{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:23:05Z","timestamp":1760984585489,"version":"3.40.5"},"reference-count":9,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>Neonatal hyperbilirubinemia is a common reason for neonates to present to the emergency department (ED). Although clinical practice guidelines provide recommendations for evaluation and therapy, few studies have evaluated ways to apply them effectively in the ED setting. The primary objective of this study was to compare time to phototherapy in neonates presenting to the ED with jaundice before and after implementation of a nursing-initiated clinical pathway. Secondary outcomes included time to bilirubin result and ED length of stay in neonates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We performed a retrospective historical control study comparing neonates presenting to the ED with jaundice during 9-month periods before and after initiation of the pathway. Charts were abstracted for times of assessment and treatment and final disposition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Three hundred neonates were included in this study: 149 before and 151 after pathway implementation. Median time to phototherapy (historical control: 128 minutes vs postintervention group: 52 minutes; P &amp;lt; .001), median time to bilirubin result (157 vs 99; P &amp;lt; .001), and median ED length of stay (268 minutes vs 195 minutes; P &amp;lt; .001) were shorter for neonates treated after the implementation of the clinical pathway. No complications were reported during the study period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>After implementation of a clinical pathway for the management of neonates with jaundice in the ED, we observed a reduction in time to phototherapy, time to bilirubin measurement, and overall length of stay.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2012-1156","type":"journal-article","created":{"date-parts":[[2012,11,13]],"date-time":"2012-11-13T10:52:14Z","timestamp":1352803934000},"page":"e1688-e1694","source":"Crossref","is-referenced-by-count":16,"title":["Management of Neonates With Hyperbilirubinemia: Improving Timeliness of Care Using a Clinical Pathway"],"prefix":"10.1542","volume":"130","author":[{"given":"Margaret","family":"Wolff","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana Aronson","family":"Schinasi","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Lavelle","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Boorstein","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph John","family":"Zorc","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2012,12,1]]},"reference":[{"key":"2021120823584448100_B1"},{"issue":"3","key":"2021120823584448100_B2","first-page":"299","article-title":"Kernicterus in full-term infants\u2013United States, 1994\u20131998.","volume":"286","author":"Centers for Disease Control and Prevention","year":"2001","journal-title":"JAMA"},{"key":"2021120823584448100_B3","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1038\/jp.2008.210","article-title":"Synopsis report from the pilot USA Kernicterus Registry.","volume":"29","author":"Bhutani","year":"2009","journal-title":"J Perinatol"},{"issue":"9","key":"2021120823584448100_B4","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/01.pec.0000139741.54215.2c","article-title":"Acute, severe bilirubin encephalopathy in a newborn.","volume":"20","author":"Mollen","year":"2004","journal-title":"Pediatr Emerg Care"},{"issue":"1","key":"2021120823584448100_B5","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1542\/peds.114.1.297","article-title":"Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.","volume":"114","author":"American Academy of Pediatrics Subcommittee on Hyperbilirubinemia","year":"2004","journal-title":"Pediatrics"},{"issue":"4","key":"2021120823584448100_B6","doi-asserted-by":"crossref","first-page":"318","DOI":"10.3171\/2010.7.PEDS09534","article-title":"Effectiveness of a clinical pathway for patients with cerebrospinal fluid shunt malfunction.","volume":"6","author":"Chern","year":"2010","journal-title":"J Neurosurg Pediatr"},{"key":"2021120823584448100_B7"},{"issue":"11","key":"2021120823584448100_B8","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1001\/archpedi.1987.04460110069024","article-title":"Capillary and venous bilirubin values. Are they really different?","volume":"141","author":"Leslie","year":"1987","journal-title":"Am J Dis Child"},{"issue":"4","key":"2021120823584448100_B9","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1542\/peds.2004-0899","article-title":"Cost-effectiveness of strategies that are intended to prevent kernicterus in newborn infants.","volume":"114","author":"Suresh","year":"2004","journal-title":"Pediatrics"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/130\/6\/e1688\/897663\/peds_2012-1156.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/130\/6\/e1688\/897663\/peds_2012-1156.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T05:24:19Z","timestamp":1639027459000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/130\/6\/e1688\/30367\/Management-of-Neonates-With-Hyperbilirubinemia"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12,1]]},"references-count":9,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2012,12,1]]},"published-print":{"date-parts":[[2012,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2012-1156","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2012,12,1]]}}}