Discharge planning

NEONATAL CARE and DISCHARGE PLANNING

What is neonatal care?- a specialist branch of medicine that looks after babies immediately after birth

Level 1 Special Care Unit (SCBU)

•continuous monitoring of their breathing or heart rate•additional oxygen•tube feeding•phototherapy (neonatal jaundice)•recovery and convalescence from other care.

Level 2 Local Neonatal Unit (LNU)

•needing short term intensive care•with apnoeic attacks who require support•receiving continuous positive airway pressure (CPAP)•receiving parenteral nutrition (tube feeding).

Level 3 Neonatal Intensive Care Unit (NICU)

•needing respiratory support (ventilation)•weighing less than 1,000g•born at less than 28 weeks gestation and need CPAP•with severe respiratory disease•who require surgery

Different levels of care

BLISS Different Levels of Care Available (2011)

Ventilation Incubators & cots

Intravenous lines & catheters

Equipments on the unit

DISCHARGE PLANNING (Charter principle 7 )- a multidisciplinary approach, and is coordinated from admission by a

dedicated member of staff with the skills to identify and assess the baby’s and family’s ongoing needs.

Criteria for achieving standard• A. The unit has an established discharge planning policy which is adhered to

by staff.• B. The unit demonstrates a multidisciplinary approach in its discharge

planning, which includes access to social services and other support professionals.

• C. Discharge plans are established from the point of admission and are continually reviewed, involving both parents and a multidisciplinary team.

• D. The unit identifies a dedicated individual to coordinate a baby’s discharge plan from the moment of admission.

• E. Parents have access to a health professional who can provide emotional/psychological support.

Bliss (2011) ‘The Bliss Baby Charter Standards ‘

Units should offer rooming-in accommodation to support discharge and help parents develop confidence in the day-to-day and clinical care of their baby.

Criteria for achieving standardSufficient rooms are available on or adjacent to the unit for rooming in (with space and resources for any oxygen equipment) to help the family prepare for the discharge.

Rooming in


Meeting the baby’s needs at homeCriteria for achieving standard

A. Before discharge, the family is given appropriate information and training to make sure they are able to meet their baby’s ongoing needs at home. The topics covered include:

• i. sleeping and positioning (FSID’s Back to sleep leaflet)• ii. immunisations• iii. continuation of breastfeeding• iv. developmental milestones• v. follow-up appointments.

B. The family is empowered and supported to deliver all aspects of their baby’s care at home (including basic life support).


Meeting the baby’s needs at home

C. Community support is provided by an integrated hospital-community neonatal team or an identifiable team of community health professionals.

D. Parents are given the opportunity to meet with the community team supporting them at home before the baby is discharged from the unit.

E. Community health teams are given timely information about the baby and any home care arrangements from the baby’s care plan, as well as the opportunity to meet neonatal staff and parents before discharge.

F. Parents are informed and understand who to contact should their baby become unwell at home, and when they may need to take them back to hospital. (The FSID publication Baby Check – is your baby really ill? is very useful.)


Resources:• Bliss (2011) ‘The Bliss Baby Charter Standards ‘ ; 2nd Edition page 19-20;

Available at www.bliss.org.uk (Accessed 11 January 2014)

• Bliss (Different Levels of Care Available and Equipments )Available at: www.bliss.org.uk (Accessed 10 January 2014).

• POPPY (2009) ‘Family-centred care in neonatal units’. A Summary of research results and recommendations from the POPPY Project’ page 31 Available at: http://www.poppy-project.org.uk/resources/Poppy+report+for+PRINT.pdf (Accessed 11 January 2014)

Discharge planning

Health & Medicine