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Impact of a Transcutaneous Bilirubinometry Program on Resource Utilization and Severe Hyperbilirubinemia
Pediatrics, 01/11/2012
Wainer S et al. – Integration of routine hospital and community TcB screening within a comprehensive public health nurse newborn follow–up program is associated with significant improvements in resource utilization and patient safety.
Methods- The authors compared the neonatal hyperbilirubinemia-related outcomes of 14?796 prospectively enrolled healthy infants >35 weeks gestation offered routine TcB measurements in both hospital and community settings by using locally validated nomograms relative to a historical cohort of 14?112 infants assessed by visual inspection alone.
- There was a 54.9% reduction (odds ratio [OR]: 2.219 [95% confidence interval (CI): 1.543–3.193]; P < .0001) in the incidence of severe total serum bilirubin values after implementation of routine TcB measurements.
- TcB implementation was associated with reductions in the overall incidence of total serum bilirubin draws and overall phototherapy rate, a reduced age at readmission for phototherapy, and duration of phototherapy readmission.
- There were earlier (P < .01) and more frequent contacts with public health nurses (1.33 vs 1.66, P < .01) after introduction of the TcB program.
