Reducing neonatal admissions from home to the children's ward

Abstract

This retrospective study of neonatal hospital admissions from home to the children's ward in 2007/2008 and 2008/2009 was conducted to ascertain if admissions had increased and what the pattern of these reflected. The findings were that neonatal admissions had increased but not significantly. Admissions associated with jaundice and feeding problems were the first and fifth most frequent reasons for admission respectively, accounting for high numbers of baby-days in hospital. High proportions of admissions in both categories required no overnight stay or only one night stay. A large number of babies required admission into the children's ward in the first month of life. A large portion of these admissions were for jaundice (20%) and feeding problems (10%) and in each category, a short stay in hospital predominated. There is potential to avoid such admissions, which might be amenable to management at home under the care of the midwife. The use of bilirubinometers in community midwifery practice might help reduce admissions for jaundice. A number of areas for further research are recommended. An important question to be examined is whether there is an association between neonatal hospital admissions and reduced home visits by midwives. In addition, more focused review of case notes of selected categories of neonatal admissions would enable exploration of social, economic, medical and other factors associated with neonatal hospitalization.