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Appendix H: Evidence tables



            What information and support should be given to parents/carers of babies with neonatal hyperbilirubinaemia?


              Author:        Study Type:          Four focus groups        Barriers  - communication    Solutions - communication      MD = physician
              Salem-Schatz S   Focus group study   1 for physicians (n = 9)   Conflicting advice from HCP’s on   Improve communication between HCP - MD   RN = Nurse
                                                  1 for nurses (n = 9)     readiness for discharge - MD   Notify community HCP  by email when baby   P = Parent
              Year:          Evidence Level:      2 for parents/carers (n = 14)   Communication gaps between handover   born – MD, RN
              2004           III                                           from hospital to community - MD, RN   Provide easy-access (on-line or form parent)
                                                  Aim:                     Key information missing MD, RN   for community HCP for lab results – MD, RN
              Country:                            To identify barriers to timely follow-                Give parents/carers ‘early warning signs’ to
                                                                      st
              USA                                 up of hyperbilirubinaemia in 1                        report – MD, P
                                                  7 days                                                 Continued contact from birth hospital to
                228
              ID:                                                                                       parent/carer – P
                                                  Focus had between 7 and 9   Barriers – systems and process
                                                  participants and lasted for between   Delays in outpatient bilirubin testing and   Solutions – systems and process
                                                  90 and 120 minutes       reporting - MD, RN           Home visit by a physician – P
                                                                           Barrier to home visits – MD, RN, P   Encourage home visits, RN, P
                                                                                                        Choose paediatrician before discharge/book
                                                                           Barriers to office visits in week 1 – MD,
                                                                       st
                                                  Content was the importance of 1    RN, P              appointment before discharge – MD
                                                  week newborn follow-up and key                        Separate visiting toom for well children – P
                                                  questions relating to physican and                    More flexible visiting time – P
                                                  parent/carer experiences                              Community HCP to visit pre-discharge – RN,
                                                                                                        P
                                                                                                        Ensure quick easy access to labs – MD, RN

                                                                                                        Solutions – systems and process
                                                                           Barriers – systems and process   Increase professional awareness – MD, RN
                                                                           Shorter hospital stays leave less time for   Parental education through continuum of care –
                                                                           parent education –RN         MD, RN, P
                                                                           Clinicians may be reluctant to educate   Support groups for new and expectant parents
                                                                           about hyperbilirubinaemia prenatally –   – MD, RN
                                                                           MD, RN
                                                                           Poor understanding by clinicians of risks of
                                                                           near-terms – MD
                                                                           Lack of clinician awareness of the
                                                                           recommendations of early follow-up visits
                                                                           – MD
                                                                           HCP recommendations forgotten once
                                                                           parent is home – P













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