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Abstract
At the time of discharge home, parents of preterm infants in the neonatal intensive care unit often feel apprehensive and may question their ability to care for their baby. The well-planned, comprehensive discharge of a medically stable infant helps to ensure a positive transition to home and safe, effective care after discharge. This statement provides guidance in planning discharge of infants born before 34 weeks' gestational age from tertiary and community settings. Discharge readiness is usually determined by demonstration of functional maturation, including the physiological competencies of thermoregulation, control of breathing, respiratory stability, and feeding skills and weight gain. Supporting family involvement and providing education from the time of admission improve parental confidence and decrease anxiety. Assessing the physical and psychosocial discharge environment is an important part of the discharge process. The clinical team is responsible for ensuring that appropriate investigations and screening tests have been completed, that medical concerns have been resolved and that a follow-up plan is in place at the time of discharge home.
Key Words: Apnea; Bradycardia; NICU; Screening; Thermoregulation
Preterm infants and their families experience an unfamiliar, highly technical and often overwhelming journey through the neonatal intensive care unit (NICU). As the time to go home approaches, parents may question their ability to care for their baby without the support of NICU staffand technology. The comprehensive, well-planned discharge of a medically stable infant helps ensure a positive transition to home and safe, effective care after discharge. Supporting and involving parents in the discharge process gives them confidence in caring for their preterm infant at home. This statement provides guidance to health professionals in planning the discharge to home of preterm infants born before 34 weeks' gestational age (GA) from the NICU or special care nursery of a tertiary or community centre. Discharge of late preterm infants (34 to 36 weeks' GA) is discussed in the Canadian Paediatric Society statement 'Safe discharge of the late preterm infant'.[1]
Hospital stay
For infants born at <34 weeks' GA, postmenstrual age (PMA) at discharge is usually between 37 and 40 weeks.[2][3] Variation among centres may result from differences in resources, geography and practices. Duration of hospitalization and PMA at discharge are inversely correlated with GA at birth.[4] [5] Morbidities, including sepsis, necrotizing...