Background

20% of admissions to UK Neonatal Intensive Care Units (NICU) involve babies 34+0 to 36+6 weeks gestation. Enabling babies to stay with mums improves perinatal experiences, bonding and breastfeeding rates.

Objectives

We aimed to assess common reasons for late preterm admissions to our unit, average length of stay, and barriers to earlier discharge. We wanted to assess whether enhancing Inreach support and home nasogastric tube-feeding packages could help prevent or shorten late preterm NICU admissions.

Methods

Using Badgernet we collated information on all admissions of 34+0 to 36+6 babies admitted to NICU over a 3 month period.

We deemed admissions potentially preventable if:
• routine admission <35/40 or <1.8kg
• no respiratory support required; needed feeding support or thermoregulation alone
• hypoglycaemia where blood sugar was always >1.0mmol/L

Results

61 babies born at 34+0 and 36+6 weeks were admitted from October to December 2017; 47% were 34/40.

The commonest reasons for admission were:

• Respiratory distress (31)
• Routine admission <35/40 (8)
• Surgical (5)
• Birth weight <1.8kg (4)
• Hypoglycaemia (3)

We subsequently deemed 14 admissions potentially preventable. A further 8 could have been shortened, whereby babies required respiratory support initially but then spent on average 10.5 days in SCBU for feeding support.

Conclusion

With enhanced Inreach care, home tube-feeding packages, optimal thermoregulation and hypoglycaemia management, we estimate 199 “special” or “normal care days” could be saved every 3 months. We’ll explore the possibility of expanding Inreach support, and re-audit one year from launching our home tube-feeding package for well NICU babies.