Jaundice Early Neonatal ( <14 days ) Community based Management

Publication: 15/05/2004  --
Last review: 13/09/2018  
Next review: 13/09/2021  
Standard Operating Procedure
CURRENT 
ID: 407 
Approved By:  
Copyright© Leeds Teaching Hospitals NHS Trust 2018  

 

This Standard Operating Procedure is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

Community based Management of Early Neonatal Jaundice (<14 days)

These guidelines refer to early jaundice. For any prolonged jaundice (i.e. jaundice beyond 14 days of life) you must refer to the Prolonged Neonatal Jaundice - Management in the Community  protocol.

Hospital

If a baby requires an early serum Bilirubin (SBR) after transfer to the Community, ward staff must liaise with the mother’s Community Midwife to see if it is feasible for her to do the SBR.

  • if the Community Midwife can do the test, then ward staff must send the following with the mother on transfer to the Community
    • clinical biochemistry form (not form for prolonged jaundice !) including time of birth and gestation in clinical details, and mothers contact number.
    • use microtainer amber tube
    • the ward midwife will be responsible for checking and acting on the result.
  • the parents must bring their baby to THE WARD FROM WHICH THEY HAVE BEEN DISCHARGED in the following circumstances:
    • heavy workload for Community Midwife
    • inability to access shuttle service
    • Saturday, Sunday, Bank Holiday = no shuttle service

→ the test will then be performed by the ward Midwife, who will be responsible for acting on the result.

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Community

If the Community Midwife feels a baby requires an early SBR, the Community Midwife must liaise with the on-call general paediatric (not neonatal) registrar to discuss the case prior to performing the test. The paediatric registrar can be contacted though the hospital switchboard or via the CAT SpR phone 3923927 or failing this the 24hr ward clerk on 3927409.

  • If it is feasible for the Community Midwife to perform the test, then Community Midwife can do the test
  • in the following circumstances the baby should attend phlebotomy at the LGI (B Floor Martin Wing, 8.30-16.30 Mon-Fri), with a completed request form, for blood testing or the children’s assessment unit (CAT) out of hours. The paediatric registrar will advise where the family should attend.
    • heavy workload for Community Midwife
    • inability to access shuttle service
    • Saturday, Sunday, Bank Holiday = no shuttle service

  • In all cases the following information is required
    • Name of baby, NHS number and date of birth
    • Time of Birth and Gestation at birth (to allow result to be plotted accurately)
    • Patients address
    • Name and contact telephone number of mother (in case treatment required)

If the test is carried out  by the midwife or in phlebotomy the community midwife is responsible for following up the results. The registrar is responsible for following up results done in the CAT unit.

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Laboratory

  • Laboratory will contact the paediatric registrar, via CAT unit, with contact details of parent (from the form) for all non-inpatient bilirubin results  >300 mmol/L. (Treatment threshold line for term baby). Paediatric registrar will then contact family to arrange admission and treatment.

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Flow-chart

Provenance

Record: 407
Objective:
Clinical condition: Jaundice Early Neonatal ( <14 days )
Target patient group: Newborns
Target professional group(s): Health Visitors
Primary Care Nurses
Secondary Care Doctors
Secondary Care Nurses
Adapted from: N/A

Evidence base

NICE quality standard [QS57] - Quality statement 2: Measurement of bilirubin level in babies more than 24 hours old

Document history

LHP version 1.0

Related information

Not supplied

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