Leave Against Medical Advice among Neonates Admitted to Neonatal Intensive Care Unit in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Abstract

Introduction: Leave against medical advice is a condition in which a patient leaves the hospital against the treating physician's recommendation and is a sensitive issue occurring frequently in neonatal intensive care units across the developing world. Investigating the causes of newborn deaths is essential as there is high neonatal mortality rate in context of Nepal and a huge gap between that rate and desired outcomes. Self-discharge of sick neonates from hospitals further increases the chance of death. Hence, this study aimed to find out the prevalence of leave against medical advice among neonates admitted to the neonatal intensive care unit in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among patients admitted to the Neonatal Intensive Care Unit from 14 April 2021 to 13 April 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 077/78-021). The patient’s demographic and clinical characteristics and reasons for self-discharge were recorded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 1352 neonates, the prevalence of leave against medical advice was 119 (8.80%) (7.29-10.31, 95% Confidence Interval). Conclusions: The prevalence of leave against medical advice from the neonatal intensive care unit was lower than in other studies done in similar settings.

Keywords

• leave against medical advice; neonatal intensive care unit; neonates; prevalence.