Document Detail

Clinician adherence to guideline for phototherapy use in newborns.
MedLine Citation:
PMID:  22773712     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The objectives of this study were (1) to determine clinician adherence to the 2004 American Academy of Pediatrics guideline for phototherapy use in newborns; (2) to compare adherence to the guideline in 2 different hospitals; and (3) to determine whether adherence to the guideline improved after the phototherapy nomogram was available in newborn charts.
METHODS: This study was a retrospective review of medical records of 1160 newborns receiving care at the normal newborn nurseries at 2 Twin City, MN, hospitals. Four hundred thirty-six infants received phototherapy.
RESULTS: When phototherapy was administered, it was indicated in 37% of cases and not indicated in 8%. In 56% of cases it was considered subthreshold. When phototherapy was not administered, it was appropriate in 99% of cases but was inappropriate or missed in 1% of cases. There was a significant difference in clinician adherence to the phototherapy guidelines between the hospitals. The addition of the phototherapy nomogram to the newborn charts did not change adherence to the guideline.
CONCLUSIONS: Clinicians infrequently missed providing phototherapy when it was indicated. Most infants received phototherapy when their bilirubin level was in the "optional" range. The interhospital variability of guideline adherence confirms results found in other studies. Because the addition of the phototherapy nomogram alone did not improve adherence to the guideline, alternative interventions targeted at nurseries should be considered.
Diane J Madlon-Kay
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Board of Family Medicine : JABFM     Volume:  25     ISSN:  1557-2625     ISO Abbreviation:  J Am Board Fam Med     Publication Date:    2012 Jul-Aug
Date Detail:
Created Date:  2012-07-09     Completed Date:  2012-11-30     Revised Date:  2013-07-08    
Medline Journal Info:
Nlm Unique ID:  101256526     Medline TA:  J Am Board Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  437-41     Citation Subset:  IM    
Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55407, USA.
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MeSH Terms
Guideline Adherence*
Hospitals, Urban
Infant, Newborn
Medical Audit
Phototherapy / standards*,  utilization*
Retrospective Studies

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