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Neonatal jaundice [CG98]

Measuring the use of this guidance

Recommendation: 1.1.1

Offer parents or carers information about neonatal jaundice that is tailored to their needs and expressed concerns. This information should be provided through verbal discussion backed up by written information. Care should be taken to avoid causing unnecessary anxiety to parents or carers. Information should include: • factors that influence the development of significant hyperbilirubinaemia • how to check the baby for jaundice • what to do if they suspect jaundice • the importance of recognising jaundice in the first 24 hours and of seeking urgent medical advice • the importance of checking the baby's nappies for dark urine or pale chalky stools • the fact that neonatal jaundice is common, and reassurance that it is usually transient and harmless • reassurance that breastfeeding can usually continue

What was measured: Patients/carers who received written information about the condition
Data collection end: August 2011
75%
Area covered: Local
Source: Ravindran R & Ashraf T (2012) Audit on Management of Neonatal Jaundice. Archives Disease in Childhood. Vol 97. Suppl 2 pA378


Recommendation: 1.2.1

Identify babies as being more likely to develop significant hyperbilirubinaemia if they have any of the following factors: • gestational age under 38 weeks • a previous sibling with neonatal jaundice requiring phototherapy • mother's intention to breastfeed exclusively • visible jaundice in the first 24 hours of life

What was measured: Babies checked for one of the risk factors for jaundice-whether baby’s previous sibling had jaundice requiring treatment
Data collection end: August 2011
15%
Number that met the criteria: 7 / 48
Area covered: Local
Source: Ravindran R & Ashraf T (2012) Audit on Management of Neonatal Jaundice. Archives Disease in Childhood. Vol 97. Suppl 2 pA378


Recommendation: 1.2.15

When measuring the bilirubin level: • use a transcutaneous bilirubinometer in babies with a gestational age of 35 weeks or more and postnatal age of more than 24 hours • if a transcutaneous bilirubinometer is not available, measure the serum bilirubin • if a transcutaneous bilirubinometer measurement indicates a bilirubin level greater than 250 micromol/litre check the result by measuring the serum bilirubin • always use serum bilirubin measurement to determine the bilirubin level in babies with jaundice in the first 24 hours of life • always use serum bilirubin measurement to determine the bilirubin level in babies less than 35 weeks gestational age • always use serum bilirubin measurement for babies at or above the relevant treatment thresholds for their postnatal age, and for all subsequent measurements • do not use an icterometer.

What was measured: Babies who had transcutaneous biblrubinometry used
Data collection end: August 2011
82.9%
Number that met the criteria: 29 / 35
Area covered: Local
Source: Ravindran R & Ashraf T (2012) Audit on Management of Neonatal Jaundice. Archives Disease in Childhood. Vol 97. Suppl 2 pA378



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