Home visits help babies transition from NICU

A healthy baby home sooner.

That's the goal of a new partnership between Children's of Mississippi and Sta-Home, a home health agency based in Jackson.

The dilemma, said Fran Malenzi, director of newborn services for the University of Mississippi Medical Center, was that some babies, those whose health and strength are growing, could go home from the neonatal intensive care unit if parents had the support of a home health nurse stopping in to check on progress.

Without that transitional support, those babies would stay in the NICU, she said.

Children's of Mississippi “built a program with Sta-Home from the ground up,” she said, “so we can care for these babies.”

Available in Hinds, Rankin, Madison, Simpson and Holmes counties, the program began in December. Carleigh Jae Course was among the first babies to be in the program.

She and twin brother Carter, now 6 months old, were born at about 24 weeks, Carleigh Jae at 1 pound, 10 ounces, and Carter just one ounce heavier than his sister. Carter came home after a three-month stay at the NICU, but Carleigh Jae, still on oxygen, stayed four months.

Brittney Course, left, and Shelly Fowler hold Course's twins, Carter and Carleigh Jae.

Sta-Home's Shelley Fowler, a registered nurse, began visiting Carleigh Jae every few days, checking her length, weight, head circumference, feeding and oxygen saturation. The bright-eyed little girl is now weaned off oxygen and weighs 11 pounds 13.5 ounces.

Mom Brittney Course of Pearl said having a home health nurse check in as part of the new program is a help in transitioning to having Carleigh Jae home. “As a mother, it puts my mind at ease knowing Shelley is stopping in.”

Fowler, who previously worked at UMMC's NICU, said working with the Course family has been a joy. “Brittney and I have become friends,” she said, “and Carleigh is so sweet.”

The Course family's experience is one UMMC and Sta-Home would like to replicate.

As the program was being created, all involved worked to define criteria to identify babies who would qualify, the process for discharging those babies to home and home health visits and communication procedures in which Sta-Home nurses can reach Children's of Mississippi staff quickly when needed.

“We've built a collaboration with Sta-Home,” said Dr. Mobolaji Famuyide, associate professor of neonatology and NICU medical director, “so we can care for babies in our NICU and subsequently transition them into the community in a safe and time-sensitive manner when they are medically ready.”

“We want this program to offer the best outcomes for families,” Malenzi said. “We're seeking a good hand-off between our team and the Sta-Home team, and we want to involve the pediatrician in the community who is taking care of the baby back home.”

Carleigh Jae Course now weighs 11 pounds, 13.5 ounces.

Peggy Stewart, Sta-Home's Jackson provider administrator, and Brittany Edwards, director of the project for Sta-Home, both say the partnership between the home health agency and UMMC is running smoothly for all involved.

“We're happy to be a partner with UMMC,” said Stewart, “in helping babies have the healthiest transition from hospital to home.”

Billy Needham, a nurse educator at UMMC, said the nursing visits can be eyes and ears for physicians. “Sta-Home nurses are an extension of us at UMMC and hopefully will catch any problems early to keep kids from coming back to the Emergency Department.”

Home health nurses are able to monitor babies' feeding and weight gain, respiratory status and oxygen requirement as well as basic developmental progress, Famuyide said. “We want to ensure that the progression of the baby's status is in the right direction.”

Communication in the program is designed to be fast, Famuyide said, “so if help is needed from us at UMMC, there will be no delay.”

Another critical facet of the program is working with local pediatricians, she said, as they'll be the primary provider for these children in the community. “We have created a system to provide a good hand-off so they are well informed when they take over.”