REFERENCES 1. National Institute for Health and Care Excellence (2020) Neonatal Parenteral Nutrition, Available at www.nice.org.uk/guidance/ng154 2. Radbone L (2019), Parenteral Feeding of Infants on the Neonatal Unit, East of England Perinatal Networks. 1262 THE HI 5S: AN INTER PROFESSIONAL QUALITY IMPROVEMENT INITIATIVE USING LEAN METHODOLOGY TO IMPROVE STAFF AND PARENTAL EXPERIENCE ON POST NATAL WARD AND NIPE CLINIC Teim Jengoa Eyo, Nitesh Singh, Puneet Nath, Heather-Leigh Davies. Department of Paediatrics, University Hospital Coventry and Warwickshire, UHCW NHS Trust 10.1136/archdischild-2022-rcpch.777 Aims Post natal wards are busy and are at a risk of not delivering safe and effective care. As such Junior doctors often dread to cover this shift and midwifery staff can find it difficult to coordinate care thus impacting patient experience. Consequent to the keen awareness of impact of stress and anxiety on wellbeing, a dedicated team of interdisciplinary professionals set out to improve the postnatal experience for all. Initial survey prior to onset of the quality improvement project revealed high anxiety levels with 2 in 3 junior doctors having anxiety levels of 5 or more (out of 10) prior to a postnatal ward shift. There was also a common theme of fre- quent interruptions, heavy workload and late finish. Our objective was to improve parental and staff experience on postnatal ward and new-born infant physical examination (NIPE) clinic Methods Using fishbone cause and effect analysis the team identified the possible causes of the anxiety levels related to the post natal ward and NIPE clinic shift. Next a driver dia- gram was used to identify key drivers for change and formu- late change ideas. (figure 1) The team used the lean methodology, 5S process- their task was to: Sort reviews, Set in order NIPE clinic by reducing interruptions and last- minute tasks, via a non-urgent jobs book and dedicated team of support staff to man the clinic, called ‘NIPE champions’ Shine at timely discharges, Standardise process in the clinic via use of ‘NIPE survival booklet’ Sustain the process via education A resurvey was done following the first intervention which was the introduction of a non-urgent jobs book with the aim of reducing need to interrupt the junior doctors and Advanced Nurse Practitioners in the middle of tasks while still ensuring tasks are not forgotten. This was done via an anonymously filled semi-structured questionnaire and data was analysed via excel. Results A total of 8 respondents filled the resurvey consisting of tier 1 junior doctors and Advanced nurse practitioners (ANNP). 75% of the respondents reported ease of use of the non- urgent jobs book 87.5% of respondents also reported reduced rate of inter- ruptions due to the use of the non-urgent jobs book although some commented that the effect was not consistent. (figure 2) Abstract 1262 Figure 1 Abstract 1262 Figure 2 Conclusion The non-urgent jobs book has seen reduction in interruptions and helped junior doctors to focus on a single task per time, mitigating the risk of errors. Next steps include senior review slots and 2 junior doctors assigned to a NIPE clinic with a survey of staff and patient experience afterwards. The QI has led to better interdisciplinary teamwork to achieve change. With the next changes, the level of anxiety related to NIPE clinic is expected to be remarkably improved as well as improved staff engagement. 1285 POSTNATAL GENTAMICIN ADMINISTRATION AND PRESCRIPTION: MIND THE GAP! Kevin Halleron, Mary-Beth Toner, Bharathi Rao. Royal Maternity Hospital, Belfast 10.1136/archdischild-2022-rcpch.778 Aims The administration and prescription of intravenous anti- biotics to neonates at risk of Early Onset Neonatal Sepsis (EONS) is common in all postnatal wards across the UK. In most cases, this is performed by junior doctors with midwifery staff support. In the Belfast Trust, a safety checklist was Abstracts Arch Dis Child 2022;107(Suppl 2):A1–A537 A481 on April 16, 2024 by guest. Protected by copyright. http://adc.bmj.com/ Arch Dis Child: first published as 10.1136/archdischild-2022-rcpch.778 on 17 August 2022. Downloaded from