Kristina Garne Holm1,2,3, Jane Clemensen1,2,4, Anne Brødsgaard5,6, Anthony C Smith7, Ragnhild Maastrup8, Gitte Zachariassen1,2. 1. Hans Christian Andersen Hospital for Children and Adolescents,, Odense University Hospital, Odense, Denmark. 2. Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. 3. OPEN, Odense Patient Explorative Network, Odense University Hospital, Odense, Denmark. 4. Center for Innovative Medical Technology, Odense University Hospital, Odense, Denmark. 5. Department of Pediatrics, Amager Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark. 6. Department of Public Health, Department of Science in Nursing, Aarhus University, Aarhus, Denmark. 7. Center for Online Health, University of Queensland, Brisbane, Australia. 8. Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Abstract
OBJECTIVE: Neonatal tele-homecare implies that parents of clinically stable preterm infants can manage tube feeding and establishment of oral feeding in the home. Support is provided from the neonatal intensive care unit (NICU) through a telehealth service. The aim of this study was to compare growth and breastfeeding rates amongst infants being managed in the NICU (conventional care) and by neonatal tele-homecare. METHODS: A total of 96 preterm infants with tube feeding requirements participated in the observational study of neonatal tele-homecare. Retrospective data in 278 preterm infants receiving standard care in the same neonatal intensive care unit prior to implementation of neonatal tele-homecare were used for comparison. Rates of breastfeeding and growth were monitored during neonatal tele-homecare. Infant weights were converted to standard deviation weight-for-age z-scores based on a reference. RESULTS: There was no significant difference in rates of exclusive breastfeeding between the neonatal tele-homecare infants and the controls. Among the very preterm singleton infants more neonatal tele-homecare infants were exclusively breastfed at discharge compared to the controls (p = 0.04). There was no significant difference in median weight for age z-scores at discharge. CONCLUSION: This study demonstrates that neonatal tele-homecare may be an appropriate model of care for the management of preterm infants outside of the hospital environment; with the added benefit of higher rates of breastfeeding at time of discharge for very preterm infants.
RCT Entities:
OBJECTIVE: Neonatal tele-homecare implies that parents of clinically stable preterm infants can manage tube feeding and establishment of oral feeding in the home. Support is provided from the neonatal intensive care unit (NICU) through a telehealth service. The aim of this study was to compare growth and breastfeeding rates amongst infants being managed in the NICU (conventional care) and by neonatal tele-homecare. METHODS: A total of 96 preterm infants with tube feeding requirements participated in the observational study of neonatal tele-homecare. Retrospective data in 278 preterm infants receiving standard care in the same neonatal intensive care unit prior to implementation of neonatal tele-homecare were used for comparison. Rates of breastfeeding and growth were monitored during neonatal tele-homecare. Infant weights were converted to standard deviation weight-for-age z-scores based on a reference. RESULTS: There was no significant difference in rates of exclusive breastfeeding between the neonatal tele-homecare infants and the controls. Among the very preterm singleton infants more neonatal tele-homecare infants were exclusively breastfed at discharge compared to the controls (p = 0.04). There was no significant difference in median weight for age z-scores at discharge. CONCLUSION: This study demonstrates that neonatal tele-homecare may be an appropriate model of care for the management of preterm infants outside of the hospital environment; with the added benefit of higher rates of breastfeeding at time of discharge for very preterm infants.
Authors: Jennifer C Weber; Kristin Sohn; Hadley S Sauers-Ford; Ashley Hanhauser; Daniel J Tancredi; James P Marcin; Kristin R Hoffman Journal: Telemed J E Health Date: 2020-09-25 Impact factor: 5.033