Time Interval from Delivery to Maternal First Neonatal ICU Contact. Are We Doing a Good Job? [39A]

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Abstract

INTRODUCTION:

To determine the interval between delivery and first maternal NICU contact, and to correlate this with maternal conditions and therapies.

METHODS:

Mothers delivered at our institution and whose infants were admitted to the NICU were identified. A retrospective chart review was performed to collect demographic data, date and time of delivery, maternal antepartum, intrapartum, and postpartum diagnoses, and therapies. NICU sign-in logs were used to determine the time of first maternal contact. Mother’s admitted to the ICU and/or whose infants were transitioned back to the low-risk nursery were excluded.

RESULTS:

The mean interval time to first maternal NICU contact was 18.3 hours. Factors associated with delayed maternal visitation includes mode of delivery (13.3 hours for vaginal vs. 21.1 hours for cesarean, P<.001), the diagnosis of pre-eclampsia with severe features/HELLP (23.9 hours vs. 16.3 hours, P=.003), medications outside routine orders including I.V. antibiotics (21.3 hours, P=.033), PCA pain control (23.5 hours, P=.024), magnesium sulfate (23.5 hours, P<.001), and blood transfusion (26.8 hours, P=.03). There was no correlation found for delayed maternal visitation for infant gender, nursing shift at time of delivery, or having any diagnosis other than pre-eclampsia with severe features/HELLP.

CONCLUSION:

The interval for first maternal NICU contact at our institution leaves much room for improvement. The highest risks populations for delayed NICU contact include cesarean deliveries, patients diagnosed with pre-eclampsia with severe features/HELLP syndrome, and patients receiving infusions such as magnesium sulfate, PCA delivery pain medications, I.V. antibiotics, or blood transfusions. Quality improvement initiatives are in development to decrease this time interval.

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