1. Hyperbilirubinemia Web Conference April 26, 2017 https://join
Hyperbilirubinemia Web Conference April 26, Dial In: Participant Code: # 

2. Introductions

3. General Information Count the Kicks
Any stillbirths with decrease movement?
Are mothers getting the brochures?
Data Collection NICU data collection ON HOLD
Did you submit data on:
2016 cesarean delivery statistics?
Safe sleep?

4. Aim: Prevent Kernicterus

5. Intervention: Evidence-based Practices

6. TSB or TcB if any jaundice noted visually (AAP, Keren)
If no visible jaundice, unlikely to develop hyperbilirubinemia
Visual assessment not accurate for determining severity of hyperbilirubinemia
AAP (2004). Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1), DOI: /peds
Keren, R., Luan, X., Friedman, S., Saddlemire, S., Cnaan, A., & Bhutani, V. K. (2008). A comparison of alternative risk-assessment strategies for predicting significant neonatal hyperbilirubinemia in term and near-term infants. Pediatrics, 121(1), e170-9.

7. Universal predischarge bilirubin screening-TSB or TcB(Maisels)
Use of clinical risk factors and predischarge bili to predict risk of hyperbilirubinemia (Maisels)
Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), DOI: /peds

8. AAP (2004). Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1), DOI: /peds

9. Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A
Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), DOI: /peds

10. Use hour-specific nomogram to interpret bili (Maisels 2009, AAP 2004)
Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), DOI: /peds
AAP (2004). Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1), DOI: /peds

11. Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A
Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), DOI: /peds

12. Written and verbal info to parents at discharge explaining jaundice and need to monitor for (AAP, 2004)
AAP (2004). Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1), DOI: /peds

13. Recommendations for Management and Follow-up

14. Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A
Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), DOI: /peds

15. Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A
Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), DOI: /peds

16. Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A
Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), DOI: /peds

17. Recommendations for Management and Follow-up
Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), DOI: /peds

18. Considerations for Timing of TcB/TSH
LOS varies
Risk of omission
Coordinate with newborn screen

19. Subcommittee on Hyperbilirubinemia, Pediatrics 2004;114:297-316
Guidelines for phototherapy in hospitalized infants of 35 or more weeks' gestation
Subcommittee on Hyperbilirubinemia, Pediatrics 2004;114:
Copyright ©2004 American Academy of Pediatrics

20. TSB or TcB if any jaundice noted visually (AAP, Keren)
SUMMARY
TSB or TcB if any jaundice noted visually (AAP, Keren)
Use of clinical risk factors and predischarge bili to predict risk of hyperbilirubinemia (Maisels)
Universal predischarge bilirubin screening-TSB or TcB(Maisels)
Use hour-specific nomogram to interpret bili (Maisels 2009, AAP 2004)
Written and verbal info to parents at discharge explaining jaundice and need to monitor for (AAP, 2004)

23. SHARING
Supplement?