Aims In our department neonates are admitted soon after birth for management of congenital heart disease. Due to the urgency of their underlying condition, routine screening including the Newborn and Infant Examination (NIPE) can often be overlooked. We aimed to evaluate the efficacy of our department in performing neonatal screening, and to improve our performance and hence the quality of care provided to our patients.
Methods In a retrospective study, notes of neonates discharged from the unit between March and July 2016 were reviewed to determine if they had a NIPE, hearing screen and immunisations as per national standards. Following these results, areas of improvement were identified and a neonatal checklist was introduced. Another audit cycle to assess the effect of these changes will be performed in February 2017.
Results This first audit cycle found that 44% of neonates did not have NIPE completed by the time of their discharge. None of the patients included in our study underwent hearing screening or were given the BCG vaccine (although eligible).
Conclusion As per national standards set out by the Department of Health England, acceptable performance threshold for NIPE examinations is ≥95.0%. The first audit cycle identified that our department fell well below these standards. We have therefore introduced a neonatal checklist as an aid to prompt medical and nursing teams to ensure that all neonates admitted to the unit have appropriate screening. In addition, all the necessary equipment (e.g. ophthalmoscope, measuring tapes and red books) has been made available in the clinical areas. Further audit will be carried out to establish the impact of the interventions and whether the change has been sustained.
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