The situation of new-borns in Poland, especially those born preterm, requires changes. What needs to be modified in order to ensure that Polish neonatology follows medical development was the main focus of a meeting held on 28 May. Polish experts participating in the event are currently working on a system of guidelines in 26 areas concerning hospital treatment and follow-up care.
Almost 400 thousand babies are born every year in Poland. New-borns, especially those born preterm often suffer from complications caused by prematurity. With the provision of appropriate care and stimulation they can often catch-up with their peers and overcome development differences.
Most new-borns begin their lives in hospital delivery units where all the necessary perinatal procedures are carried out. Hospital stays of preterm babies can last for months with countless complex medical procedures. After the baby is discharged from hospital parents take up the role of „coordinators” of further medical care. The follow-up care includes check-up appointments with specialist doctors, infections prophylaxis, development stimulation etc.
„In order to be able to put into practice all the recommendations provided by the medical team at the time of discharge from hospital, the parents need to have appropriate conditions that will allow them to schedule all the necessary specialist appointments. Thus, it is essential that educational activities for the parents of premature babies are put in place”. – says prof. dr. Maria Katarzyna Borszewska-Kornacka, the President of Polish Neonatology Society and the Initiator of the „Coalition for Preemies”.
Polish Neonatal Society is working jointly with a group of experts on a „New-born multiplex care system”. By and large, the programme will provide a manual with current medical knowledge for the medical professionals, but also for the decision-makers who need explanation as to required changes in the area of perinatal care of new-born babies. The guidelines will cover approximately 26 areas concerning caring over infants. In spheres where Polish standards are below European ones, directions for modifications in the health care system will be provided.
What makes the „New-born multiplex care system” so unique and innovative is versatility as it focuses on all the important issues that can concern new-born babies, especially those born prematurely. Issues of neonatal period are treated comprehensively, with emphasis on finding solutions to all problems and not only to selected ones. Another important part of the programme is that the group of experts normally taking care of the little patients in hospitals is now doing all they can to ensure the follow-up care is less demanding and troublesome. Authors of the companion firmly believe in cooperation between the national healthcare system decision-makers and clinicians. Last year, cooperation between abovementioned groups resulted in the abolishment of the date-of-birth-criterion in the RSV prophylaxis programme. Since July 2013, the weakest preemies are receiving treatment against respiratory failure resulting from severe lower respiratory duct disease. Despite the positive developments a lot remains to be done. For this reason, the document is also going to concern those groups of patients where the RSV prophylaxis needs and ought to be expanded and equalled to EU standards
For some years now, medical experts are trying to bring the attention to the need for a comprehensive multispecialty system of care. We would like to see that selected neonatal units in each region are equipped with best medical staff and instruments, that a neonatologist is coordinating entire perinatal care of a preemie and that the baby is able to come in for all the necessary specialist appointments over one day. This form of supervision over premature babies should be continued until the baby is 3. Only then it is possible to assess whether the baby is overcoming development differences- be it intellectual, physical or emotional as compared to a baby born on due date. In our opinion, provision of such system is indispensible and may likely result in a decrease in the number of disabilities at various levels. It would be most helpful for the parents and very good for the babies. „Travelling” from doctor to another is neither beneficial to the babies nor for their carers” says prof. Dr Ewa Helwich, National Consultant on Neonatology.
The „new-born multiplex care system” structures and unifies the knowledge regarding most important issues and hospital procedures, such as diagnostics of central nervous system, oxygen therapy, surfactant treatment, invasive ventilation, parenteral nutrition, fungal infections or vaccination of new-borns. It will allow for a unification of procedures among all the hospitals in Poland providing neonatal care. The document will be a compilation of current medical knowledge and recommendations for medical professionals and will be edited on the basis of European and world guidelines published by leading neonatology societies. Polish experts will use the instructions of such institutions as American Academy of Paediatrics (AAP) or World Health Organization (WHO).
Eminent experts working on the document in Poland include prof. Dr Maria Katarzyna Borszewska- Kornacka, the President of Polish Neonatal Society, prof. Dr Ewa Matylda Gulczyńska, Regional Consultant on Neonatology for Łódź Voivodeship, prof. Dr Janusz Gadzinowski, Regional Consultant on Neonatology for Wielkoposka Voivodeship, prof. Dr Ewa Helwich, National Consultant on Neonatology, Dr of Biological Sciences Grażyna Kmita, the Principal of Early Psychological Intervention Unit at the Mother and Child Institute in Warsaw, prof. Dr Ryszard Lauterbach, Regional Consultant on Neonatology for Małopolska Voivodeship, Dr Jan Mazela from Neonatology Department at UM in Poznań, prof. Dr Andrzej Piotrowski, the Principal of Intensive Care and Anesthesiology Unit at Pediatrics Department of Łódź University, prof. Dr Magdalena Rutkowska from Neonatology and Intensive Newborn Theraphy at Mother and Child Institute in Warsaw and prof. Dr Jerzy Szczapa, Regional Consultant on Neonatology in Lubuskie Voivodeship.
The „New-born multiplex care system” is a collection of information which will provide the basis for discussions with decision makers concerning introducing changes striving to put Polish neonatology at the European and global levels. Draft programme will be completed by the end of the year.