Table 1.

Overview of Newborn Nursery Standardized Order Changes

OutcomeOld Nursery OrdersNew Nursery Orders
Hepatitis B virus vaccinationPhysicians must “opt in,” ie, specifically order the vaccinePhysicians must “opt out,” ie, specifically order that no vaccine be given
Discharge follow-up recommendationsNo guidanceRecommendations based on infant's age at discharge, transcutaneous bilirubin result before discharge, and jaundice risk factors, including breastfeeding. Follow-up intervals based on AAP recommendations.4
GBS disease preventionIf the mother was positive for GBS, infant's vital signs were measured more frequentlyFollow CDC recommendations including observation for 48 hours for many infants.2Orders differ from CDC guideline by requiring only complete blood counts, and not blood cultures, for certain infants.
  • GBS, group B streptococcal; AAP, American Academy of Pediatrics; CDC, Centers for Disease Control and Prevention.