Research Article
Volume 11 Issue 6 - 2022
Improving Monitoring and Treatment of Jaundice in Term Infants Discharged from the Postnatal Ward: A Quality Improvement Project
Yasin Fatine, Sherif Dabbour, Sakina Ali and Claudia Chetcuti Ganado*
Neonatologist, Paediatric Training in Malta, Addenbrookes Hospital, ANTS Neonatal Transport Team for East of England, UK
*Corresponding Author: Claudia Chetcuti-Ganado, Neonatologist, Paediatric Training in Malta, Addenbrookes Hospital, ANTS Neonatal Transport Team for East of England, UK.
Received: May 11, 2022; Published: May 25, 2022




Abstract

Background: Neonatal jaundice is a common condition affecting many term and preterm infants. If left untreated, there are known long-term health implications, and there are considerable litigation costs to the health service for cases of kernicterus.

Methods and Results: This project aimed to improve the identification of high-risk infants pre-discharge, using a transcutaneous bilirubinometer (TCBR) which is a non-invasive way of screening for jaundice. During the intervention period, from December 2020 to November 2021, from a cohort of 3438 live births, 1763 babies were screened for jaundice; 2% (34 babies) required immediate phototherapy, 1337 (76%) infants were discharged with normal follow-up and 392 (22%) were identified as high-risk, requiring closer monitoring. Of the high-risk babies, 14 (3.5%) infants later required readmission for phototherapy. The median length of stay was shorter in this group compared to the median length of stay in readmissions for phototherapy prior to our intervention. We have found a statistically significant reduction in the need for admission for phototherapy in the intervention group 34/1000 live births in our unit compared to 15/1000 live births (p = 0.02).

Conclusion: We conclude that TCBR screening before discharge can identify a proportion of jaundiced infants missed by clinical assessment alone. Closer monitoring and feeding support have resulted in a reduction of infants needing phototherapy. Due to its resource implications, a cost effectiveness study needs to be undertaken before recommendations for wider scale adoption can be made.

 

Keywords: Monitoring; Jaundice; Infants; Phototherapy

Citation: Claudia Chetcuti Ganado., et al. “Improving Monitoring and Treatment of Jaundice in Term Infants Discharged from the Postnatal Ward: A Quality Improvement Project”. EC Paediatrics 11.6 (2022): 03-09.

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