1118 Implementation of a neonatal daily review sheet on a post-natal ward

Published Date: 11th October 2021

Publication Authors: Garr R, Scowcroft R, Vataha K

Background
The paediatric team review babies daily on the busy post-natal ward located within the maternity unit. It was noted that there was lack of clarity in the daily documentation regarding neonates. Current documentation was in a folder comprised of multiple documents written on randomly assorted continuation sheets. There is a daily rotation of medical and midwifery staff and not a formal multidisciplinary team ward round which leads to chaotic environment regards patient plans and discharges and potentially creates excessive work for senior staff members as plans and follow up plans not clearly documented.

Objectives
The objective of this study is to improve continuity of care and communication by implementation of a daily review sheet with aim to make documentation clear and provide guidance for daily review for junior doctors who frequently rotate.

Methods
We created a daily review sheet to be used on the post natal ward for neonates on the medical ward round. We created a pre implementation and post implementation questionnaire to be filled out by members the medical team to compare any subjective improvement the daily review sheet has made. The questionnaire contained 7 questions regarding whether staff thought different aspects of documentation and communication was clear with a suggestions/comments section. A Likert scale with questions ranked from 1 – 5 with 1 equal to agree and 5 equal to disagree, therefore 3 equals neither agree or disagree.

Results
14 members of staff filled in our questionnaire before and 12 after

Conclusions
The overall median value (table 1) for clarity of documentation, discharge and follow up plans, documentation of the newborn infant physical examination (NIPE) and antenatal paediatric alert (which notify antenatal problems) improved from 4 to 1 showing improvement in overall communication and facilitated daily reviews by structuring documentation, this could be further reviewed. There are recent reviews that recommend combined notes for medical and nursing/midwifery staff, so that important information is not lost between teams. A daily review sheet will greatly aid this process.

Garr, R; Scowcroft, R; Vataha, K. (2021). 1118 Implementation of a neonatal daily review sheet on a post-natal ward. Archives of Disease in Childhood. 106 (Supp 1), A235-A236

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