BAPM has been notified by the Coroner’s Office that a question was raised in a prevention of future death report about the use of Kaiser Permanente Sepsis Risk Calculator (KP SRC) verses the NICE Categorical Framework and the NEWTT2 in conjunction with these. BAPM has provided the following clarification on how the tools should be used.

While the majority of newborn infants require only short-term surveillance, there are groups at risk of developing complications particular to the perinatal period. These groups should have additional observations tracked using the NEWTT2 tool. One type of ‘at-risk group’ is infants at risk of early neonatal infection.

The Kaiser Permanente Sepsis Risk Calculator and the NICE categorical framework are tools to determine the risk of early onset infection in newborn babies. (Please refer to relevant national and local guidance to ensure you are using these tools appropriately.) These two tools can be used to determine which babies need additional observations. The NEWTT2 chart can then be used to track these observations and provides recommendations on escalation where necessary.

At present there is a lack of evidence on whether the Kaiser Permanente Sepsis Risk Calculator or NICE categorical framework is a better tool for determining which babies are most at risk. The revised April 2021 NICE guidance states that the Kaiser Permanente neonatal sepsis calculator can be used as an alternative to the NICE categorical framework for babies born after 34+0 weeks with ongoing prospective audit. Whilst there has not been a gold standard randomised controlled trial in the UK comparing KP SRC versus NICE, there have been observational regional studies that have not shown strong evidence of harm. BAPM continues to advocate for more neonatal research to be conducted to address uncertainties.

For any questions about the use of the NEWTT2 framework and chart please visit the NEWTT2 section of the BAPM website or contact [email protected]

British Association of Perinatal Medicine (BAPM) is registered in England & Wales under charity number 1199712 at 5-11 Theobalds Road, London, WC1X 8SH.
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