PS1006 SARASOTA MMORIAL HOSPITAL NURSING DPARTMNT POLICY TITL MOTHR/BABY UNIT Job Title of Reviewer FFCTIV DAT RVISD DAT POLICY TYP Director, Women s and Children s Services 7/87 9/15 DPARTMNTAL INTRDPARTMNTAL DPARTMNTS PROVIDING NURSING CAR 1 of 5 PURPOS To establish discharge criteria for the mother/baby couplet. POLICY STATMNT Mother and newborn may be discharged per provider order. Discharge process will be completed by nurse prior to attending the discharge class. In cases where the mother is not ready for discharge, the newborn may be discharged to guardian per provider order. Mothers and their infants may be independently discharged when the following criteria have been met MOTHR 1. The anticipated discharge plan will be discussed with the obstetrician and pediatrician early in the post-partum period. 2. The mother vital signs are WNL and physician has discussed maternal plan of care for her discharge home. Her blood pressure is within the normal range or the doctor has discussed a plan of care for blood pressure management. The amount and color of lochia are appropriate for the duration of recovery. The uterine fundus is firm. Urinary output is quantity sufficient. Any surgical repair or wound has minimal edema and no evidence of infection and appears to be healing without complication or a plan of care for the complication has been addressed by the physician. There are no abnormal physical or emotional findings or abnormal findings have been addressed by physician. The mother is able to eat and drink without difficulty.
TITL MOTHR/BABY UNIT 2 of 5 Arrangements have been made for postpartum follow-up care and mother verbalizes understanding. The mother has received education for self and newborn care. Nurse will review at bedside and patient may attend discharge class to reinforce education. The mother demonstrates readiness to care for herself and her baby. Pertinent laboratory results are available and physician is aware of any abnormal laboratory data. 3. Options for birth control have been discussed with the patient. 4. The patient is aware of possible complications and has been instructed to notify her provider, as necessary. 5. Mother has received physician ordered Rh immune globulin if necessary per nursing procedure Blood Type/Rh Testing Obstetrical Patients and is documented in significant events. 6. Vaccinations are administered as ordered by physician including seasonal flu vaccine during flu season. 7. Patients under the age of 18 to be discharged from the mother baby unit, discharge disposition should be collaborated with and determined by her legal guardian. INFANT 1. Late pre- term infants (<37 weeks gestation) will have a minimum 48 hour hospital stay. 2. The baby s vital signs are documented to be WNL and infant plan of care has been discussed by pediatrician. 3. The newborn is stable and able to maintain thermal homeostasis, has urinated and passed one stool, and demonstrates effective feeding abilities. 4. Physical examination reveals no abnormalities that require continued hospitalization. 5. In circumcised males, there is no evidence of excessive bleeding at the circumcision site for at least 2 hours. 6. Pertinent laboratory data are available and Physician is aware of any abnormal laboratory data.
TITL MOTHR/BABY UNIT 3 of 5 7. The mother/legal guardian has received self and newborn care education. 8. Metabolic screening and CHIP (CHild Identification Program) have been collected. Instructions have been given for a repeat test, if necessary. 9. Pulse Oximetry testing and if necessary follow-up testing or referral has been completed. 10. Umbilical tag and cord clamp have been removed. 11. Hearing screening has been completed. If necessary instructions have been given for further evaluation. 12. The birth certificate and Healthy Start screening forms have been completed. 13. Mother/identified guardian has been instructed on newborn follow up care and verbalizes understanding. 14. Vaccinations are administered as ordered by physician. 15. Infant/ maternal bands are matched for final time comparing bands to the newborn identification document; maternal band is cut off and taped to document. 16. Where applicable, infant must be cleared by the Department of Children and Families. XCPTIONS As ordered by the physician. PROCDUR RSPONSIBILITY Follow established discharge procedures. 1. It will be the responsibility of the physician to determine discharge and write discharge orders and instructions. 2. It will be the responsibility of the Director of Women s and Children s Services to see that nursing personnel are aware of, and adhere to, this policy.
TITL MOTHR/BABY UNIT 4 of 5 RFRNCS American College of Obstetricians and Gynecologists and The American Academy of Pediatrics. (2013) Guidelines for perinatal care. (7 th ed.) Washington, D.C. and lk Grove Village, IL Author. Kathleen Rice Simpson, PhD, RNC, FAAN, Patricia A. Creehan, MS, MA, RNC, ACC, AWHONN Perinatal Nursing (4 th d.) 2014. SMH Nursing Procedure. Blood Type/Rh Testing Obstetrical Patients. (obs27). SMH Author. RVIWR (S) Colleen Burton, MSN, Advanced Practice Nurse, MBU Judy Cavallaro, RNC, BSN, Clinical Manager, Mother Baby Unit, Labor & Delivery, OB Testing & Triage Carolyn Ramirez, BSN, RNC-MN, CLC,MBU Clinical Coordinator Renee Maietta, MSN, RNC, C-FM, CBC, Clinical Coordinator, MBU/Antepartum
TITL MOTHR/BABY UNIT 5 of 5 APPROVALS Signatures indicate approval of the new or reviewed/revised policy Date 9/4/15 Title Pam Beitlich, Director, Women s and Children s Services Title Title Title Committee/Sections (if applicable) Clinical Practice Council 9/3/15 Vice President/Administrative Director (if applicable) Name and Title 9/10/15 Name and Title Jan Mauck, Vice President, Chief Nursing Officer