J Nurs Care Qual. 2025 Apr-Jun 01;40(2):165-172. doi: 10.1097/NCQ.0000000000000831. Epub 2025 Jan 27.
ABSTRACT
BACKGROUND: Hemolytic disease of the newborn (HDN) is a rare condition with the potential for high morbidity.
LOCAL PROBLEM: Practice at a large maternity care center did not align with the American Academy of Pediatrics (AAP) revised hyperbilirubinemia guidelines.
METHODS: A pre/post-implementation design with Plan-Do-Study-Act cycles was used.
INTERVENTIONS: A clinical pathway was implemented to improve timely evaluation of newborns at risk for HDN due to a positive maternal antibody using cord blood.
RESULTS: Cord blood testing increased among the subset of newborns who did not meet collection criteria prior to the practice change (pre: 0% n = 7, post: 39% n = 23). Missed opportunities to test cord blood occurred less frequently post (35 versus 26 days between missed opportunities). Feasibility data identified the need for educational and clinical tools.
CONCLUSIONS: A clinical pathway and tailored tools support the AAP recommendation. Electronic health record supports could bolster future efforts.
PMID:39977837 | DOI:10.1097/NCQ.0000000000000831
