1139 Prolonged Rupture of Membranes in Term Infants: Should All Babies Be Screened?

Background: Prolonged rupture of membranes is a major risk factor for early onset sepsis in neonates. In Northern Ireland there is no consistency on the management of this problem and individual clinical guidelines vary widely between neonatal departments. A present in Craigavon Hospital all term babies born with prolonged rupture of membranes have screening bloods performed. Setting: The neonatal department of Craigavon Hospital a district general hospital in Northern Ireland. Objectives: To determine if the current guidelines are being followed and to try and determine if the decision on whether to perform screening bloods was left up to the individual doctor's clinical judgement, would they make a safe decision. Design: A prospective audit was carried out between October 2008 and January 2009. Results: At present there is 100% compliance with the current guidelines and there is evidence that if the decision of whether to perform screening bloods is left up to the individual doctor's clinical judgement, they will make a sensible decision based on the infants risk factor assessment. None of the infants that the doctor decided they wouldn't screen, if it were not the policy to have done so, would have come to any harm if they hadn't had screening bloods performed. Conclusion: Combining the results of the audit and the availability of nationally recognised guidelines it was decided to adopt the NICE guidelines in Craigavon Hospital. To help facilitate this change a Neonatal Early Warning Score observation chart has been developed to record the observations recommended by NICE.