Keeping mothers and babies together: Reducing admissions into the Neonatal Intensive Care unit (NICU) at our Women’s Hospital
This week we spoke with Fiona Terry, our Neonatal Intensive Care unit Governance Lead and Dudu Nyathi, our Fetal Monitoring and Surveillance Midwife, representing the Avoiding Term Admissions into Neonatal Units (ATAIN) project team at our Women’s Hospital.
Launched by NHS Improvement in 2018, with aims to reduce term admissions into Neonatal units to below 5% of births per month. This only applies to babies born at 37 weeks or above. The aim of the ATAIN framework is to avoid unnecessary separation between the baby and mother.
Over the last year, we have seen consistent reductions in term admissions to our Neonatal Intensive Care unit (NICU), which is measured by the number of babies born at 37 weeks or more compared with the number of babies admitted to the NICU. This framework allows babies to be with their mothers on our post-natal and transitional care wards, to begin building important bonds and routines as a new family, reducing any harm that may be caused by separation.
Our team of clinicians have reduced term admissions by:
-
Providing warm care bundles and administering Glucogel for hypoglycemia
-
Feeding care plans to reduce jaundice
-
Revising our fetal monitoring training
Over the past 12 months, our fetal monitoring training has been revised and improved upon in line with the national publication ‘Saving Babies Lives Care Bundle’. This training has supported staff to improve their knowledge and care of women in labour, which results in the reduction of term admissions to our neonatal unit where fetal monitoring has been a contributory factor. 
The training looks into five key elements that can affect birth and pregnancy, leading to increased admissions to our Neonatal unit. By strengthening our training and knowledge of these factors, we have been able to preemptively address fetal wellbeing in a timely manner.
Our Fetal Monitoring and Surveillance Midwife spoke with us about the importance of additional checks to prevent unnecessary complications and harm during birth. Dudu Nyathi said: “Revamping the fetal monitoring training sessions has made a significant improvement in reducing the number of term babies admitted to our Neonatal unit, where fetal monitoring was a contributory factor.
“An understanding of basic fetal physiology helps us to individualise the care. Improving outcomes calls for timely identification and escalation of concerns, as well as focusing on the wider clinical picture, rather than making decisions based on CTG alone.”
This work feeds into ATAIN in reducing term admissions but is not directly part of ATAIN.
Fiona Terry said: “It is important to us that as many term babies (as possible) and their mothers are able to stay together so that they can make important family bonds as soon as possible.”
We’d like to say a big thank you to all of our clinicians working across Maternity and Neonatal to make these reductions in admissions a possibility. To learn more about ATAIN, visit our NHS England website here.