Neonatal Jaundice Management  -  SJH protocol
Management SJH protocol		The suggested protocol below represents an amalgam of current St. John practices and the 2004 AAP Guidelines. It involves education of nursing and house staff on management of hyperbilirubinemia and provides for education of parents about jaundice. It stresses specific assessment of jaundice risk at discharge, interpretation of all bilirubins using the Bhutani risk nomogram, appropriate outpatient follow-up and AAP-approved treatment indications. A printer page is provided to allow printing of pertinent material from this lecture. The main components of the protocol are as follows: Key educational points for physicians and nurses Use of the hour-specific risk nomogram by Bhutani Risk assessment form on discharge Provide parents with educational material on jaundice at discharge Ensure appropriate follow-up according to discharge Risk Assessment Form Follow AAP treatment guidelines for phototherapy and exchange transfusion What the protocol does NOT answer are the following questions: Can the RN order a bilirubin on her own? Will we mandate bilirubins on ALL babies before discharge? Will we mandate bilirubins on babies who have risk factors before discharge? Will we do serum or transcutaneous bilirubins? Will we change the current parent handout on jaundice? Will we mandate timing of follow-up? The answers to these questions are in part financial, part legal and part personal preference. The department committee on jaundice is currently working on this problem and will bring specific suggestions to the next section meeting. Return to top of page