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Clinical Pediatrics, Vol. 39, No. 10, 581-590 (2000)
DOI: 10.1177/000992280003901003

Problem Identification in Apparently Well Neonates: Implications for Early Discharge

Gregory L. Jackson, MD, MBA

Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9063

Kathleen A. Kennedy, MD

University of Texas Health Science Center, Houston

Dorothy M. Sendelbach, MD

Dale H. Talley, MS/N, RN, CPNP

University of Texas Southwestern Medical Center, Dallas

Cheryl L. Aldridge, MSN, RN, CPNP

Debra A. Vedro, MSN, RN, CPNP

Parkland Health & Hospital System, Dallas, Texas

Abbot R. Laptook, MD

University of Texas Southwestern Medical Center, Dallas

The frequency, time of identification, and type of problems of newborns in an urban indigent population were prospectively studied during their hospital stay to evaluate feasibility of early hospital discharge. Eight percent (563) of 7,021 term and near-term low-risk infants developed one or more predefined problems. Of those with problems, 42.1% received therapy and/or a higher level of care. Tachypnea, temperature instability, and cyanotic episodes were the most frequently treated problems. Nearly 69% of all problems were detected after the initial examination, and 31% developed problems after 24 hours of age; 5% were transferred to the NICU. Problems occurring after 24 hours of age emphasize the need for follow-up within days after hospital discharge in this population.


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