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

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

Process Map for Room Temperature checking Labour Wards, Theatre and Recovery Rooms Scoping of Thermometers Checking Temperatures of Ensuring Thermometers are available available Rooms regularly  Order thermometers for rooms which need  Identify all rooms at Lincoln and  Use the database to create an them Pilgrim where babies are birthed audit/check list to record the  Arrange installation of thermometers in all or initial care occurs temperature in all rooms at rooms  Create a database of all of these Lincoln and Pilgrim where babies Risks are birthed or initial care occurs rooms Cost of thermometers at least once/day  Identify which rooms require Cost of installation of thermometers Risks thermometers Availability of Estates to complete this work Staff do not have time to support Risks Staff do not have time to support this this initiative All rooms are not identified initiative Staff do not complete the audit Staff do not have time to support this Poor communication daily initiative All rooms are not identified Poor communication Poor communication All rooms are not identified Patient centred . Excellence . Respect . Compassion . Safety

Environmental Temperature PDSA Cycle • To identify possible causes • Plan: will re- of hypothermia audit once • Findings: no Estates has Estates Audit of environment completed this Requested Baby temperatures work available to Increase Temp and Temperature Care Post s Birth Audit of Purchased Room and Installed Temperature Room s Thermomete • Literature Search of • Findings: rs Optimal Theatres and Environmental Recovery Temperatures 25 ° C- Rooms often 28 ° C (WHO 1997) cold 19 ° C-23 ° C 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 on 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 Patient centred . Excellence . Respect . Compassion . Safety