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G239 Reducing Neonatal Readmissions and Re-Attendances with Jaundice: Role of Transcutaneous Bilirubinometers
  1. V Ponnusamy,
  2. A D’Amore
  1. Neonatal Intensive Care Unit, Addenbrookes Hospital, Cambridge, UK

Abstract

Aims Up to 60% of newborns have jaundice within the first week of life. Significant jaundice necessitates readmission to hospital. NICE guidance on neonatal jaundice in 2010 recommending checking bilirubin levels and not relying on visual inspection alone led to increased numbers of babies attending our Emergency Department (ED). We aimed to address the raising re-attendances and readmissions to paediatrics.

Methods A n Audit identified increasing readmissions within the first week of life. We collected data for readmissions to wards and re-attendances to ED due to physiological jaundice. We compared readmissions prior to use of transcutaneous bilirubinometers (TCBRs) and for one month post introduction. A monthly average was used for comparison.

Results Over the years, the proportion of infants readmitted increased (Table 1). Most were term breastfed babies. Length of stay increased when discharged early. TCBRs can be used as a screening tool. We identified that screening by Community Midwives at home could decrease hospital referrals. TCBRs were obtained in May 2012 through charity funding.

Abstract G239 Table 1

Readmissions within first week of life 2009-2011

Post TCBR use, average monthly re-attendances to ED fell from 40 to16 (Table 2). Average monthly readmissions and financial costs to the Primary Care Trust (PCT) were calculated.

Abstract G239 Table 2

Re-attendances and readmissions: pre and post TCBR use

Conclusions Introduction of TCBR’s reduced attendance rates to ED, but did not significantly affect readmissions. PCT billing reduced significantly. Families could be monitored at home. We are pursuing other strategies like producing a DVD to promote awareness of jaundice and improve breast feeding support and plan to reanalyse following this.

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