title: Standardizing documentation and the clinical approach to apnea of prematurity reduces length of stay, improves staff satisfaction, and decreases hospital cost.
abstract: BACKGROUND
  Apnea of prematurity, a common disorder, can severely compromise an infant's condition unless correctly diagnosed and treated. Infants with a history of apnea of prematurity can be discharged home but then be rehospitalized for an apneic event, an apparent life-threatening event, or sudden infant death syndrome. The definition of a clinically significant cardiopulmonary event, such events' documentation, and the treatment approach were standardized, and discharge criteria were refined.
  
  
  METHODS
  A prospective, single-center comparison was conducted between a group of premature infants before and after implementation of the standard approach. Data were collected prospectively from August 1, 2005, through July 21, 2006, for the prestandard-approach group and from August 1, 2006, through September 16, 2007, for the standard-approach group.
  
  
  RESULTS
  Twenty-two (35%) of the 63 infants in the prestandard-approach group experienced discharge delays because of poor documentation, whereby the clinician could not determine the safety of discharge. This resulted in 59 additional hospital days (mean length-of-stay [LOS] increase, 5.7 days). The standard-approach group of 72 infants experienced no discharge delays and no additional hospital days, and LOS decreased (all p < .0001). Annual charges were reduced by more than $58,000 in avoiding unnecessary hospital days. Readmission to the hospital for apnea of prematurity occurred for 5 (7.9%) of the prestandard-approach group but none of the standard-approach group (p = .0203). Overall compliance with the standardization process has been maintained at > or = 96%.
  
  
  CONCLUSIONS
  Implementation of a standard approach to the definition of apnea of prematurity and its treatment and documentation decreases LOS and reduces cost.
authors.forename: T Jeffrey
authors.initials: TJ
authors.lastname: Butler
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Firestone
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Grow
authors.forename: Anand D
authors.initials: AD
authors.lastname: Kantak
mesh_terms: D001049:Apnea / Q000191:economics / Q000628:therapy*; D002110:Caffeine / Q000008:administration & dosage; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D004282:Documentation / Q000379:methods*; D005865:Gestational Age; D017721:Hospital Costs; D006801:Humans; D007234:Infant, Premature; D007318:Inservice Training / Q000458:organization & administration; D007588:Job Satisfaction; D007902:Length of Stay / Q000706:statistics & numerical data; D018670:Monitoring, Ambulatory; D010351:Patient Discharge; D011446:Prospective Studies; D011787:Quality of Health Care / Q000458:organization & administration
chemical_list: D000697:Central Nervous System Stimulants; D002110:Caffeine