{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:43:15Z","timestamp":1761561795279,"version":"3.40.5"},"reference-count":13,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>The goal of this study was to improve compliance with published guidelines regarding management of neonatal hyperbilirubinemia in infants admitted to a general pediatric hospital ward and to improve support for their breastfeeding mothers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>This quality improvement project was conducted by using Plan-Do-Study-Act cycles and statistical process control methods. Study subjects were infants &amp;gt;35 weeks\u2019 gestation admitted for hyperbilirubinemia to the general inpatient ward of a large, freestanding pediatric hospital. We developed and implemented a guideline for the inpatient management of jaundiced neonates, with ongoing feedback given to the faculty on group performance. Outcome measures included monthly compliance scores based on American Academy of Pediatrics (AAP) guidelines for management of neonates &amp;gt;35 weeks\u2019 gestation and the percentage of admitted jaundiced, breastfeeding infants whose mothers received lactation consultation during hospitalization. To determine the AAP compliance score, we reviewed and assigned points to each patient admission for completion of a standard evaluation, avoidance of unnecessary intravenous (IV) fluids and peripheral IV line placement, avoidance of rebound bilirubin checks while in the hospital, and the bilirubin level at discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>Mean monthly AAP compliance scores increased from 60.5% of total possible points during the baseline period (January 2010\u2013December 2010) to 90.4% during the intervention period (January 2011\u2013December 2011). Lactation consultations increased from 48% during our baseline period to 63% during our early intervention period and to 90% during the last 5 months of our intervention. Length of stay was unchanged during the baseline and intervention periods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>Interprofessional collaboration between nurses and physicians combined with a thoughtful campaign to increase awareness of published guidelines were successful in improving the care of infants admitted with unconjugated hyperbilirubinemia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2012-0103","type":"journal-article","created":{"date-parts":[[2013,9,27]],"date-time":"2013-09-27T17:52:00Z","timestamp":1380304320000},"page":"251-257","source":"Crossref","is-referenced-by-count":14,"title":["A Quality Project to Improve Compliance With AAP Guidelines for Inpatient Management of Neonatal Hyperbilirubinemia"],"prefix":"10.1542","volume":"3","author":[{"given":"Kimberly M.","family":"Tartaglia","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Internal Medicine, Wexner Medical Center at The Ohio State University, and Nationwide Children\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital, Columbus, Ohio; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Shaniuk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard E.","family":"McClead","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital, Columbus, Ohio; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2013,7,1]]},"reference":[{"issue":"4","key":"2021120908240972000_B1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.110.4.e47","article-title":"Imbalance between production and conjugation of bilirubin: a fundamental concept in the mechanism of neonatal jaundice","volume":"110","author":"Kaplan","year":"2002","journal-title":"Pediatrics"},{"issue":"9","key":"2021120908240972000_B2","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1056\/NEJMct0708376","article-title":"Phototherapy for neonatal jaundice","volume":"358","author":"Maisels","year":"2008","journal-title":"N Engl J Med"},{"issue":"11","key":"2021120908240972000_B3","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.earlhumdev.2009.09.003","article-title":"Neonatal hyperbilirubinemia and kernicterus\u2014not gone but sometimes forgotten","volume":"85","author":"Maisels","year":"2009","journal-title":"Early Hum Dev."},{"issue":"3","key":"2021120908240972000_B4","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1542\/peds.108.3.763","article-title":"Neonatal jaundice and kernicterus","volume":"108","author":"AAP Subcommittee on Neonatal Hyperbilirubinemia","year":"2001","journal-title":"Pediatrics"},{"issue":"6 pt 1","key":"2021120908240972000_B5","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1542\/peds.112.6.1388","article-title":"Applying the \u201c10 simple rules\u201d of the Institute of Medicine to management of hyperbilirubinemia in newborns","volume":"112","author":"Palmer","year":"2003","journal-title":"Pediatrics"},{"issue":"suppl 1","key":"2021120908240972000_B6","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1038\/jp.2008.215","article-title":"Systems changes to prevent severe hyperbilirubinemia and promote breastfeeding: pilot approaches","volume":"29","author":"Stark","year":"2009","journal-title":"J Perinatol"},{"issue":"3","key":"2021120908240972000_B7","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1542\/peds.2007-0233","article-title":"Improving newborn preventive services at the birth hospitalization: a collaborative, hospital-based quality-improvement project","volume":"120","author":"Mercier","year":"2007","journal-title":"Pediatrics"},{"issue":"6 pt 1","key":"2021120908240972000_B8","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1542\/peds.112.6.1264","article-title":"Management of hyperbilirubinemia in newborns: measuring performance by using a benchmarking model","volume":"112","author":"Chou","year":"2003","journal-title":"Pediatrics"},{"issue":"4","key":"2021120908240972000_B9","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1067\/mpd.2002.123098","article-title":"System-based approach to management of neonatal jaundice and prevention of kernicterus","volume":"140","author":"Johnson","year":"2002","journal-title":"J Pediatr"},{"issue":"6","key":"2021120908240972000_B10","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2012-1156","article-title":"Management of neonates with hyperbilirubinemia: improving timeliness of care using a clinical pathway","volume":"130","author":"Wolff","year":"2012","journal-title":"Pediatrics"},{"issue":"1","key":"2021120908240972000_B11","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.jpeds.2006.02.011","article-title":"Neonatal hyperbilirubinemia in African American males: the importance of glucose-6-phosphate dehydrogenase deficiency","volume":"149","author":"Kaplan","year":"2006","journal-title":"J Pediatr"},{"key":"2021120908240972000_B12","volume-title":"The Improvement Guide: A Practical Approach to Enhancing Organizational Performance","author":"Langley","year":"2009","edition":"2nd Ed"},{"issue":"6","key":"2021120908240972000_B13","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1136\/qhc.12.6.458","article-title":"Statistical process control as a tool for research and healthcare improvement","volume":"12","author":"Benneyan","year":"2003","journal-title":"Qual Saf Health Care"}],"container-title":["Hospital 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