A Safe Passage from the NICU to Home:  The Importance of Health Literacy and Discharge Instructions

Posted by Cindy Grosik on July 1, 2015 at 1:09 PM

Safe-passageNearly half of all US adults have difficulty understanding and using health information, according to a 2004 landmark report from the Institute of Medicine of the National Academies. To the nurses at ProgenyHealth, health literacy is the ability of caregivers, most often the parents, whose infant(s) are in the Neonatal Intensive Care Unit (NICU) to attain, process, and understand health information and services needed to make informed decisions.

One issue healthcare is faced with is whether caregivers truly understand their discharge instructions and are able to apply the information provided to them once they are in the home setting. Taking an infant home is an anxious time for caregivers and limited health literacy can result in increased stress and poor compliance with discharge instructions. Poor health literacy among caregivers can lead to increased infant mortality and morbidity along with increased cost of healthcare after discharge, especially with infants who have complex medical issues. If not appropriately prepared for discharge, limited literacy leads to increased hospitalizations, errors with medication administration, and less knowledge of disease management and health promoting behaviors. Additionally, caregivers are less likely to follow the discharge plan or use preventative services.

Assessing health literacy among caregivers is essential in health care today. Knowledge of caregiver health literacy can provide valuable information that will allow improved conversations and discharge teaching instructions. Discharge teaching should not be a cookie cutter approach; understanding the literacy level of the caregiver population allows the healthcare team to develop the appropriate teaching method to provide a safer discharge to home.

Nurses have the important role of communicating and providing caregivers with ongoing education, which can be challenging at times. The NICU infant that is ready to go home remains at risk for health-related complications in the first year of life, but also thereafter. A successful transition from the NICU to the caregivers’ charge requires careful planning and preparation for discharge. Recognizing each caregivers’ educational needs requires astute assessment by skilled nurses. The nurse plays a crucial part in the discharge which should include efforts to improve caregivers’ ability to learn and retain discharge instructions. To improve the safety of transition from the NICU to home, caregivers’ discharge instructions need to be caregiver-specific. The discharge material should provide caregivers with information that is easy to read, understand, and is culturally sensitive. From the day the infant is admitted to the NICU to the day the infant is discharged, NICU nurses teach the essential skillsets caregivers need to care for their infants at home. Successful discharge preparation facilitates family readiness and ultimately improves outcomes in the important transition from the NICU to home.

Here at ProgenyHealth, our team of NICU nurses and social workers continuously collaborate with the hospital’s discharge planners, utilization reviewers, social workers, and care coordinators throughout the infant’s hospital stay. These teams work together, establishing the discharge plan and making sure the caregivers are educated on, and comfortable with, the discharge instructions. Our nurses are dedicated to providing caregivers with the essential tools and connecting them with necessary medical, community, and benefits services to provide the safest transition from the NICU to home. These teams stay connected throughout the first year of life; guiding, educating, and supporting the family.

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Cindy Grosik is a Nurse Case Manager at ProgenyHealth.

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Topics: collaboration, NICU collaboration, NICU nurse, NICU team, nurse case managers, planning for discharge

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