Audit of neonatal discharge process in neonatal intensive care unit of Mahdieh hospital in Tehran

The discharge process begins upon the admission of the infant in neonatal intensive care unit and continues to even after the infant is discharged and taken home. This study was conducted to audit the process of infant discharge from the neonatal intensive care unit of a selected center in Shahid Beheshti University of Medical Sciences and Health Services. In this study, 90 infants admitted to the neonatal intensive care unit were selected using convenience sampling method. The data were collected using demographic information of the nurses, infants, and parents; and a checklist formulated on the basis of existing standards for infant discharge process. The checklist consisted of six parts: 1- available evidence-based guidelines to support the clinic and treatment, 2- documentation, 3- an available plan for individual discharge of every infant simultaneous to the admission according to the ward’s guidelines, 4- training the parents, 5- the plan of the discharge day, and 6- parent questionnaire. The validity and reliability of the checklist was examined using content and face validity (94%) and the inter-rater correlation coefficient (ICC=95%). The results of the study showed that the implementation rate of the discharge process in the first, second, third, fourth, fifth, and sixth part were weak(score=33), moderate(68), moderate(64), weak(29), moderate(61), and weak(37), respectively. The discharge process cares in all the studied areas were moderate. The entire provided care was of a moderate level. Mann-Whitney test revealed a significant difference between the status of specialized training courses for neonatal intensive care and implementing discharge standards in the second part (P<0.001), third part (P=0.004), fourth part (P=0.004), fifth part (P<0.002), and sixth part (P=0.025). Regarding the importance of the neonatal intensive care unit and also the comparison made between results of this study and those of other studies performed in other countries, the provided care were not qualified and there was a need to more attempts for improving the quality of discharge process in Iranian hospitals, especially in neonatal intensive care units.