Delivering better care for infants with brain injury

The team succeeded in establishing a regional neuroprotection care pathway for babies with HIE by:

• using existing infrastructure by working with the regional Acute Neonatal Transfer Service, the national cooling database and radiologists
• providing training by clinical nurse specialists in all 19 secondary care organisations in the region
• bringing together the neonatal and radiology communities to agree a standard protocol
• establishing family coffee mornings for parents of children with HIE and producing a family booklet and website
• developing a business case and securing funding for one clinical nurse specialist post to sustain the work long term.

Strong support from consultants at all three tertiary centres was critical for the success of this project.

Significant improvements were made on all key performance indicators for neuroprotection.

The project did face challenges which included:

• The fact that HIE occurs infrequently (1-2 per 1,000 live births) made it difficult to employ some common quality improvement techniques. It also meant there was little pre-knowledge among the units they were training.
• It was difficult to make a cost benefit argument because no specific budget would feel the benefits.
• Due to staff turnover, it was necessary to be more repetitive in training (repeating key messages) than initially planned.
• Engagement with families was delayed due to issues over ethical approval.

Who was involved?

The project was run by Cambridge University Hospitals NHS Foundation Trust in conjunction with the East of England Perinatal Network.

Dr Topun Austin, Consultant Neonatologist at the trust and clinical lead for the network, led the project team. The team was made up of health professionals and parents from across the east of England.