Canadian family physician Medecin de famille canadien · 2013
Management of neonatal jaundice varies by practitioner type.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Mateo Patrocinio C, Lee Kyong-Soon, Barozzino Matthew, Sgro Michael
Аннотация
OBJECTIVE: To survey current practices among different types of medical practitioners in Ontario to assess if national guidelines for screening and management of neonatal hyperbilirubinemia were being followed.
DESIGN: An anonymized, cross-sectional survey distributed by mail and e-mail.
SETTING: Ontario.
PARTICIPANTS: From each group (general practitioners, family medicine practitioners, and pediatricians), 500 participants were randomly selected, and all 390 registered midwives were selected.
MAIN OUTCOME MEASURES: Compliance with national guidelines for screening, postdischarge follow-up, and management of newborns with hyperbilirubinemia.
RESULTS: Of the 1890 potential respondents, 321 (17%) completed the survey. Only 41% of family physicians reported using national guidelines, compared with 75% and 69% of pediatricians and midwives, respectively (P < .001). Bilirubin was routinely measured for all newborns before discharge by 42% of family physicians, 63% of pediatricians, and 22% of midwives (P < .001). Newborn follow-up was completed within 72 hours after discharge by 60% of family physicians, 89% of pediatricians, and 100% of midwives. Management of neonatal hyperbilirubinemia differed significantly (P < .001), with 91% of family physicians, 99% of pediatricians, and 79% of midwives correctly managing a case scenario according to the guidelines.
CONCLUSION: The management of jaundice varied considerably among the different practitioner types, with pediatricians both most aware of the guidelines and most likely to follow them. Increased knowledge translation efforts are required to promote adherence to the jaundice management guidelines across all practitioner types, but particularly among family physicians.
DESIGN: An anonymized, cross-sectional survey distributed by mail and e-mail.
SETTING: Ontario.
PARTICIPANTS: From each group (general practitioners, family medicine practitioners, and pediatricians), 500 participants were randomly selected, and all 390 registered midwives were selected.
MAIN OUTCOME MEASURES: Compliance with national guidelines for screening, postdischarge follow-up, and management of newborns with hyperbilirubinemia.
RESULTS: Of the 1890 potential respondents, 321 (17%) completed the survey. Only 41% of family physicians reported using national guidelines, compared with 75% and 69% of pediatricians and midwives, respectively (P < .001). Bilirubin was routinely measured for all newborns before discharge by 42% of family physicians, 63% of pediatricians, and 22% of midwives (P < .001). Newborn follow-up was completed within 72 hours after discharge by 60% of family physicians, 89% of pediatricians, and 100% of midwives. Management of neonatal hyperbilirubinemia differed significantly (P < .001), with 91% of family physicians, 99% of pediatricians, and 79% of midwives correctly managing a case scenario according to the guidelines.
CONCLUSION: The management of jaundice varied considerably among the different practitioner types, with pediatricians both most aware of the guidelines and most likely to follow them. Increased knowledge translation efforts are required to promote adherence to the jaundice management guidelines across all practitioner types, but particularly among family physicians.