Development and Implementation of a State-wide Newborn Observation and Response Charts (Newborn project)
National standards stipulate that patient observation charts should identify thresholds indicating abnormal vital signs, such as respiratory rate, and incorporate a ‘track and trigger’ system to escalate care when deterioration occurs. Over the last three years the ViCTOR (Victorian Children’s Tool for Observation and Response) team have developed a set of standardised observation and response charts for use in paediatric patients aged 0 – 18 years, in both ward and urgent care settings (see www.Victor.org.au). The ViCTOR charts have been implemented in at least 55 Victorian hospitals. The benefits of a standardised approach to paediatric observations has been the earlier recognition of patient deterioration, clearer communication between wards and hospitals, and improvement in direct patient care throughout the hospital stay, including inter-hospital transfer. In Victoria, there is no standardised approach to newborn patient observation charting or identification of thresholds used to identify sick neonates.
The ViCTOR Newborn project aims to develop a standardised newborn ‘track and trigger’ observation and response chart (or charts) for Victorian newborn services that complements the existing suite of ViCTOR charts and will:
- Provide a consistent and standardised approach to recognising and responding to deterioration in the Victorian newborn setting
- Utilise best available evidence to inform trigger thresholds for escalation of care
- Build on existing Victorian nursery charts
- Build on existing ViCTOR chart design including, format and colours
- Link directly with the newly released Victorian newborn service capability framework
- Be piloted and evaluated in a range of newborn services
A range of experts consisting of neonatologists, paediatricians, midwives and nurses will be involved in the development of the chart/s. The charts will be piloted (August to December 2016) in 12 health services across the state, including Birth Suite, Postnatal, Special Care Nursery, Paediatric Wards and Emergency Department settings. Pilot evaluation is due to be completed March 2017.
Kinney, S., Moulden, A., & Sloane, J
Victorian Paediatric Clinical Network and the Victorian Maternity and Newborn Clinical Network, Department of Health and Human Services (2016-2017)