Neonatal nurses on the special care baby unit at Yeovil Hospital are now able to diagnosis and treat jaundice in newborns within minutes.
The success is the result of a service evaluation project run by senior sister Beth Hawken and staff nurse Eleonora Forbes, which investigated re-admissions of babies with jaundice.
Part of Somerset NHS Foundation Trust’s chief nurse research fellowship, the project initially explored the clinical journal of newborns readmitted to Yeovil Hospital with jaundice.
“We studied every aspect of their care pathway in great detail, from the moment they were re-admitted to hospital and the time they were reviewed by a doctor, to when their bloods were taken,” Beth explained.
“We wanted to find out whether any part of this process seemed to cause a delay for every baby we care for, and if there was a way that we could improve it.”
Following a case study and literature review, the pair discovered that one of the main reasons for a delay in treatment was the seven-hour blood sample journey, which they felt they could reduce.
“We found out we were actually already using this type of blood gas analysing equipment on our maternity unit, and one of the results shows the level of bilirubin in the blood – which is the main cause of jaundice,” Eleonora added. “The machine wasn’t calibrated for analysing the bilirubin level in small neonatal babies though.”
“From our earlier literature search, we found that some units did use this type of machine in neonatal care, so we contacted our biochemist consultant and asked whether we could do this with our machine.”
Following safety checks, the unit was given the green light to begin analysing bilirubin levels on their machine. This instantly reduced diagnosis and treatment times, and resulted in babies spending significantly less time on the unit.
“Sometimes if the jaundice gets so high, we aren’t able to treat it at YDH so the baby has to be transferred to Musgrove Park Hospital, or even Bristol Children’s Hospital, so starting it early can only be a good thing for everyone.”