National Healthcare Group Polyclinics1
Serum bilirubin (SB) test is one of the most frequent reasons for blood sampling in neonates. Previously, a “heel prick” (SB) test was ordered for every neonate for Neonatal Jaundice (NNJ) assessment. With the introduction of Transcutaneous bilirubin (TcB) measurement, a non-invasive test for measuring bilirubin level, we can identify jaundiced neonates who require SB measurement, thereby reducing the number of invasive SB tests required.
TcB measurement is proven as a safe screening test to identify babies who need a SB test. Retrospective data of 954 visits from Nov 2018 to Mar 2019 of neonates aged 0 to 14 days; who went through both TcB and SB were audited. The correlation between TcB and SB was 0.722, comparable with data from KKH and NUHS. By using TcB cut-off readings to trigger SB measurement in high-risk neonates based on 80% of the phototherapy and exchange transfusion threshold, safety was assured as no visits were missed.
Results from 23 Oct 2018 to 31 Mar 2021 Safe – TcB measurement is a safe screening test to identify babies who need a SB test
Effective – Reduce unnecessary SB tests by 66.7%
Efficient – $124,849.80 in cost savings achieved
Patient-centred – Better patient and caregiver experience
TcB is a useful screening test for monitoring neonates with NNJ in NHGP. The introduction of TcB screening, as part of a comprehensive evaluation and follow-up program in the management of NNJ neonates, has resulted in significant improvements in patient experience and cost reduction.