1327 Audit on Management of Neonatal Jaundice

Abstract

Background Neonatal jaundice is a common medical problem in postnatal wards. With the introduction of NICE guidelines in UK, the management of jaundice of newborn infants has achieved clarity. Aims An audit was undertaken to check if local team were adhering to the NICE guidelines on neonatal jaundice management (May 2010) and to make recommendations to improve compliance. Methods Prospective audit was conducted between January 2011 to August 2011 and 48 newborn infants with jaundice in postnatal ward were randomly selected and included. Data was collected using proforma, baby/maternal notes and blood results on computer system. Results Poor performance was demonstrated in identifying the risk factor for jaundice-whether baby's previous sibling had jaundice requiring treatment (15% as compared to 100% standard). There was 90% compliance with NICE guidelines (standard 100%) with regards to serum bilirubin (SBR) measured for infants with jaundice <24 hours. 83% of infants (29/35) with jaundice onset >24 hours had transcutaneous bilirubinometry(TCB) measurement which reduced the number of blood tests performed on these infants. Only 75% of the parents of infants with jaundice received information leaflets on newborn jaundice. Conclusion 1. When used appropriately, TCB reduces need for invasive blood tests and the workload of paediatric doctors on postnatal wards. The midwives and junior doctors should receive training for TCB use and management of jaundice in accordance with NICE guidelines. 2. All parents of newborn infants with jaundice should receive NICE information leaflets on jaundice to increase awareness of the condition.