WHAT TO PREPARE BEFORE THE ARRIVAL OF THE NNTP
RED TEAM:
It would be a great assistance to the NNTP if, in conjunction with infant stabilisation procedures, the following checklist was prepared prior to the arrival of the team at the referring hospital:
- Complete NNTP Referral History Form as appropriate (Copies sent to all units and also available as download on this site).
Please include:- Maternal antenatal and perinatal records
- Neonatal records ( ie .history, diagnosis, treatment, orders, times drugs given, PKU, etc.)
- Relevant social history
- Parental contact information
- Consent to transfer ( NNTP consent forms are completed when NNTP team arrives)
- Make photocopies of relevant records and laboratory results (maternal & baby's)
- Make copies of X rays, if originals are to remain at the referring hospital
- Collect 10 ml of maternal blood in a plain tube and label appropriately (This is only necessary for some
accepting hospitals-please consult with NNTP team) - Ensure infant has two identity bands in situ
- Ensure that all infusions are administered via syringe pumps
- EBM for transfer with the infant should be placed on ice.
- Encourage parents to be present when NNTP team arrive in order to discuss the transfer and also to sign the NNTP Consent for Transfer and Treatment Sheet - if parents are unavailable then contact details are required in order to obtain a witnessed verbal consent
- Take photos of the infant for the parents
- Facilitate as much as possible that parents see and touch their infant
- If possible attend to any religious or cultural rites requested by the parents
- Identify appropriate support persons as necessary
After the NNTP Team Leaves
- Encourage and initiate expression if the mother wishes to breast feed
- Offer to call the receiving hospital and facilitate communication with the nursing and/or medical staff
BLUE TEAM:
To facilitate the timely transport of infants by the NNTP Blue team (Nurse led), the following checklist must be completed by the referring hospital prior to NNTP team arrival of the team. This helps to avoid delays and improves safety and efficiency.
o Bed in receiving hospital has been confirmed on day of transport
o Parents informed of transfer and given information about the NNTP (available on www.nntp.ie /parental section)
o Medical review completed on the day of transfer to verify the patient’s condition still safe for transfer
o Full medical and nursing handover to the receiving hospital completed over the phone by the referring team
o NNTP Referral History form completed and copied
o Hospital discharge summary completed and printed
o CD of all radiology images and reports (if referring and receiving hospital not both on NIMIS)
o All recent lab results (including blood type)
o Copies of all NBSS forms
o Copies of all eye screening
o Copies of the medication chart, fluid prescription chart, fluid chart and last 48 hours of clinical observation charts
o All patient history and notes accompanying the patient to be securely contained in a clearly labelledenvelope to maintain integrity and patient confidentiality
o If infant feeding with EBM: Fresh and frozen EBM stored according to HSE Expressed Breast Milk Handling and Storage Policy and clearly labelled with patient’s MRN, name, date of birth and date/time EBM expressed or defrosted[1]
o If infant feeding with formula: please ensure a bottle of formula is available for transfer
o Infant’s belongings are to be contained in one bag please, not to exceed 5kg
o Infant to be dressed appropriately for transport in an incubator
Just Before the NNTP arrives
o Check that two patient ID bands are present; each on a different limb
o Addressograph labels x 4 are available
o Patient observations documented within 1 hour of ETA of NNTP
o Patient is fed – patient should be fed as per feeding regime until contacted by NNTP to advise otherwise. Please note the feeding schedule for the journey will be decided by the NNTP nurse in consultation with the NNTP consultant on an individual basis
o Medications administered (also administer medications due during transfer as they cannot be administered during transport)
o If the need for an IV for the journey is advised by the NNTP on the referral call, please ensure this is inserted, secured and working prior to NNTP arrival
o IV fluids with ‘BBraun Infusomat Space’ giving set or sufficient fluids for transfer + 2 hours drawn up please, into 50mL syringes and appropriately labelled according to HSE Policy.
[1] Please note: The capacity to carry EBM is limited. Stock in excess of 48 hours supply will require alternative transfer arrangements to be made by the hospital and parents
RESPONSIBILITY OF CARE
- The stabilisation of the infant prior to transfer does not only begin when the transport team arrive at the
referring centre but rather is an ongoing process from when the transport is accepted. - It is the responsibilty of the referring hospital, in consultation with the transport team, to stabilise the infant before the NNTP arrive at the referring hospital.
- On arrival of the NNTP, the responsibility of care is shared between the referring hospital and the NNTP team.
- The NNTP teams keep records of any interventions they conduct, but the referring hospital should also keep their own records while the infant is still in the hospital.
- The NNTP is not a 'Swoop and Scoop' Service. The team must be satisfied that the infant is stable prior to transport and will carry out that which is necessary to stabilise the infant at the referring hospital. During this time the NNTP team rely on the staff at the referring hospital to work in collaboration with them (i.e. giving history, helping with procedures etc.).
- Consultant responsibility follows the same order as above. The transport team refer to the consultant on call in their parent hospital or with the receiving hospital.
