Objectives: To examine the characteristics of incident reporting systems in neonatal intensive care units (NICUs) in relation to type, aetiology, outcome and preventability of incidents. Methods: Systematic review. Search strategy: Medline, Embase, Cochrane Library. Included: relevant systematic reviews, randomised controlled trials, observational studies and qualitative research. Excluded: non-systematic reviews, expert opinions, case reports and letters. Participants: hospital units supplying neonatal intensive care. Intervention: none. Outcome: characteristics of incident reporting systems; type, aetiology, outcome and preventability of incidents. Results: No relevant systematic reviews or randomised controlled trials were found. Eight prospective and two retrospective studies were included. Overall, medication incidents were most frequently reported. Available data in the NICU showed that the total error rate was much higher in studies using voluntary reporting than in a study using mandatory reporting. Multi-institutional reporting identified rare but important errors. A substantial number of incidents were potentially harmful. When a system approach was used, many contributing factors were identified. Information about the impact of system changes on patient safety was scarce. Conclusions: Multi-institutional, voluntary, non-punitive, system based incident reporting is likely to generate valuable information on type, aetiology, outcome and preventability of incidents in the NICU. However, the beneficial effects of incident reporting systems and consecutive system changes on patient safety are difficult to assess from the available evidence and therefore remain to be investigated.

The Bilicheck is a screening device with the potential to reliably indicate hyperbilirubinemia in very preterm infants. Caution is required when skin measurements are performed in the presence of peripheral edema and/or a poor peripheral circulation. Its application in the NICU environment has the potential to reduce the number of blood samples by 40%.

The Bilicheck is a screening device with the potential to reliably indicate hyperbilirubinemia in very preterm infants. Caution is required when skin measurements are performed in the presence of peripheral edema and/or a poor peripheral circulation. Its application in the NICU environment has the potential to reduce the number of blood samples by 40%.

Data from 32 patients who were transported for neonatal extracorporeal membrane oxygenation (ECMO) over a 66-month period were reviewed. One ground ambulance transport had to be postponed because of poor weather conditions; the patient died. One patient was excluded for ECMO on arrival at the ECMO centre. Of the remaining 30 infants, 20 (67%) required ECMO treatment, of which four (20%) died. All 10 (33%) patients who were treated with conventional therapy survived. During transportation all children remained stable in terms of oxygenation. Early referral and transportation by an experienced and well-equipped transport team allows safe transport of these critically ill neonates.