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• W4381164319 abstract "<h3>Objectives</h3> To examine whether the tertiary neonatal intensive care unit (NICU) and sister special care baby unit (SCBU) are attaining best practice in the management of neonatal hypoxic ischaemic encephalopathy (HIE) To identify areas in which practice could be improved To inform the planned update to the departmental guidance on HIE <h3>Methods</h3> A list of infants admitted to the NICU and sister SCBU over a 14 month period with a diagnosis of HIE was obtained retrospectively from BadgerNet. Infants at risk of but not diagnosed with HIE, and infants not admitted to the unit were not captured. Data was obtained from electronic clinical systems, predominantly BadgerNet and Metavision. <h3>Population</h3> All infants admitted to the NICU or sister SCBU with a diagnosis of HIE (as recorded on BadgerNet) <h3>Timescale</h3> A 14 month period inclusive of May 2020 – June 2021 Management was compared to standards set out in the BAPM Framework for Practice¹ <h3>Results</h3> 16 babies were initially identified. 2 were excluded from some data collection due to management of HIE elsewhere, and a further 3 could not be fully audited due to the online record systems not being used at the sister SCBU at the time of their birth. <h3>Key findings</h3> Only 3/7 (42%) born at the NICU or sister SCBU had a formal neurology examination documented within the 1st hour of life, with mean time to first neurology examination 2 hours 24 minutes. Documentation of this examination was also inconsistent and incomplete in every case. 10/13 (77%) babies treated with TH had a neurological assessment documented somewhere in their clinical record on every day of cooling. In only 7/14 (50%) of instances could time to target temperature in therapeutic hypothermia (TH) be established retrospectively. No babies had documented aEEG prior to commencing TH, 7/14 (50%) of babies had a documented CruSS within 12 hours of life, 8/10 (80%) eligible babies had an MRIB at 5–15 days, and 4/9 (44%) eligible babies had documented hearing screening before discharge. In only 3/9 (33%) of eligible babies was a discussion with parents about prognosis documented before discharge. <h3>Conclusions</h3> Documentation was inconsistent and difficult to access with multiple areas of best practice potentially being missed or underperformed. In response to these findings new clinical guidelines were produced based upon the BAPM Framework.¹ The figure ‘Flowchart 1’ is an example featured within these guidelines, supporting assessment of criteria for TH. <h3>Reference</h3> Therapeutic Hypothermia for Neonatal Encephalopathy: A Framework for Practice, BAPM, December 2020. https://www.bapm.org/resources/237-therapeutic-hypothermia-for-neonatal-encephalopathy" @default.
• W4381164319 created "2023-06-20" @default.
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• W4381164319 date "2023-06-19" @default.
• W4381164319 modified "2023-09-27" @default.
• W4381164319 title "821 Neonatal hypoxic ischaemic encephalopathy: audit of practice in a tertiary neonatal unit using BAPM Framework for practice (December 2020)" @default.
• W4381164319 doi "https://doi.org/10.1136/archdischild-2023-rcpch.261" @default.
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