5953 Sats Sats Baby – Improving routine pulse oximetry screening on NIPE

Objectives Early pulse oximetry screening (POS) identifies babies with congenital heart disease (CHD) and other pathologies that without early detection could lead to postnatal collapse.1 POS is intended for well, asymptomatic babies and should ideally be performed at 4–12 hours of life. Routine POS was introduced on Newborn and Infant Physical Examination (NIPE) checks in Royal Jubilee Maternity Hospital Belfast in August 2022. Methods Snapshot audits were conducted on all of the postnatal wards to monitor adherence to the routine POS guideline. It was noted that there was an initial suboptimal completion of POS and further education sessions were provided to staff involved in NIPE checks. In addition, a new format of NIPE documentation was introduced with POS specified. A further snapshot audit was conducted after the implementation of these changes in May-July 2023. Data was collected including: SpO2 recordings at POS, age at POS, record keeping and the management of abnormal POS. Results Initial audit findings in October 2022 and December 2022 showed 60% (56/94) and 74% (76/103) of babies respectively had routine POS as part of NIPE checks. The re- audit in July 2023 following education sessions and changes to the NIPE documentation showed 96% (49/51) of babies had routine POS, with some postnatal wards achieving 100% compliance. Of these babies, 29% had POS in the first 24 hours of life, and 80% within first 48 hours of life. 2 babies were admitted to NNU with low SpO2 recordings and required further investigations including Chest X-Ray and echocardiogram; both were subsequently diagnosed with transitional circulation. No babies were diagnosed with critical CHD. Conclusion There has been significant improvement in compliance with routine POS as part of NIPE checks with staff training and the new documentation format. Although there have been no cases of critical CHD detected on POS to date, the screening test is now fully implemented with almost all babies (96%) receiving POS in our unit. Furthermore, most babies (80%) have their NIPE check completed within the first 48 hours of life. Reference Singh A, et al. The impact of routine predischarge pulse oximetry screening in a regional neonatal unit. Arch Dis Child Foetal Neonatal Ed. 2014;99:F253-F253.