Background Readmissions of infants younger than 28 days back into hospital are highly undesirable. It is upsetting for the families and puts babies at risk of hospital acquired infection. We have subjectively noted an increase in readmissions, so decided to research the number of readmissions and reflect on the factors associated with these
Objectives To study the number of readmissions in infants under 28 days into the paediatric wards, and to see whether there has been an increase compared to 2019. To compare the data between the hospitals in our region.
Methods The project was done as a retrospective study in 3 separate hospitals in Northern Ireland- Antrim Area Hospital, Craigavon Area Hospital and the Royal Belfast Hospital for Sick Children (RBHSC). We looked at the neonatal readmissions in infants under 28 days of age, we excluded infants needing intensive care after birth.
The timeline we studied was between 1st April and 1st July in 2020, which was the height of the first wave of the Coronavirus pandemic in Northern Ireland. We looked at the main reason for readmission in each infant, comparing the data with the readmission rates and causes in 2019.
We also looked at the NIMATS documents of the infants who were readmitted to establish their length of stay in the postnatal ward before discharge.
Results Overall, the number of neonatal readmissions varied among the three hospitals studied.
In Craigavon Area Hospital, the total number of readmissions was 50 in 2020, and 40 in 2019. This signifies a 20% increase in neonatal readmissions.
In Antrim Area Hospital, the total number of neonatal readmissions was 46 in 2020, compared to 62 in 2019.
The RBHSC, the tertiary centre, also noted a decrease of neonatal readmissions, from 37 in 2019 to 25 in 2020.
In regard to the length of postnatal ward stay, in all of the hospitals studied, it was reduced in 2020. In Antrim hospital, the mean length of stay in postnatal ward in the infants needing readmitted went from 44.3 hours in 2020, to 37.5 hours in 2019. In Craigavon, the mean length of stay in postnatal ward was 44.7 hrs in 2019, compared to 38.5 hrs in 2020. In the RBHSC, the mean length of stay was 45.2 in 2019 and reduced to 29.1 hrs in 2020.
The leading cause of readmissions was jaundice in both Craigavon Area hospital and Antrim Area hospital in 2020 and 2019.
Conclusions It was interesting to see such variation in neonatal readmissions among three hospitals in the same country.
There has been an overall increase of readmissions for infants with poor feeding, which could be explained by less support available for mums during the pandemic. This could have been due to overall shorter stay in the postnatal ward, dads not being allowed into the postnatal ward, and less frequent midwife visits.
A decrease of conditions such as bronchiolitis could be explained by less mixing of newborn infants with older children.
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