Reduction of term admissions into the Neonatal Unit: Focus on - - PowerPoint PPT Presentation

Patient centred . Excellence . Respect . Compassion . Safety

Reduction of term admissions into the Neonatal Unit: Focus on Hypothermia

ULHT The Journey and our progress

Patient centred . Excellence . Respect . Compassion . Safety

Aim

• 1. To prevent separation of mother and baby
• 2. To reduce avoidable harm to the term neonate and

prevent unnecessary admission to the neonatal unit

• 3. To promote optimal thermoregulation for the

neonate

Patient centred . Excellence . Respect . Compassion . Safety

Interventions:

• Introduction of the warm bundle
• Hats on babies
• Promoting skin to skin
• Improving environmental temperatures
• Introduction of the BAPM hypoglycaemia

guideline

• Increased Transitional Care Capacity

Patient centred . Excellence . Respect . Compassion . Safety

Hats on babies PDSA Cycle

Patient centred . Excellence . Respect . Compassion . Safety

Promotion of Hats on Babies

• Part of ‘Warm Bundle’
• Promotion poster
• Displayed in each

Labour ward room on both units and on postnatal wards.

Patient centred . Excellence . Respect . Compassion . Safety

Promotion of skin to skin at birth

• Part of ‘Warm

Bundle’

• Promotional

poster for parents and staff

• Displayed in each

Labour ward birthing room on both units.

Patient centred . Excellence . Respect . Compassion . Safety

Ensuring Thermometers are available

 Order thermometers for rooms which need them  Arrange installation of thermometers in all rooms Risks Cost of thermometers Cost of installation of thermometers Availability of Estates to complete this work Staff do not have time to support this initiative Poor communication All rooms are not identified

Scoping of Thermometers

available  Identify all rooms at Lincoln and Pilgrim where babies are birthed

• r initial care occurs

 Create a database of all of these rooms  Identify which rooms require thermometers Risks All rooms are not identified Staff do not have time to support this initiative Poor communication

Checking Temperatures of Rooms regularly

 Use the database to create an audit/check list to record the temperature in all rooms at Lincoln and Pilgrim where babies are birthed or initial care occurs at least once/day Risks Staff do not have time to support this initiative Staff do not complete the audit daily Poor communication All rooms are not identified

Process Map for Room Temperature checking Labour Wards, Theatre and Recovery Rooms

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Environmental Temperature PDSA Cycle

• Literature Search of

Optimal Environmental Temperatures 25°C- 28°C (WHO 1997)

• Findings:

Theatres and Recovery Rooms often cold 19°C-23°C

• To identify

possible causes

• f hypothermia
• Findings: no

environment temperatures available

• Plan: will re-

audit once Estates has completed this work

Estates Requested to Increase Temperature s Audit of Baby Temp and Care Post Birth Purchased and Installed Room Thermomete rs Audit of Room Temperature s

Patient centred . Excellence . Respect . Compassion . Safety

Comparison of Term Babies admitted with Hypothermia to the Neonatal Units at ULHT

Data collected for a 10 month period from November to August

Patient centred . Excellence . Respect . Compassion . Safety

Way Forward

• ‘Fresh Eyes’ approach
• Repeat Audit of Hats on Babies
• Repeat Audit of Babies and Environment

Temperatures

• Ongoing Audit of Babies with Hypothermia
• n admission to the Neonatal Unit
• ATAIN Champion to promote good practice
• Timely review of term admissions

Patient centred . Excellence . Respect . Compassion . Safety

Conclusion

• Further education and training
• Ongoing audit
• Ownership
• Embedding good practice

Patient centred . Excellence . Respect . Compassion . Safety

Any Questions?

Cathy Franklin Matron Neonatal Services ULHT Emily Exell Specialist Midwife Infant Feeding Coordinator ULHT