Discharge Planning of Premature Infant

Year 2017, Volume: 9 Issue: 4, 71 - 80, 20.07.2017

Prof. Dr. Nurullah Okumuş

Abstract

AbstractAlong with the improvement in technology and knowledge in neonatal intensive care units (NICU), the increased survival rates of infants with very low birth weight have increased the frequency of complications due to prematurity and new me-dical practices have been introduced in the treatment and follow-up of these infants.Premature infants’ families should be aware of the importance of short and long-term follow-up, as they are at high risk for chronic complications and sequelae, leadingto functional limitations such as long-term neurodevelopmental disorders as well asearly. The management plan for the preparation of the premature infant's dischargeshould include; the determination of the readiness of the infant for discharge, the pre-paration of the family and home environment, communication between the family andthe health care provider, the preperation of review of the hospital course and discharge phases. The most important functional markers indicating that the baby is readyfor discharge, including the physiological competencies of thermoregulation, respiratory control (apnea follow-up), respiratory stability, nutrition/sucking ability and weight gain. Providing the transition to the home with a com-prehensive, well-planned management under optimalconditions will reduce recurrent hospitalization and mortality risk again. For this reason, discharge should be a process starting from the moment of entry into the hospital.

Keywords

Premature, discharge, high- risk infants

Prematüre Bebeğin Taburculuğa Hazırlanmas

Abstract

Öz

Yenidoğan yoğun bakım ünitelerinde (YYBÜ) teknoloji ve bilgi açısından kaydedilen iyileşmeyle beraber, çok düşük doğum ağırlıklı (ÇDDA) bebeklerin artan yaşama oranları prematüriteye bağlı ortaya çıkan komplikasyonların sıklığını da artırmış ve bu bebeklerin tedavi ve takibinde yeni tıbbi uygulamaları gündeme getirmiştir. Prematüre bebekler, erken dönemdeki sorunlarının yanı sıra uzun dönem nörogelişimsel bozukluklar gibi fonksiyonel kısıtlılığa yol açan kronik komplikasyon ve sekeller açısından yüksek riskli olduklarından ailenin olası riskleri, kısa ve uzun dönem izlemin önemini kavraması sağlanmalıdır. Prematüre bebeğin taburculuğa hazırlanmasında yönetim planı; bebeğin taburculuğa hazır olduğunun tespiti, aile ve ev ortamının hazırlığı, aile ve sağlık bakımını sağlayacaklar arasındaki iletişim, epikrizin hazırlanması ve taburculuk aşamalarını içermelidir. Bebeğin taburculuğa hazırolduğunu gösteren en önemli 4 fonksiyonel maturasyon göstergesi; termoregülasyon, solunumun kontrolü (apne takibi), solunumsal stabilite, beslenme/emme becerisi ve kilo alımıdır. Kapsamlı, iyi planlanmış bir yönetimle eve geçiş sürecinin optimal şartlarda sağlanması, tekrar hastaneye yatış ve mortalite riskini azaltacaktır. Bunedenle taburculuk hastaneye giriş anından itibaren başlayan bir süreç olmalıdır.

Keywords

Prematüre, taburculuk, yüksekriskli bebek

References

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