G97(P) A QI project to introduce point of care CRP testing for asymptomatic babies receiving antibiotics on the post natal ward. (25th October 2020)

• Record Type: Journal Article
• Authors: Dyer, E; Styles, K; Bartrum, N; Radomska, M
• Is Part Of: Archives of disease in childhood. Volume 105(2020)Supplement 1
• Page Start: A32
• Page End: A32
• Publication Date: 2020-10-25
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2020-rcpch.78
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aim: To see if point-of-care (POC) rather than laboratory C-reactive protein (CRP) testing on the postnatal ward (PNW) leads to earlier discharge for asymptomatic babies >37 weeks gestation who have been screened and treated for sepsis based on risk factors alone. Method: Babies > 37 weeks gestation receiving antibiotics for sepsis risk factors on the PNW were prospectively identified from the daily medical handover list. The trust sepsis risk factors are maternal group B streptococcal infection, prolonged rupture of membranes > 18 hours and suspected maternal sepsis. Babies were excluded if clinically unwell. In our trust all babies meeting the threshold for screening and treating for infection have a full blood count, CRP and blood culture at birth with antibiotics administered afterwards. A second CRP should be performed at 18–24 hours of life. Babies who remain clinically well with the second CRP being <10, will stop antibiotics prior to the 48-hour blood culture result and be discharged back to midwifery care. We investigated whether these babies had their second CRP performed at the correct time and if they were discharged earlier with using the POC CRP testing. Results: Conclusion: Babies receiving POC CRP testing on the PNW had their antibiotics stopped slightly sooner and were discharged to midwifery care slightly earlier, however these differences were slight. They did not go home sooner as many required further midwifery care, most commonly feeding support. We anticipate that as our teams become more familiar with the POC CRP testing less babies will receive unnecessary doses of antibiotics and will return to midwifery care sooner.