Nursing diagnosis neonatal hyperbilirubinemia: A survival analysis

Abstract

Purpose

To analyze the short-term survival of the nursing diagnosis of neonatal hyperbilirubinemia in hospitalized neonates within the first 24 h of life and over a maximum of 7 days.

Methods

A prospective open cohort study with a longitudinal design was developed with 120 newborns during the first 24 h of life. The survival rate after a nursing diagnosis of neonatal hyperbilirubinemia was analyzed for 7 days.

Findings

The number of new cases of neonatal hyperbilirubinemia during the follow-up was 82 (RR: 90.1%, daily incidence rate: 34.17%). The greatest manifestation of the diagnosis occurred in the first three days (n = 97). The median diagnostic survival time was 2 days (95% CI: 2–2). Yellow-orange skin color (RR = 8.08), yellow mucous membranes (RR = 2.05), yellow sclera (RR = 1.99), and female gender (RR = 1.36) had the highest risk ratios.

Conclusions

A rapid impairment of neonatal hyperbilirubinemia in hospitalized neonates was observed. Some clinical indicators were associated with an increased risk for this diagnosis.

Implications for nursing practice

Studies on the prognostic capacity of the clinical indicators of nursing diagnoses like neonatal hyperbilirubinemia strengthen the clinical reasoning of nurses and subsidize diagnostic inferences and accurate clinical decisions.

Keywords

neonatal jaundice neonatal hyperbilirubinemia new born nursing diagnosis survival analysis

Get full access to this article

View all access options for this article.

References

Aprillia

Gayatri

Waluyanti

F. T.

(2017). Sensitivity, specificity, and accuracy of kramer examination of neonatal jaundice: Comparison with total bilirubin serum. Comprehensive Child and Adolescent Nursing, 40, 88–94. https://doi.org/10.1080/24694193.2017.1386975

Bakken

K. S.

Skjeldal

O. H.

Stray-Pedersen

(2015). Neonatal jaundice and the immigrant population: A comparison study at a low-risk maternity ward in Norway. Nordic Journal of Nursing Research, 35(3), 165–171. https://doi.org/10.1177/0107408315590566

Bhutani

V. K.

Srinivas

Cuadrado

M. E. C.

Aby

J. L.

Wong

R. J.

Stevenson

D. K.

(2016). Identification of neonatal haemolysis: An approach to predischarge management of neonatal hyperbilirubinemia. Acta Paediatrica, 105(5), e189–e194. https://doi.org/10.1111/apa.13341

Bittencourt

G. K. G. D.

Crossetti

M. G. O.

(2013). Critical thinking skills in the nursing diagnosis process. Revista da Escola de Enfermagem da USP, 47(2), 341–347. https://doi.org/10.1590/S0080-62342013000200010

Britton

J. R.

Britton

H. L.

Beebe

S. A.

(1994). Early discharge of the term newborn: A continued dilemma. Pediatrics, 94, 291–295. https://pubmed.ncbi.nlm.nih.gov/8065852/

Cortey

Renesme

Raignoux

Bedu

Casper

Tourneux

Truffert

(2017). Ictère à bilirubine non conjuguéedunouveauné de 35 semainesetplus: Dudépistage au suiviaprèssortie de lamaternité. Recommandationspourla pratique clinique. Archives de Pédiatre, 24(2), 192–203. https://doi.org/10.1016/j.arcped.2016.11.011

Dantas

A. V. V. C.

Farias

L. J. R.

De Paula

S. J.

Moreira

R. P.

Silva

V. M.

Lopes

M. V. O.

Guedes

N. G.

(2018). Nursing Diagnosis of Neonatal Jaundice: Study of Clinical Indicators. Journal of Pediatric Nursing, 39, e6–e10. https://doi.org/10.1016/j.pedn.2017.12.001

Graan

A. C. M.

Williams

J. S.

Koenb

M. P.

(2016). Professional nurses' understanding of clinical judgment: A contextual inquiry. Health SA Gesondheid, 21, 280–293. https://doi.org/10.4102/hsag.v21i0.967

Greenberg

R. S.

Daniels

S. R.

Flanders

W. D.

Eley

J. W.

Boring

I. I. I. J. R.

(2005). Epidemiologia clínica (3rd ed). Artmed.

10.

Greco

Arnolda

Boo

N. Y.

Iskander

I. F.

Okolo

A. A.

Rohsiswatmo

Shapiro

S. M.

Watchko

Wennberg

R. P.

Tiribelli

Zabetta

C. D. C.

(2016). Neonatal jaundice in low- and middle-income countries: Lessons and future directions from the 2015 Don Ostrow Trieste yellow retreat. Neonatology, 110, 172–180. https://doi.org/10.1159/000445708

11.

Henny-Harry

Trotman

(2012). Epidemiology of neonatal jaundice at the University Hospital of the West Indies. West Indian Medical Journal, 61(1), 37–42. https://westindies.scielo.org/scielo.php?script=sci_arttext&pid=S0043-31442012000100007

12.

Herdman

T. H.

Kamitsuru

(2018). NANDA International Nursing Diagnoses: Definitions and classification, 2018–2020 (11th ed). Thieme.

13.

Keren

Luan

Friedman

Saddlemire

Cnaan

Bhutani

V. K.

(2008). A comparison of alternative risk-assessment strategies for predicting significant neonatal hyperbilirubinemia in term and near-term infants. Pediatrics, 121(1), e170–e179. https://doi.org/10.1542/peds.2006-3499

14.

Leung

T. S.

Kapur

Guilliam

Okell

Lim

MacDonald

L. W.

Meek

(2015). Screening neonatal jaundice based on the sclera color of the eye using digital photography. Biomed Opt Express, 6(11), 4529–4538. https://doi.org/10.1364/BOE.6.004529

15.

