National Neonatal Surgical Benchmarking Group (NNSBG)

The NNSBG is an innovative and dynamic group dedicated to the delivery of high quality care to a unique group of infants. The surgical neonate has complex needs, which are usually met on a regional basis. In the past units often had to work in isolation, as the nursing procedures were unique to this group of patients. There is very little evidence or research to support such practices, and many are based on anecdotal evidence or surgeon preference.

The NNSBG formed in March 2003 with a very enthusiastic response. Membership is continually increasing and there are currently 15 units from across the British Isles involved. The group developed a philosophy that we all adhere to:

"Through the process of benchmarking we aim to identify and facilitate the best achievable neonatal surgical practice nationally. Evaluation and critique of available evidence, comparison and sharing of current practices will enable the formation of best practice. The use of professional consensus in lieu will be used when there is a lack of evidence. The group will share and compare current practice and ideas.
Evidence, knowledge and support will be encouraged from members of the multidisciplinary team to support developing practice."

The group meetings are very supportive of each other and a good communication network has been established between the units to deal with any questions or concerns, which may arise, at any unit – full support is given and advice is shared.

Benchmarks completed to date are:

* Wound Management – in developing this benchmark much work has taken place in order to develop an appropriate neonatal wound assessment tool, teaching packs and staff competencies in order to provide the highest quality care. The shortfalls in each unit were identified, shared and compared and an appropriate action plan formulated in order to move the service forward.

* Stoma Management – this benchmark enabled thorough action plans to be formulated to meet the needs of the child and family and also move practice forward. From this benchmark audit activity is underway to develop guidelines and an eventual benchmark for bowel management.

* Gastrostomy Management

* Nasogastric Tube Management – following development of this benchmark action plans have been put in place to bring practice and service delivery in line with the benchmark.

Benchmarks in progress:

* Pain Management – this benchmark is under review, a thorough literature search will be undertaken and evidence and research examined. Practices will be shared and compared and a benchmark will be devised.

* Preoperative Management – this is an area which is very important with this group of infants and it was felt that this should be a benchmark in itself.

Involvement with NNSBG

Involvement with the group also promotes the success of multi-centre research and audit in developing the service provided to this group of infants. There are many advantages to being involved with the benchmarking group, not just the impact on care, but on the staff as a whole. Benchmarking is a practitioner-led initiative and staff from all levels are involved. This promotes ownership for the staff, which leads to increased motivation and moral within the team resulting in increased retention of staff and improvement of the quality of service delivery. Benchmarking can also be used as evidence for the need for additional resources or risk management, and also acts as a tool for quality assurance.

If you feel you would like to become involved with this very exciting and innovative group please do not hesitate to contact either Melanie Haughan or Ann O'Neill