Discharging Babies with Down Syndrome: Improving Compliance with Guidelines

The Down Syndrome Medical Interest Group in UK and Ireland have guidelines suggesting safe standards of care for children and adolescents with Down Syndrome. We planned to create a checklist to improve compliance with these guidelines in a regional neonatal centre, and first audited historical compliance

Method: This retrospective review identified cases of babies with Down Syndrome from the Maternity Information System, in order to retrieve and review medical records. Anonymised data was analysed using a proforma.

Results: There were 20 babies diagnosed with Down Syndrome identified as part of the historical audit, all postnatally diagnosed with no antenatal concerns. Every baby had karyotype confirmation of their diagnosis of Down Syndrome, as well as referral to Early Intervention and Physiotherapy, TSH checked on Newborn Bloodspot Screening card and Newborn Hearing Screening. 90% (n=18) babies had cardiology referral before discharge. 35% (n=7) of babies were plotted on appropriate centile charts and only 25% of babies had ophthalmology referral completed. Early reports of checklist use (n=2) demonstrated 100% compliance.

Conclusions: Implementation of a checklist has the potential to improve compliance with guidelines for the medical discharge of babies with Down Syndrome.