PQCNC Care of the Late Preterm Infant Snapshot

7. Which type of nurseries are present at your facility? (Utilize AAP definitions) *This question is required.

• Level I Nursery
• Level II Nursery
• Level III / IV Nursery

8. Which providers take care of newborn infants in the Level I nursery? Check all that apply.  *This question is required.

• General pediatricians
• Pediatric hospitalists
• Neonatal hospitalists
• Family Medicine physicians
• Neonatologists
• Resident physicians
• Advanced Practice Providers (NP, PA, etc)
• Other

9. What is the birthweight threshold for admission to the Level I nursery? *This question is required.

• ≥ 1800 grams
• ≥ 1900 grams
• ≥ 2000 grams
• ≥ 2200 grams

10. What is the gestational age threshold for admission to the Level I nursery?  *This question is required.

• ≥ 34 weeks
• ≥ 35 weeks
• ≥ 36 weeks
• ≥ 37 weeks

11. Do infants need to meet both the birthweight and the gestational age cutoffs for admission to the Level I nursery?  *This question is required.

• Yes
• No
• Provider discretion

12. Does your facility have a protocol for managing and discharging late preterm infants?  *This question is required.

• Yes
• No

If you answered yes to ‘Does your facility have a protocol for managing and discharging late preterm infants’, please indicate aspects of care that are addressed in the protocol: (check all that apply) *This question is required.

• Minimum length of stay
• Bilirubin monitoring
• Allowed weight loss
• Hypoglycemia screening
• Thermoregulation

13. Does your facility have a standard practice of labeling/identifying infants who are 34 0/7 – 36/67 weeks gestation as late preterm infants in the medical record? *This question is required.

• Yes
• No

14. Does your facility practice rooming in or couplet care for healthy late preterm infants to remain in their mother’s room?  *This question is required.

• Yes
• No

15. Which of the following interventions can be performed in the mother’s room? Check all that apply. *This question is required.

• Phototherapy
• Dextrose gel
• Intravenous fluids
• Nasogastric or orogastric tube feeds
• Isolette for thermoregulation
• Continuous cardiorespiratory monitoring
• None of the above

16. Which best describes screening of infants for hyperbilirubinemia at your facility? *This question is required.

• All infants receive a serum bilirubin during hospitalization
• All infants receive a transcutaneous bilirubin during hospitalization, with serum measurement as needed
• Infants receive either a serum or transcutaneous bilirubin, depending on risk factors
• No site-specific protocol, management per provider discretion

17. Which of the following guidelines most inform the management of hyperbilirubinemia at your facility?  *This question is required.

• Phototherapy thresholds per the AAP Clinical practice guidelines
• Phototherapy thresholds per the Northern California Neonatal Consortium
• Institution specific phototherapy thresholds
• No site-specific protocol, management per provider discretion

18. Are infants in NBN or SCN/NICU discharged home on phototherapy? *This question is required.

• Yes
• No
• Not sure

19. For late preterm infants whose mothers are attempting breastfeeding, is a consult with a lactation consultant ordered and completed (virtual or in person) during hospitalization?
 *This question is required.

• Yes, but it must be ordered by the provider or nurse
• Yes, lactation consults are automatic for all late preterm infants
• No, we do not have lactation consultants at our facility but we try to assign nurses with training in lactation to these mothers

20. Does your facility assess and document LATCH scores for breastfeeding infants?   *This question is required.

• Yes
• No

21. In treating infants requiring phototherapy for hyperbilirubinemia do you ever stop breastfeeding and substitute formula feeding until bilirubin levels decrease? *This question is required.

• Yes routinely
• Yes, but at provider discretion
• No

22. Do you track percent weight loss for late preterm infants during hospitalization?  *This question is required.

• Yes
• No

If you answered ‘Yes’ to ‘Do you track percent weight loss for late preterm infants during hospitalization’, what percent weight loss dictates closer follow up of feeding frequency or quality? *This question is required.

• 5-7%
• 8-10%
• > 10%
• provider discretion

23. Does your facility utilize the NEWT tool to track newborn weight loss? *This question is required.

• Yes
• No

24. For late preterm infants who are clinically well appearing with no maternal factors limiting discharge, how long would these infants routinely be hospitalized after an uncomplicated vaginal delivery? *This question is required.

• less than 24 hours
• 24-36 hours
• 36-48 hours
• 48-72 hours
• greater than 72 hours

25. Does your facility accept readmissions of an infant in any facility unit post discharge? *This question is required.

• Yes
• No
• Readmission would depend on the reason for needing care (ie. Hyperbilirubinemia treatment would be readmitted, sepsis would not)

26. What is the standard follow up appointment time for discharged late preterm infants? *This question is required.

• within 48 hours
• within one week

27. Do any providers follow up discharge of late preterm infants with a phone call to the pediatric provider? *This question is required.

• Yes
• No