RESEARCH ARTICLE Adherence to AAP Healthy Newborn Discharge Criteria in a Tertiary Care Children’s Hospital Nonie S. Arora, BS, a Anne M. Danicek, BS, b Rachel R. Osborn, MD, c Sarah Q. Fried, b Olivia R. Negris, BS, b Karson Lychuk, d Kerry P. Mychaliska, MD, c Maria S. Skoczylas, MD, c Kimberly K. Monroe, MD, MS c ABSTRACT OBJECTIVES: In 2015, the American Academy of Pediatrics (AAP) published an updated consensus statement containing 17 discharge recommendations for healthy term newborn infants. In this study, we identify whether the AAP criteria were met before discharge at a tertiary care academic children’s hospital. METHODS: A stratified random sample of charts from newborns who were discharged between June 1, 2015, and May 31, 2016, was reviewed. Of the 531 charts reviewed, 433 were included in the study. A review of each chart was performed, and data were collected. RESULTS: Descriptive statistics for our study population (N 5 433) revealed that all 17 criteria were followed ,5% of the time. The following criteria were met 100% of the time: clinical course and physical examination, postcircumcision bleeding, availability of family members or health care providers to address follow-up concerns, anticipatory guidance, first appointment with the physician scheduled or parents knowing how to do so, pulse oximetry screening, and hearing screening. These criteria were met at least 95% to 99% of the time: appropriate vital signs, regular void and stool frequency, appropriate jaundice and sepsis management, and metabolic screening. The following criteria were met 50% to 95% of the time: maternal serologies, hepatitis B vaccination, and social risk factor assessment. Four of the criteria were met ,50% of the time: feeding assessment, maternal vaccination, follow-up timing for newborns discharged at ,48 hours of life, and car safety-seat assessment. CONCLUSIONS: Our data reveal that the AAP healthy term newborn discharge recommendations are not consistently followed in our institution. a University of Michigan Medical School and b College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, Michigan; c Department of Pediatrics and Communicable Diseases, Michigan Medicine, Ann Arbor, Michigan; and d College of Arts and Sciences, Loyola University Chicago, Chicago, Illinois www.hospitalpediatrics.org DOI:https://doi.org/10.1542/hpeds.2018-0061 Copyright © 2018 by the American Academy of Pediatrics Address correspondence to Kimberly K. Monroe, MD, MS, Department of Pediatrics, C.S. Mott Children’ s Hospital, 1540 E. Medical Center Dr, Ann Arbor, MI 48109. E-mail: monroek@med.umich.edu HOSPITAL PEDIATRICS (ISSN Numbers: Print, 2154-1663; Online, 2154-1671). FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING: No external funding. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. Ms Arora created the study concept and design, created a data collection plan, retrieved data, performed the data analysis, wrote the first version of the manuscript, and executed all manuscript edits; Ms Danicek, Ms Fried, Ms Negris, and Ms Lychuk retrieved data, contributed to data analysis, and all manuscript revisions; Dr Mychaliska created the study concept and design and contributed to the data analysis and all manuscript revisions; Dr Skoczylas contributed to study design, the data analysis, and all manuscript revisions; Dr Osborn contributed to manuscript revisions; Dr Monroe supervised all aspects of the study concept and design, the data collection and analysis, and first draft of the manuscript and all revisions; and all authors approved the final manuscript as submitted. HOSPITAL PEDIATRICS Volume 8, Issue 11, November 2018 665 by guest on June 5, 2020 http://hosppeds.aappublications.org/ Downloaded from