Reducing prolonged hospital stay for moderate and late premature babies in Neonatal Intensive Care Unit (NICU) of Kabgayi district Hospital

Abstract

Prolonged hospital stay is one of the problems that premature babies face worldwide. Length of stay (LOS) is normally a significant indicator of the efficiency of the hospital management when does not prolonged. Reduction of days patients take in hospitalization indicates the decrease of infection risks, medication side effects and improvement of the quality of treatment and efficiency of bed management (1). This study was a pre-post intervention in nature which viwas aiming at reducing hospital stay for moderate and late premature babies in the Neonatal Intensive Care Unit (NICU) of Kabgayi District Hospital. Study results noticed an average LOS of 14 days at pre intervention among all premature babies admitted in NICU from July to December 2019 and 10.95 days at post intervention from January to June 2021. Results also stated an average LOS of 23.4 days at pre intervention among all moderate and late preterm babies admitted in pre intervention that took 13 days and more in NICU and then be decreased up to 19 days at post intervention period. Results of the study have shown that majority of babies admitted at baseline were males than females 76 vs 71 while at post intervention females were more than males 84 vs 78 respectively. There was a close relationship between APGAR at 1min and LOS, an association between death and APGAR p=0.001 and ANOVA test was positive between death and APGAR 2, 3, 4…at 1min. The majority of NICU staff was not aware of the discharge policy and its content at Pre intervention but after intervention they were knowledgeable. NICU staff members were not educating mothers to involve them in the care of their babies before intervention. Medical doctors were not performing tour round in NICU but after their frequency of visits have tremendously increased. The bed occupation rate of NICU was reduced from 117% to 87% at post intervention. The real root cause of LOS was small NICU with inappropriate localization and inadequate follow up of medical doctors to babies admitted in NICU before intervention.

In conclusion, the hospital should always have an open eye by visiting services in order to assess their working status especially the vulnerable services like Neonatology/NICU. NICU staff members are always encouraged to increase education to mothers of admitted babies in order to skill them in the care, increase interaction and attachment between parents especially mothers as well as the increase of their satisfaction.

Key words: Prolonged Hospital Stay, Late and Moderate Preterm Babies, Premature Babies