The impact of nurses and mothers signing the discharge letter on maternal knowledge and satisfaction after discharge from a neonatal unit: A before and after study

Objective To assess the maternal recall of the neonatal discharge letter instructions with and without nurse and mother signing the document in addition to the physician signature. Methods Maternal recall of the discharge letter instructions was assessed by telephone interviews conducted 2–3 weeks following discharge. One hundred and nine mothers who signed the discharge letter following a change of information delivery policy at discharge were compared with 110 mothers who gave birth when their signature was not yet required. The impact of the discharge form on maternal recall was evaluated by stepwise regression analysis adjusted for obstetric, perinatal and demographic variables. Results Recall of specific instructions verified by the discharge notes and satisfactory understanding of the discharge letter as graded by the mother were higher among 109 mothers who signed the discharge letter (82% and 88%, respectively) than among 110 mothers who did not add their signature (58% and 73%, respectively), the differences being statistically significant (p=0.002 and 0.022, respectively). The statistical difference was maintained also following adjustment with independent variables. Conclusion Signing the neonatal discharge letter by both nurse and mother may improve maternal comprehension and recall of the delivered information. A prospective controlled study is necessary to validate this hypothesis.