Lindsey

P. L.

Jenkins

(2013). Nursing students' clinical judgment regarding rapid response: The influence of a clinical simulation education intervention. Nursing Forum, 48(1), 61–70. https://doi.org/10.1111/nuf.12002

16.

Lopes

M. V. O.

Silva

V. M.

Araújo

T. L.

(2013a). Métodos de pesquisa para validação clínica de conceitos diagnósticos. In Herdman

T. H.

Carvalho

E. C.

(Eds.), PRONANDA – Programa de atualização em diagnósticos de enfermagem – Conceitos básicos (pp. 85–129). Artmed Panamericana.

17.

Lopes

M. V. O.

Silva

V. M.

Araújo

T. L.

(2013b). Validação de diagnósticos de enfermagem: Desafios e alternativas. Revista Brasileira de Enfermagem, 66(5), 649–655. https://www.scielo.br/pdf/reben/v66n5/02.pdf

18.

Manila

Suvinee

(2018). The development of neonatal nursing standards of practice for Cambodia: A Delphi study. Journal of Health Research, 32(1), 12–23. https://doi.org/10.1108/JHR-11-2017-002

19.

Mojtahedi

S. Y.

Izadi

Seirafi

Khedmat

Tavokolizadeh

(2018). Risk factors associated with neonatal jaundice: A cross-sectional study from Iran. Open Access Macedonian Journal of Medical Sciences, 6(8), 1387–1393. http://doi.org/10.3889/oamjms.2018.319

20.

Olusanya

B. O.

Ogunlesi

T. A.

Slusher

T. M.

(2014). Why is kernicterus still a major cause of death and disability in low-income and middle-income countries? British Medical Journal, 99, 1117–1121. https://doi.org/10.1136/archdischild-2013-305506

21.

Olusanya

B. O.

Ogunlesi

T. A.

Kumar

Boo

N. Y.

Iskander

I. F.

Almeida

M. F.

Vaucher

Y. E.

Slusher

T. M.

(2015). Management of late-preterm and term infants with hyperbilirubinemia in resource-constrained settings. BMC Pediatrics, 15, 39. https://doi.org/10.1186/s12887-015-0358-z

22.

Pace

E. J.

Brown

C. M.

DeGeorge

K. C.

(2019). Neonatal hyperbilirubinemia: An evidence-based approach. The Journal of Family Practice, 68(1), e4–e11.

23.

Rathore

Kumar

C. V. K.

Sharashchandra

(2020). A critical review on neonatal hyperbilirubinemia-an Ayurvedic perspective. Journal of Ayurveda and Integrative Medicine, 11(2), 190–196. http://doi.org/10.1016/j.jaim.2018.08.006

24.

Santos

A. P. S.

Silva

M. L. C.

Souza

N. L.

Mota

G. M.

França

D. F.

(2014). Nursing diagnoses of newborns with sepsis in a Neonatal Intensive Care Unit. Latin American Journal of Nursing, 22(2), 255–261. http://doi.org/10.1590/0104-1169.3101.2410

25.

Scrafford

C. G.

Mullany

L. C.

Katz

Khatry

S. K.

LeClerq

S. C.

Darmstadt

G. L.

Tielsch

J. M.

(2013). Incidence of and risk factors for neonatal jaundice among newborns in southern Nepal. Tropical Medicine and International Health, 18(11), 1317–1328. https://doi.org/10.1111/tmi.12189

26.

Sousa

V. E. C.

Lopes

M. V. O.

Keenan

G. M.

Lopez

K. D.

(2018). Developing and testing of a software prototype to support diagnostic reasoning of nursing students. International Journal of Nursing Knowledge, 29(2), 124–132. https://doi.org/10.1111/2047-3095.12145

27.

Swanson

S. A.

Lindenberg

Bauer

Crosby

R. D.

(2011). A Monte Carlo investigation of factors influencing latent class analysis: An application to eating disorder research. International Journal of Eating Disorders, 45(5), 677–684. https://doi.org/10.1002/eat.20958

28.

Tekleab

A. M.

Amaru

G. M.

Tefera

Y. A.

(2016). Reasons for admission and neonatal outcome in the neonatal care unit of a tertiary care hospital in Addis Ababa: A prospective study. Research and Reports in Neonatology, 6, 17–23. http://doi.org/10.2147/RRN.S95455

29.

Thielemans

Trip-Hoving

Bancone

Turner

Simpson

J. A.

Hanboonkunupakarn

vanHensbroek

M. B.

vanRheenen

Paw

M. K.

Nosten

McGready

Carrara

V. I.

(2017). Neonatal hyperbilirubinemia in a marginalized population on the thai-Myanmar border: A study protocol. BMC Pediatrics, 17(1), 32. https://doi.org/10.1186/s12887-017-0798-8

30.

Van Graan

A. C.

Williams

M. J. S.

Koen

M. P.

(2016). Professional nurses' understanding of clinical judgment: A contextual inquiry. Health SA Gesondheid, 21, 280–293. https://doi.org/10.1016/j.hsag.2016.04.001

31.

Wickremasinghe

A. C.

Kuzniewicz

M. W.

Newman

T. B.

(2013). Black race is not protective against hazardous bilirubin levels. The Journal of Pediatrics, 162(5), 1068–1069. http://doi.org/10.1016/j.jpeds.2012.12.092

32.

Woodgate

Jardine

L. A.

(2011). Neonatal jaundice. BMJ Clinical Evidence, 2015, 0319. https://europepmc.org/article/pmc/pmc3217664#free-full-text