OBJECTIVE: To determine the safety, efficacy, and cost savings of early hospital discharge of women delivered by unplanned cesarean delivery. METHODS: Using randomized assignment, 61 postpartum women were discharged from the hospital at the usual time, and 61 were discharged early and had nurse specialist home follow-up care. The latter group received comprehensive discharge planning, instruction, counseling, home visits, and daily on-call availability from the nurse specialists. Both groups were followed from delivery to 8 weeks postpartum. RESULTS: Women who were discharged early and received transitional home care services by clinical nurse specialists were sent home a mean of 30.3 hours earlier than the control group (P < .001). They had significantly greater satisfaction with care, more of their infants had timely immunizations at the end of follow-up, and they had a 29% reduction in health care charges compared to the control group receiving routine care. Although there were no statistically significant differences in maternal and infant rehospitalizations and acute-care visits, there were more maternal rehospitalizations in the control group than in the nurse specialist-followed group (three versus zero). No statistically significant differences were found between the groups in the outcomes of maternal affect and overall functional status. CONCLUSION:Early hospital discharge of women after unplanned cesarean birth, using the model of nurse specialist transitional home care, is safe, feasible, and cost-effective.
RCT Entities:
OBJECTIVE: To determine the safety, efficacy, and cost savings of early hospital discharge of women delivered by unplanned cesarean delivery. METHODS: Using randomized assignment, 61 postpartum women were discharged from the hospital at the usual time, and 61 were discharged early and had nurse specialist home follow-up care. The latter group received comprehensive discharge planning, instruction, counseling, home visits, and daily on-call availability from the nurse specialists. Both groups were followed from delivery to 8 weeks postpartum. RESULTS:Women who were discharged early and received transitional home care services by clinical nurse specialists were sent home a mean of 30.3 hours earlier than the control group (P < .001). They had significantly greater satisfaction with care, more of their infants had timely immunizations at the end of follow-up, and they had a 29% reduction in health care charges compared to the control group receiving routine care. Although there were no statistically significant differences in maternal and infant rehospitalizations and acute-care visits, there were more maternal rehospitalizations in the control group than in the nurse specialist-followed group (three versus zero). No statistically significant differences were found between the groups in the outcomes of maternal affect and overall functional status. CONCLUSION: Early hospital discharge of women after unplanned cesarean birth, using the model of nurse specialist transitional home care, is safe, feasible, and cost-effective.
Authors: D Brooten; S Kumar; L P Brown; P Butts; S A Finkler; S Bakewell-Sachs; A Gibbons; M Delivoria-Papadopoulos Journal: N Engl J Med Date: 1986-10-09 Impact factor: 91.245
Authors: Fabian T Camacho; Carol S Weisman; Roger T Anderson; Marianne M Hillemeier; Eric W Schaefer; Ian M Paul Journal: Matern Child Health J Date: 2012-07
Authors: Daniela C Gonçalves-Bradley; Natasha A Lannin; Lindy M Clemson; Ian D Cameron; Sasha Shepperd Journal: Cochrane Database Syst Rev Date: 2016-01-27
Authors: Sasha Shepperd; Helen Doll; Robert M Angus; Mike J Clarke; Steve Iliffe; Lalit Kalra; Nicoletta Aimonio Ricauda; Vittoria Tibaldi; Andrew D Wilson Journal: CMAJ Date: 2009-01-20 Impact factor: 8.262
Authors: Dorothy Brooten; Mary D Naylor; Ruth York; Linda P Brown; Barbara Hazard Munro; Andrea O Hollingsworth; Susan M Cohen; Steven Finkler; Janet Deatrick; JoAnne M Youngblut Journal: J Nurs Scholarsh Date: 2002 Impact factor: 3.176
Authors: Daniela C Gonçalves-Bradley; Steve Iliffe; Helen A Doll; Joanna Broad; John Gladman; Peter Langhorne; Suzanne H Richards; Sasha Shepperd Journal: Cochrane Database Syst Rev Date: 2017-06-26