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ACR – Neonatal Assoc Professor Nicola Austin CDHB

ACR – Neonatal Assoc Professor Nicola Austin CDHB. Overview. SURPRISES Term Admissions Near term admissions Very preterm morbidity Outcomes. Surprises. Lower admissions 2017/18 and occupancy 93% 852 in 2018 - counted if stay over midnight. Term admissions.

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ACR – Neonatal Assoc Professor Nicola Austin CDHB

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  1. ACR – Neonatal Assoc Professor Nicola Austin CDHB

  2. Overview • SURPRISES • Term Admissions • Near term admissions • Very preterm morbidity • Outcomes

  3. Surprises • Lower admissions 2017/18 and occupancy 93% • 852 in 2018 - counted if stay over midnight

  4. Term admissions • Drivers ……. Look in the labour and birth section • Timing

  5. Term admissions • Drivers ……. Look in the labour and birth section • Type of delivery Emergency caesarean (n=793) for fetal distress 25.3% and obstructed labour 53.2%

  6. Term admissions • Drivers ……. Look in the labour and birth section • Acuity ? Reason for induction

  7. ACR data compared with Clinical indicator 20

  8. Near term admissions

  9. What about the term and near term cared for on the postnatal ward? • Transitional care …….. No data • New categoury in Neonatal service specification for ratification • 35/36 wk in NICU 99+8=107, PN =197

  10. Very preterm morbidity- Prevention

  11. Very preterm morbidity • Respiratory support • Chronic Lung Disease • Retinopathy • Intraventricular Haemorrhage • Sepsis • Feeding • Neurodevelopmental Outcome

  12. Very preterm morbidityRespiratory support

  13. Very preterm morbidityChronic lung disease

  14. CLD – management

  15. Very preterm morbidityReduced Retinopathy and Intraventricular Haemorrhage 1

  16. Very preterm morbidityInfection 7 • 10 Early onset – Gp B Strep 4, E coli 4 (30-34w) • 7 CLABBSI / 25 Late onset sepsis • Coagulase negative staphylococci 4 / 8 • NEC reduced since probiotics in 2011

  17. Feeding at discharge from NICU

  18. Neonatal outcome

  19. Conclusion • Large range of data and outcomes • Drivers of neonatal admissions • Missing data on transitional care babies on PN • Kapai • Questions

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