PAT I ENT MONI TORING
Improving safety for neonatal patients
East Kent Hospitals University Foundation Trust has improved safety for neonatal patients and transformed workflows, by implementing an Sp02 dashboard.
What started as a project to clarify inconsistent SpO2 data during patient transfers has triggered a workflow revolution for the Special Care Baby Unit (SCBU) at Queen Elizabeth The Queen Mother Hospital (QEQM). Working with Mindray’s clinical applications team to create an oxygen therapy tool tailored to its neonatal requirements, QEQM has cut the average length of stay for patients, delivering babies back to parents faster than ever. Oxygen saturation levels is one of the key parameters measured in the SCBU, requiring consistent data throughout the baby’s journey from the High Dependency Unit (HDU) to the SCBU. Current National Institute for Health and Care Excellence guidelines place target saturation levels at between 91% and 95% for preterm babies, with anything lower than 91% posing an increased risk to mortality.1 So, when the unit began to see differences in SpO2 data after transfers, it knew a more precise oxygen therapy tool was required. After an initial trial period, QEQM received eight Mindray ePM patient monitors for the SCBU as part of a Trust- wide purchase by East Kent Hospitals University Foundation Trust. As well as delivering more accurate and substantiated saturation data than the previous machines, the ePM devices also offered customisable neonatal monitoring. During the installation the devices’ neonatal dashboards were configured to meet the unit’s unique oxygen therapy needs, allowing staff to track patient performance for longer and in greater detail.
Tracey Twyman, ward manager for East Kent Hospitals University NHS foundation Trust (second from left), with the QEQM neonatal team
Reducing the need for sleep studies
When a baby remained on oxygen for an extended period of time, the SCBU would carry out an in-depth study for the affected neonate, which would often have to be repeated for accuracy. These studies would often last an average of four days each and involve posting data to the unit’s sister site for downloading and analysis. This meant the average length of stay for affected babies was eight days, totalling £3,200 per baby.
The new neonatal saturation screen has significantly reduced the number of formal sleep studies we are performing. It has enabled us to wean babies from oxygen safely and more effectively and has meant babies do not have to remain in the unit for longer than necessary. Tracey Twyman, ward manager, East Kent Hospitals University Foundation Trust.
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The new devices have since helped generate a 95% reduction in time- consuming sleep studies, delivering an estimated cost saving of £32k per annum. QEQM performed 22 studies in 2019 but has only carried out one so far in 2020. This sharp decline in studies is a result of the ePM’s specialised neonatal dashboard, as Tracey Twyman, ward manager for the Trust, explained: “The new neonatal saturation screen has significantly reduced the number of formal sleep studies we are performing. It has enabled us to wean babies from oxygen safely and more effectively and has meant babies do not have to remain in the unit for longer than necessary.”
A specialised oxygen therapy tool QEQM worked closely with Mindray to create its own unique goal management tool for oxygen therapy on its new monitors. The personalised neonatal dashboards now allow the consultants to make discharge decisions at the bedside, collecting all the saturation data they need into one screen. The ability
NOVEMBER 2020
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