Background: Many community hospital affiliated home care agencies do not have nurses well trained in caring for high risk neonates at home. At times, there are increased visits to the hospital outpatient center, physician offices, and most costly, readmission to the to the acute care setting. We organized a home care follow-up program whereby nurses working in the special care nursery are specifically cross-trained to provide home care to neonates discharged from our nursery. Elmhurst Memorial (EM) has been able to significantly decrease the high cost of inpatient days by providing safe and cost-effective care to the high risk neonate in the home. The presentation of case studies based on the results of a retrospective chart audit and clinician interviews illustrates the success of this program.

Method: We reviewed data for 1 year, identifying high risk infants discharged to EM Home Health Care. Neonates for normal newborn follow-up or hyperbilirubinemia were excluded. Discharge to home criteria: infants with a stable cardiorespiratory status, appropriate weight gain, ability to maintain their own body temperature outside of the isolette, and feeding well whether PO or NG. None of the infants required rehospitalization during their home care. One infant returned to the emergency room secondary to a problem with the intravenous access site. Table

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Conclusion: This program supports that high risk neonates can be safely discharged home by using a core group of neonatal nurses trained to provide community based home care. This system significantly reduces the cost of caring for sick neonates yet provides quality care. It also reduces parental anxiety.