Dramatic reduction in babies born with brain damage

Friday, 6 February 2009

North Bristol NHS Trust has seen a dramatic reduction in the number of babies born with brain damage thanks to an innovative way of applying guidelines by the maternity team at Southmead.
Figures show the significant sustained decrease in the number of babies who have suffered from brain damage or had to be resuscitated after birth. From the table below the implementation of the new guidance can clearly be seen in the difference of numbers from January 2001.
January 1998 – December 1999: brain damage per 10,000 births = 27.3
January 2001 – December 2003: brain damage per 1,000 births = 13.6
January 1998 – December 1999: needed resuscitation at birth per 10,000 births = 86.6
January 2001 – December 2003: needed resuscitation at birth per 10,000 births = 44.6
Dimitrios Siassakos, Clinical Lecturer, said: "Delays in recognising and taking action when a baby is in difficulty could lead to long-term neurological impairment.
"At North Bristol NHS Trust we introduced a compulsory multi-professional training course for all maternity staff to improve interpretation of electronic fetal monitoring.
"We also developed a sticker checklist to use in maternity notes to ensure consistent reporting and a quick response when needed.

"We evaluated the effect by comparing results before and after the new guidelines which demonstrated significant improvements.
This wasn't about making a one off improvement - we have now developed a surveillance system that will rapidly detect periods of deteriorating standards using readily available, routinely collected, electronic patient data.
"Finally, we have continually updated our training material in line with further national recommendations.”
The maternity team led by Tim Draycott (Consultant Obstetrician), Dimitrios Siassakos, (Clinical Lecturer), Thabani Sibanda (Research Fellow) and Cathy Winter (Midwife) applied guidelines from the National Institute for Health and Clinical Excellence (NICE) to the maternity unit at Southmead Hospital. This resulted in a reduction in the number of babies born with brain damage.
In addition to the decrease in numbers, NBT won the overall shared learning award by NICE in recognition of the innovation in applying guidelines and developing monitoring systems to maintain good outcomes.
Val Moore, Implementation Director, at NICE said: "The NICE Shared Learning Award celebrates the best real life examples of how organisations have successfully implemented NICE clinical or public health guidance.
"On behalf of NICE, I would like to congratulate Dimitrios Siassakos and his team who are this year's overall and clinical category winner. Through implementing the NICE guidelines on intrapartum care, the team have worked together to target resources and efforts at areas that offer the most significant health improvement and achieved outstanding results.
"NICE is always interested to hear about how local organisations are putting NICE guidance into practice to help patients and communities."
NBT's levels have stabilised and are now at a much lower level than before and systems are in place to ensure that they remain at this low stable level.
The maternity team continue to monitor the unit's performance. Their work consists of a spiralled approach of multi-disciplinary good practice.