often rather complex little ones, and we finish the teaching and discharge them. All the babes have a teaching book with goals that a parent and one other primary care giver need to be checked off on. They need to give 2 return demonstrations for each skill before they can be signed off. When the book is almost finished we start coordinating with outcomes to make sure everything is in place for discharge. (And anyway ... our docs are so reluctant to do ANYTHING on the weekends, so them kicking babies out the door on a Saturday would be nothing short of a miracle.)

dawngloves, BSN, RN · Jul 9, 2007

We have a checklist at the bedside for d/c needs. Once a week there are d/c rounds and the charge nurse, attending and social worker discuss who will be going home soon and what they need.

georgiagalRN · Jul 9, 2007

We have a discharge nurse who is just in charge of discharging those complex babies. She works 8a-5p M-F. When a baby is coming upon discharge, she is assigned those specific babies. She then works with the parents to teach how to give meds and she cooridinates the discharge with social services and home health. Only on unusual circumstances will a baby be discharged on the weekend. Having this person pretty much do the whole discharge has been such a blessing to the entire staff. And after the baby has been discharged, she makes follow-up phone calls to see how the infant is doing at home and if there is anything that could've made the discharge easier. That way, we get the parents' input on the discharge process.

RNSC · Jul 9, 2007

We have a checklist at the bedside for d/c needs. Once a week there are d/c rounds and the charge nurse, attending and social worker discuss who will be going home soon and what they need.

we have this too but somewhere the communication is breaking down between attending and intern and charge nurse and bedside nurse. Maybe this is where the "streamlining" I want to do will come into play.

Thanks

RainDreamer, BSN, RN · Jul 10, 2007

We have a discharge coordinator that strictly follows the progress on the kids' getting ready to go home. They also have discharge rounds once a week like someone else mentioned.

We have a checklist too that we keep track of when we're preparing for discharge. Then the night before discharge, the parents room-in with the baby ...... if it's a real complex baby and we feel the parents need another night to room-in, they can.

By the time the dischage date arrives, everything's usually just about done.

RNSC · Jul 13, 2007

We have a discharge coordinator that strictly follows the progress on the kids' getting ready to go home. They also have discharge rounds once a week like someone else mentioned.
We have a checklist too that we keep track of when we're preparing for discharge. Then the night before discharge, the parents room-in with the baby ...... if it's a real complex baby and we feel the parents need another night to room-in, they can.
By the time the dischage date arrives, everything's usually just about done.

This is how its suppose to work for us as well. I was talking to our nurse educator today and maybe revamping the checklist is in order. Make it more applicable (sp?) to the complex babies. It seems to me that the babies we are discharging are more complex than ever: traches, continous G-tube, or J-tube feeds, ostomies, PICC lines and broviacs HAL/TPN, home and/or hospice care etc. And I hope this doesn't sound mean but to parents who'se education level isn't the greatest, it's got to be overwhelming. Heck I would be overwhelmed to take one of our complex kids home.