Rahila AL Balushi
Royal Hospital , OmanPresentation Title:
Early Recognition and Management of Newborn Jaundice admitted in Maternity Unit
Abstract
Background: Newborn Jaundice (Hyperbilirubimia) is very common affecting approximately 60 percent of term newborns and 80 percent of premature babies. However, some condition like prematurity, infection, certain blood disorders can lead to a rapid accumulation of bilirubin to toxic level and long hospitalization.(NICE 2023). In Our Hospital the treatment will start after 24 hours from birth after pediatrician examination the sample of jaundice screening will be collected and sent to confirm the newborn jaundice, after tracing the result the photo therapy will be started for required babies. Due to this long process cause high level of serum bilirubin rate in the blood so, the baby will be kept even under double to triple photo lights at once and transferred to NICU for capsule treatment then exchange blood transfusion. Therefore, the demand of equipment like incubator and photo lights increased and usage cannulas and samples bottles were doubled, led to work overload for staffs, chances of long hospitalization from five to seven days, risk of infection increased with reduce satisfaction and cooperation from parents. So, it’s affected the cost of the hospital a lot.
Purpose: To detect newborn jaundice by early recognition and management through bilirubinometer and phototherapy management.
Methods: This project was conducted at largest tertiary hospital in Oman from February 2023 to November 2023. Included all newborns were admitted in postnatal wards except NICU admission babies and those already on photo light due to pathologic disorder like ABO incompatibility, Blood Disorders, Congenital anomalies. Pre and post statistics maintained for findings and results. Total number of babies in sample was 600 babies. The Management process was started after 8 hours of birth of baby by using bilirubinometer to detect jundice level through neonatal jaundice graph without any cannulation and blood collection. The phototherapy treatment started just according jaundice level and continued to 24 hours. After that, a sample of SBR was sent to trace bilirubin level before discontinuing. Mother advised for continue exclusive breast feeding every 2 hours along formula milk if mother with less milk to prevent dehydration.
Findings: Out of 600 babies 67% of newborns were hospitalized more 48 hours of life before implementing the project (from Feb – Apr). After implementation (from May-Jul) the number of newborns hospitalized more than 48 hours of life decreased to 27%. However, the cost of single jaundice screening was calculated it is 5.33$, so the total amount coasted for 67% of newborns before project with long hospitalization was 10909.9$ and after project for 27% of newborns coasted 1402.60$. so, the project shown a huge impact on early detection and management of neonatal jaundice and a great lean management for the hospital resources.
Conclusion: Early detection and recognition of newborn jaundice is an effective method for early management and discharge of patient.
Biography
With an experience of 15 years
as staff nurse / Midwife, I am working at Royal Hospital, the biggest Hospital
in Oman as a tertiary hospital which received all high risk cases all over
Oman. I have graduated from Muscat Nursing Insatiate in Oman as staff nurse in
2009 and from Oman Specialized Nursing Institute as a Midwife in 2013. I have
been working Maternity Unit with different experiences as staff nurse, Senior
Nurse, Shift In charge, Midwife and Ward In charge for the last 12 years. Then
from 2023 till today acting 2nd Deputy of Head Unit Nurse of
Maternity department along with responsibilities of Ward Nurse in Postnatal
Ward of Maternity Unit. Have an experience to work with different committees in
Royal Hospital in creating and updating policies, analyzing the unit incidents,
part of career development and moderator and organizer for certain events in
the department.
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