Online in Time? An audit of Postnatal Neonatal Hospital Registration

Background: After birth neonates’ demographic details are registered onto hospital software. Delays in registration are common due to various reasons including poor bed state and staffing. Such delays result in the inability to order urgent investigations if the need arises.

Objective: The aim of this audit is to determine the time to hospital registration for neonates, with a view to planning interventions to decrease this parameter. A literature review concluded that this a novel audit and therefore there are no previous standards to compare to.

Method: Time of birth and registration were collected from physical and electronic medical notes. Time to registration was calculated and subdivided according to time blocks (24 hours). Results were compared between different postnatal wards. A mean and median time to registration was calculated.

Results: Data was collected from 726 neonates born from 1st August 2019 until 30th September 2019. 7 neonates were excluded from the audit due to insufficient data. The average time to register a neonate was 290 minutes (95% CI 270 to 310) and median time 182 minutes. 22 (3.02%) registered within one hour, 335 (45.95%) between 1-3 hours, 219 (30.04%) between 3-6 hours of birth, 73 (10.01%) between 6-12 hours, 62 (8.50%) between 12-24 hours and 18 (2.47%) more than 24 hours after birth.

Conclusion: When neonates are unwell in the postnatal wards, on-call staff may require investigations on which subsequent management may rely, these investigations are booked via the electronic hospital system. Additionally national congenital screening programmes are booked via the same system. When neonates are not registered on the hospital-wide online software, investigations and therefore management are delayed, compromising patient safety.

The authors have nothing to declare.