Neonatal Intensive Care Audit

Prematurity is defined as born before 37 weeks of gestation and has a world estimate of 9.6% of all live births. One to 2% of the preterm infants are born before 32 weeks of gestation or have a birth weight below 1500g. This group contributes disproportionally to the burden of mortality and morbidity related to prematurity. Fifteen to 25 % of the surviving infants will present neurodevelopment or physical impairment. Main complications are cerebral palsy, cognitive impairment, neurosensory function alterations, behaviour, attention deficit and hyperactivity disorders and pulmonary insufficiency. Furthermore an increasing number of diseases in adulthood like cardiovascular diseases or obesity have their origin in the pre- and perinatal period. Prematurity combined with growth retardation favors appearance of those diseases in later life. Continuous improving of neonatal care is a major issue in public health. At the level of an individual neonatal intensive care unit, one of the strongest tools for improvement is benchmarking with other units. There is an international consensus on the registration of relevant items on the very preterm infants to make comparisons available. Benchmarking and feedback to the units helps them in understanding their performance. In Belgium the national neonatal network has been implemented through a Royal Decree (15-2-1999) describing the tasks of the Colleges of Physicians and depending on the Ministery of Health. The Colleges have to define quality indicators and evaluation criteria which have to be registered electronically. The first College of Physicians in Neonatal Intensive Care (NIC) was nominated in 2004. Participation is on a voluntary basis but recommended by the health authorities. In 2008 we introduced a new software (eNewborn) which is a unique state of the art web application allowing online benchmarking and reporting (demo www.enewborn.org). Since then the participation increased to 100% in 2011 and is maintained. Items are entered online or by uploading of files. Two sets of items are registered: items related to neonatal characteristics and evolution during NIC hospital stay Intensive and Items for the European registration (Euroneonet/e-Newborn). The set of items for nosocomial infections (Neokiss) is described apart. The items for nosocomial infections and the Follow-up items and Database are described as a separated project.