Newborn Hospital Transfer

7/28/2019 Newborn Hospital Transfer

1/4

Newborn Hospital Transfer 1 WACSClinproc4.20Oct-10

WACSClinProc4.20

Title: Newborn Hospital Transfer

Replaces: Newborn Transport Policy LGH 67- 96Description: Management of hospital transfer of newborns for medical careTarget Audience: Midwives, nurses, medical officers, WACSKey Words: Hospital transfer of newborns for ongoing medical care

Policy Supported: Royal Hobart hospital clinical practice guidelines &protocolsNeonatal Transfer GuidelinesTransfer and Perinatal Bed Finding GuidelineInter Hospital Transfer Policy and Guidelines

Purpose:Newborns are birthed and managed in a variety of centres across Tasmania. Newbornhospital transfer may be necessary when the newborn requires specialist care. Thechoice of centre for perinatal management should be based on the medical needs of thenewborn and family and the capabilities and resource availability of the centres. Thetransfer of newborns between centres should be the outcome of discussion between thesending and receiving consultants arriving at a mutually acceptable decision about thelocation, timing and method of transfer.

In utero transfer is the ideal but in the event of birth being imminent the NETS team can be

mobilised prior to birth. Efforts may be appropriate in some instances to attempt to delaydelivery until the NETS team arrives

Specific Points:1. For singleton newborns, without intrauterine growth restriction, the lowest gestation

that would ordinarily be cared would be:

Launceston General Hospital: 30 weeks

Mersey Community Hospital: 34 weeks

WPH: 32 weeks

Calvary Hospital Hobart: 34 weeks

2. The decision to transfer an infant is made by the Paediatrician, in consultation withthe newborns parents.

3. Admission and mode of transport to the receiving hospital is arranged by thePaediatrician and Clinical Nurse Manager or Nurse in Charge of Shift

4. For urgent cases requiring NETS transport, the Hobart Paediatrician on call willmake the arrangements.

5. The LGH Patient Travel Co-ordinator / After Hours Nurse Manager will assist withtravel and accommodation arrangements for the family.

6. If the infants mother still requires postnatal care, admission to a postnatal ward willbe arranged by the 4O staff.

NETS Transfer

LGH Paediatrician will contact the on call RHH Paediatrician 03 6222 8588

Launceston General Hospital

Clinical Guideline

SDMS ID: P2010/0387-001
http://intra.dhhs.tas.gov.au/dhhs-online/page.php?id=16562http://intra.dhhs.tas.gov.au/dhhs-online/page.php?id=16562http://intra.dhhs.tas.gov.au/dhhs-online/page.php?id=1470http://intra.dhhs.tas.gov.au/dhhs-online/page.php?id=1470http://intra.dhhs.tas.gov.au/dhhs-online/page.php?id=1470http://intra.dhhs.tas.gov.au/dhhs-online/page.php?id=16562


2/4


NETS transfer will be co-ordinated by the NPICU staff, who will advise of theexpected time of arrival to the LGH

LGH Paediatrician will discuss with the newborns parents the need for transfer.

Requirements for transfer include:

o Mothers blood (10 ml clotted)

o Cord blood (where available)

o Photocopy of infants case notes and mothers where appropriate.

o Referral letter from Paediatrician (keep a copy in history)

o Relevant x-rays (x-ray films may be sent with baby)

o Copy of laboratory data

o NETS consent form for transport and treatment (signed by parent)

o EBM, (keep cold in esky with ice pack)

o Completed blue PTAS form (Patient Travel Assistance form)

On arrival of NETS transport team to the unit there with need to be a medical andnursing hand over of care.

Notes and orders to be reviewed

All documentation is to be checked.

NETS consent form for transport and treatment check and signed

Parents notified and introduced to team members.

Assist the team to stabilise condition and prepare for transportation.

LGH Transfer of Unstable Newborn to the NNICU

In the event of our medical team needing to transport the infant, the paediatricregistrar or nurse will escort the infant, as clinically appropriate.

