The integration of telemedicine protocols improves adaptation after discharge from the neonatal intensive care unit (NICU) in patients with severe conditions like fetal and neonatal alloimmune thrombocytopenia (FNAIT), according to a recently published study in Advances in Neonatal Care.
Patients born with FNAIT often require care in the NICU, and longer stays are often associated with high costs and increased stress for families. Additionally, many families do not anticipate the challenges of life after NICU discharge. Many patients require several follow-up consultations with multiple medical specialties, which means caregivers may have to take time off work or incur additional transportation expenses.
In an effort to reduce long NICU stays and improve post-discharge adaptation, the authors created a follow-up program for patients discharged from the NICU. The program included early feeding and nutrition visits and developmental follow-ups.
During the early stages of the program, the authors identified recurring problems such as medication errors and insufficient understanding of tube-feeding regimens. As a result, they added a telemedicine consultation component to troubleshoot these issues.
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“Visits were designed to be a quick, 20–30 minute ‘check-in’ with caregivers to troubleshoot any problems that arose after discharge,” the authors wrote.
Feedback obtained from 30 families participating in the program revealed that 28 of them were very satisfied with the telemedicine consultations. Commonly mentioned benefits included savings on transportation costs, shorter wait times and reduced stress.
Approximately 23% of participants reported that telemedicine resolved issues and concerns that had not been previously addressed in the hospital.
Close to 16% of patients reported technical issues, including connection and audio problems. Two caregivers did not find the consultations beneficial: one did not understand the purpose of the consults, and the other expressed a preference for in-person conversations.
“Telemedicine appears to provide benefits to families of children with medical complexity discharging from the NICU,” the authors concluded. “Telemedicine visits may serve as a safety net for families who, at the time of NICU discharge, do not yet realize the types of challenges they will face once at home.”
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