An Audit of the Management of Neonatal Jaundice in a Level 2 Neonatology Unit of a Maternity Hospital Against the 2023 NICE Guidelines

BackgroundIn Pakistan, neonatal jaundice is a common cause of neonatal morbidity.This audit was conducted to evaluate adherence by the local team to NICE (National Institute for Health and Care Excellence) guidelines in the management of neonatal jaundice in children under 28 days of life admitted to the Level 2 Neonatology Unit of Maternity Hospital and to identify any deviations from NICE guidelines regarding the assessment, monitoring, and treatment to improve care provided to neonates with jaundice. MethodsAround 46 neonates admitted and diagnosed with visually apparent jaundice or at risk of jaundice at the Neonatal Unit of Maternity Hospital were included from February 2024 to April 2024.We included data on history, clinical examination, serum total bilirubin measurements, and jaundice management and analyzed them using IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, NY, USA). ResultsWe included 46 neonates with a mean age of 3.17 ± 1.371 days, gestational age of 35.07 ± 2.768 weeks, and mean weight of 2.17 ± 0.677 kg.Visual jaundice was present in 91.3% (N = 42/46), but only 21.7% (N = 10/46) had serum bilirubin levels requiring phototherapy, with a p-value of 0.27.Interventions were proactive: 21.7% (N = 10/46) received phototherapy, and 52.2% (N = 24/46) had bilirubin monitoring.Risk factor documentation and follow-up plans were high: 87% (N = 40/46) and 84.8% (N = 39/46), respectively.Patient education was thorough, at 93.5% (N = 43/46).There was 54.3% (N = 25/46) adherence to NICE guidelines regarding serum bilirubin levels, need for phototherapy, bilirubin monitoring frequency, patient education, and follow-up plans in the local setup, compared with the 100% (N = 46/46) standard, emphasizing the need for improvement. ConclusionWhile the audit indicates satisfactory levels of guideline adherence in certain areas of neonatal jaundice management, it also highlights significant areas for improvement, which are crucial for optimizing care outcomes in the management of jaundice in neonates.