Ambulance transport to be requested by completion of Tas Ambulance Service

Long Distance Transfer Request form, and fax to (03) 62 308515 or phone 1800008 008

Contact Patient Travel Co-ordinator (7249) to arrange return transport for escort.After hours, contact AH Nurse Manager.

Contact Social Work Services for assistance with family travel and accommodationarrangements.

Transfer of a Newborn by Domestic AirlineContact Patient Travel Co-ordinator (7249) of After Hours Nurse Manager who willarrange:

Seat on airline for baby and escort (eg nurse and / or parent)

Hospital transport from QVMU to Launceston airport

Taxi voucher from destination airport to receiving hospital

Accommodation if necessary

Return of escort to Launceston airport and to LGH.

Complete RCH admission form

Blue PTAS form to be completed by paediatrician and to go with patient

Nursing transfer form

Medical fitness-to-fly form if required by airline (eg for oxygen)Relevant X-rays, lab data and copies of case notes.

Referral letter from paediatrician.


3/4


Nurse escort to have:

Photo ID for self.

Copy of flight details and hospital / taxi arrangements

Phone contact names and numbers for receiving hospital and transport service

Appropriate sized Laerdal bag and mask, and mucous extractor on the transport

Adequate feeding equipment for trip

Nappy changing equipment

Stethoscope

Change of infant clothing

Infants requiring SaO2 monitoring during transport are to be monitored using a pulseoximeter with adequate battery life

EBM is to transported in an esky with a freezer ice pack

Transfer to Other Northern Hospital by LGH Staff

Decision to transfer is made in consultation with paediatrician and the family.

The medical officer will consult with the receiving hospitals medical staff to arrange the

continued care of the neonate and confirm the mode of transport required.

Nursing staff will then arrange a date and time for transfer.

MRSA swabs to be taken if requested by the receiving hospital.

Nursing and medial transfer letters need to accompany the neonate. Copies can be

made of relevant medical information needed by the receiving hospital.

Patient travel request form is to be faxed to transport department. Transport services

will confirm if available for transfer. The mother may travel in the van with the neonate

if there is room. Transport will confirm this after receiving the referral.

Transport equipment is available including a double walled incubator with oxygen and

suction. Pulse oximetry should be considered.

The escort will remain with the neonate at all times.

Neonates nursed in incubators will have temperature, heart rate and respirations

documented every 30 minutes.

No neonate will have an oral feed during transportation. Consideration of feeding times

should be considered when organising the transfer.

If the paediatrician believes it is appropriate for the baby to travel by car with the

parents the staff will confirm with the parents that the appropriate child seat that meets

current Australian standards is fitted in the car. An adult escort apart from the driver

should be available to attend to the newborn.

Transfer to Calvary Postnatal Ward

Decision to transfer made in consultation with Paediatrician

Transfer date and time arranged with Calvary postnatal ward, in conjunction with

QVMU postnatal ward

Calvary staff will collect infant from 4N and complete transfer

Consent for Release of Information form to be completed by parent

Have ready copies of:

Obstetric summary


4/4


Nursing progress notes

Weight chart, percentile growth chart if premature

Observation / feed chart

Medication chart

Lab data

neonatal nursing transfer form (retain copy for history)

Perinatal data form

Personal Health Record

EBM (to be kept cold)

Performance Indicators: Evaluation of compliance with guideline to be achieved throughmedical record audit annually by clinical Quality improvementMidwife WACS

Review Date: Annually verified for currency or as changes occur, andreviewed every 3 years via WACS Reference groupcoordinated by the Clinical and Quality improvement midwife.June 2011

Stakeholders: Midwives and medical staff WACS

Developed by: Dr A Dennis Co-Director (Medical) Sue McBeath Co-Director(Nursing & Midwifery) Womens & Childrens Services

Dr A Dennis Sue McBeathCo-Director (Medical) Co-Director (Nursing & Midwifery)Womens & Childrens Services Womens & Childrens Services

Date: _________________________

Documents

Newborn Hospital Transfer