Background The use of early warning system scores and track & trigger charts is widespread in adult and paediatric hospitalised patients. Its use in neonatal group is not well recognized. Lack of well established normal ranges for biophysical variables in preterm/term neonates illustrate difficulties in establishing a scoring system that can potentially be used on the neonatal units and postnatal wards.
Aim To develop neonatal track and trigger observation chart in order to enable early identification of neonates in need of urgent medical assessment and intervention.
Methods A core group involving local paediatricians, neonatal nurses and midwifery sister was established to lead the project. The group contacted various neonatal units in different newborn networks in England seeking information if early warning scores or track & trigger system was being developed or already well established. Literature search was carried out to identify studies related to newborn early warning system scores.
Results One relevant published study was retrieved from Medline search (Roland 2010). None of the neonatal units contacted had an established early warning neonatal scoring system. Group developed newborn observation chart for “At Risk” and “High Risk” Infants. It was based on neurophysiological parameters, intervention criteria and staff concerns. A decision tree was devised based on trigger scores.
Conclusions Prospectively evaluation of Burton neonatal track and trigger observation chart is required to ascertain its efficacy. If found to be reliable and valid, it will facilitate observation of neonates deemed to be at risk and prompt an early review in triggered neonates.
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