| Autor: |
Michele Seddon, Christine Cavanagh, Helen Lewis-Parmar |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
Abstracts. |
| DOI: |
10.1136/archdischild-2021-rcpch.289 |
| Popis: |
Background Delayed diagnosis means delayed initiation of treatment for screen positive babies in the newborn blood spot screening (NBS) programme which can have a significant impact on long term clinical outcome. The need to repeat a sample because the initial sample is of insufficient quality for testing in an important contributor. These ‘avoidable repeats’ are monitored at maternity unit level as a key performance indicator. To check that NBS samples have a result in the recommended timeframes all maternity units in England use an IT system called the newborn blood spot failsafe solution (NBSFS). In North West England half of all delays in initial blood spot samples are for babies in a hospital setting. Babies that need to be admitted are more likely to have a screening positive condition and are also those that are the most likely to have a delay in initial sampling. Objectives Comparison of avoidable repeat rates for babies in hospital settings compared to those in the community at the time of sampling Make recommendations for quality improvement in the timeliness of NBS screening completion for inpatient babies. Methods Review of newborn blood spot failsafe solution data to see how it can be used to provide assurance of the completion of screening for babies in hospital at the time of sampling Identification and analysis of laboratory data from one North West laboratory to calculate an avoidable repeat rate for babies that are in hospital at the time of sampling. Feedback from quality assurance visits on processes to prompt timely initial blood spot screening and any repeat samples for babies on neonatal units and other inpatient settings. Results NBSFS is incomplete for recording of inpatient status. The field is not mandated and the use of the term NICU does not allow for babies in other settings e.g. children’s hospitals. Alternative methods of identification such as Day 0 samples were also found to be unreliable. Analysing laboratory data for over 12,000 first samples received found an overall avoidable repeat rate of 2.1% (acceptable threshold ≤ 2.0%, achievable threshold ≤ 1%). An avoidable repeat rate of 5.2% was found for inpatient babies compared to 1.7% for community babies. Badgernet is a neonatal IT system that issues screening reminder prompts in neonatal units to trigger completion of screening in neonatal units, these can be dismissed when screening is not complete. This system is not used in standalone children’s hospitals. Conclusions Laboratory data can provide maternity units with information to be able to identify differential avoidable repeat rates for babies in hospital settings. This allows the targeting of quality improvement work to reduce avoidable repeats. NBSFS is currently not able to provide differential information about inpatient babies. This would be improved by renaming the ‘NICU’ field as ‘inpatient’ and mandating completion. Access to NBSFS for neonatal units and other inpatient children’s settings would support completion of timely screening. In the interim, local feedback mechanisms to update maternity units on screening status are needed. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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