P645 An audit to improve neonatal readmission number at wexford general hospital. (June 2019)

• Record Type: Journal Article
• Authors: Ahmed, Riaz; Shori, Naeem; Bone, Allie; Jawad, Muhammad
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 3
• Page Start: A407
• Page End: A408
• Publication Date: 2019-06
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-epa.976
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Introduction: A readmission within a few weeks after discharge of an ostensibly healthy new-born from a well-baby nursery and postnatal ward is an undesirable event for parents, physicians, and payers. Such a readmission may reflect an inadequate assessment of the new-born's readiness for discharge, a lack of resources and/or an inability of a parent to provide early new-born care, or inappropriate and/or untimely availability of, or access to, outpatient care. Potentially preventable problems including jaundice and feeding problems account for the majority of hospital readmissions among new-borns within 28 days after discharge. Numerous studies have reported that the length of stay (LOS) for childbirth has been steadily decreasing in recent decades, in an effort to decrease costs and de medicalise pregnancy. The medical necessity of hospitalisation for and after childbirth is influenced by a variety of factors. Aim: To assess the preventable causes of neonatal readmission to Paediatric unit in and find a link with current practice of discharge from postnatal ward by comparing with practice followed at tertiary care maternity hospital across Ireland in one year. Standard: Protocols followed at three tertiary care maternity hospitals at Dublin Ireland Nice guidelines of postnatal care European Standards of New born care Methodology: Retrospective review of admission notes of neonates who were less than two weeks old admitted to WGH in 2018 from January to December, excluding babies transferred from other hospital. Results: A total of 24 babies less than two weeks of age were readmitted to Paediatric unit WGH which makes 1.4% of the total babies who were discharged from the postnatal unit. Among the 24 readmitted babies 37.5% were readmitted with Jaundice, while feeding issues and to out rule sepsis consisted of 20% each. The rest were minor causes like delayed passage of meconium, BRUE, transfer from SCBU. Conclusion: Jaundice and feeding issues are the two most important reason for the babies readmitted to Paediatric unit at Wexford general Hospital. In our audit it was found that all those babies who were readmitted from postnatal ward had no documented weight and bilirubin level check at the discharge. Recommendations: All those babies from postnatal ward should who serum bilirubin checked by transcutaneous billimeter and their weight measured at discharged especially the breast fed babies. Loop audit: After a period of 1 year following these recommendations.