PA.03 EFFECT OF A NEONATAL OUTREACH TEAM ON DISCHARGE OF PREMATURE BABIES FROM A SPECIAL CARE BABY UNIT

E. Wood², K. Turnock¹, M. E. Campbell¹. ¹NICU, Guy’s and St Thomas’ NHS Foundation Trust, London, UK, ²Neonatal Outreach Team, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

Background: Length of stay is used as a performance measure in healthcare. Length of stay for preterm babies is determined by physiological maturity; however, the ultimate discharge day may be affected by availability of community support.

Aims: To audit the impact of a nurse-led 7-day neonatal outreach team (ORT) on discharge weight and discharge delay in babies on the special care baby unit (SCBU) at St Thomas’ Hospital.

Methods: We prospectively audited all SCBU admissions <36 weeks’ gestation between 1 January and 31 March 2005 and in 2007 after the establishment of the ORT. Birthweight, gestational age, discharge weight and discharge delay were documented. Delay was defined as a 24-hour period when the baby no longer required either SCBU medical or nursing input.

Results: We identified 50 babies in 2005 and 60 in 2007 who were discharged home from the SCBU. There were no differences in gestational age or birthweight between the two groups. In 2007 median (interquartile range) discharge weight was significantly lower at 1920 g (1786–2150) versus 2055 g (1910–2265), p = 0.014 and fewer babies (21.7 versus 48%) experienced any discharge delay, p<0.01.

Unnecessary bed days decreased (157 versus 79) with an average delay of 2.1 days in 2005 compared with 0.74 in 2007 (p<0.001), with no re-admissions within 48 h due to discharge failure.

Conclusions: The development of the neonatal ORT significantly reduced discharge weight and discharge delay in premature babies in the SCBU. This team plays a central role in promoting early discharge and improving the efficiency of SCBU cot utilisation.

PA.04 A WORKFORCE FOR THE 21ST CENTURY: AN EVALUATION OF ADVANCED NEONATAL NURSE PRACTITIONERS

S. Smith¹, P. Wagstaff¹, M. …