Scope Of Care
- Still require NGT feeds until full oral feeding is established (not long term NGT)
- Require repeat/routine neonatal bloods
- Are on phototherapy
- Have not established a substantive weight gain pattern in hospital
- Require regular monitoring of withdrawal medication (in alternative care only)
- Oxygen dependant babies and those who require neuro disability monitoring are seen in the community by CDDFT paediatric nurses and community paediatricians
- Intravenous antibiotic therapy
- Blood glucose monitoring for infants of diabetic mothers, low / high birthweight babies and babies of mothers who have had labetalol antenatally
- Any baby discharged to the postnatal ward from the NNU will be monitored on transitional care for at least 24 hours
Northern Neonatal Network Care Pathways – October 2017
County Durham & Darlington NHS Foundation Trust – University Hospital of North Durham & Darlington Memorial Hospital
Scope of care
County Durham & Darlington NHS Foundation Trust provide neonatal services on two sites – at the University Hospital of North Durham (UHND) and Darlington Memorial Hospital (DMH). The Units at Darlington and Durham also receive referrals from the Midwifery-led Unit at Bishop Auckland General Hospital, which now no longer provides inpatient Special Care/neonatal services, although the delivery numbers are included in statistical returns from Darlington, as well as obstetric ante-natal transfers where non-intensive care in anticipated and the mother can be safely moved. There is a high degree of collaboration and co-operation between the two Units and both are overseen by the same Divisional/Directorate management team as well as the Lead Consultant Paediatrician, who clinically oversees both sites. There is also a rotation system in place for the nursing staff.
The current services provided on each site are as follows;
SCBU, Darlington Memorial Hospital
Current Unit capacity
12 Special Care cots.
Annual number of deliveries
2030 (April 2016 – March 2017 figures).
Annual number of admissions
218 (April 2012 – March 2013 figures).
Current threshold for routine ante-natal transfers
Generally obstetricians will try to transfer < 30/40 gestation mothers to a Level 3 NICU hospital, or < 32/40 weeks gestation if a multiple pregnancy.
Current threshold for routine post-natal transfers
< 28/40 are routinely transferred to a Level 3 NICU for Intensive care.
Other thresholds for routine post-natal transfer
Babies who can be cared for and requiring investigations that can be undertaken at Darlington will usually not be transferred. Examples of those who we will require transfer include: babies requiring ventilation, Cardiac/surgical assessment/intervention before discharge, babies requiring Long lines & TPN, Exchange transfusion, Intensive treatment for HIE, babies with Metabolic disorders requiring specialised treatment and also any baby identified as requiring transfer after discussion with regional colleagues.
Routine investigations/tests/screening currently undertaken
ROP screening, MRI, CT scans, ECG, Cardiac scans (simple).
Surgical procedures undertaken or post-surgical care provided if not?
No surgery is currently provided at Darlington.
Cooling for H.I.E undertaken?
The NNU is currently passively cooling babies prior to transfer to a NICU for active cooling if required/indicated.
T.P.N. provided on-site?
No all babies requiring TPN are transferred to regional services.
Neonatal community outreach team/services provided?
Both CDDFT units operate an outreach service across the county supporting discharged babies who:
Transitional Care provision on-site?
Comprehensive transitional care provision with designated baby support workers support both neonatal nurses and midwives to identify appropriate babies requiring transitional care and any extra support for vulnerable babies. The current criteria for transitional care includes: