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Scholar Feature: Dr. Gina Higginbottom, MBE on Improving Health Outcomes in Black, Asian & Ethnic Minority Newborns through Neonatal Health Assessment Review

 

The Manning Price Spratlen Center for Anti-Racism and Equity in Nursing (MPS CARE) is featuring the groundbreaking work of Dr. Gina Higginbottom, MBE, Emeritus Professor Ethnicity & Health, University of Nottingham. She, along with colleagues Frankie Fair, Sheffield Hallam University, Amy Furness, Sheffield Hallam University, Sam Oddie, Bradford Teaching Hospitals NHS Foundation Trust, and Hora Soltani, Sheffield Hallam University compiled a report reviewing Neonatal Assessment and Practice in Black, Asian and Minority Ethnic Newborns. Their report examines the effectiveness of tests like Apgar Score, the Detection of Cyanosis, and Jaundice in black, Asian and ethnic-minority newborns and why these tests are less effective for these populations when compared to white newborns. We are excited to feature Dr. Higginbottom and this report on our blog as we know this work will contribute to the continued transformation of nursing practice and research, an endeavor which our Center is steadfastly committed to. Access the full report here: https://www.nhsrho.org/wp-content/uploads/2023/07/RHO-Neonatal-Assessment-Report.pdf

 

Continue reading to learn more about this work and Dr. Higginbottom’s perspectives.

 

MPS CARE: How can it be that infants have such disparate treatment?

Dr. Higginbottom: “Lack of clinical observational skills of in respect of infants with darker skin. The need for a national bank of images showing medical conditions in darker skin, improved training for healthcare professionals and the use of more culturally appropriate terminology. In respect of neonatal jaundice: Health professionals need to check for yellowing on the palms of the hands or the soles of the feet, which could be easier to see in babies with darker skin tones. Checking for yellowing of the whites of the eyes (sclera) and of the gums should also be used. These methods still rely on clinical observational skills which may be subjective, bilirubinometers provide a more objective measure.”

MPS CARE: What recommendations do you have to improve care for infants and pregnant people?

Dr. Higginbottom: “Our top three recommendations are as follows:

 Area of Focus

Who is it aimed at?
Policy
Recommendation 3, page 151

 

There is an urgent need for regular education and training for healthcare professionals and healthcare students on undertaking clinical assessments on neonates from Black, Asian, or minority ethnic backgrounds, including within the yearly updates on neonatal resuscitation. Better education for families is also required. All training requires process evaluation to ensure effectiveness.

 Professional associations (including BAPM, iHV, NNA, RCOG, RCPCH,

RCM, RCN) and regulatory bodies (NMC and GMC)

HEIs

NHS Trusts

 
Practice
Recommendation 4, page 152

 

Guidelines that refer to neonatal assessment by skin colour should be

immediately reviewed and updated to highlight the impact of race and

ethnicity (BAPM, HEE, iHV, NICE, NNA, OHID, RCM, RCN, RCOG, RCPCH,

Resuscitation Council, WHO). This should include guidelines around general

care of the newborn, as well as specifically for jaundice, cyanosis and Apgar

scoring.

 BAPM, HEE, iHV, NICE, NNA, OHID, RCM, RCN, RCOG, RCPCH,

Resuscitation Council, WHO
Research
Recommendation 1, page 151

 

Jaundice: Exploration of wider availability and use of

bilirubinometers is recommended to decrease health inequalities and

ensure safe care for all. Collaboration with organisations such as CQC,

RCOG, BAPM, iHV, RCPCH and RCM and other key stakeholders is

recommended.

 CQC

RCOG

BAPM

iHV

RCPCH

RCM

RHO to launch Jaundice ITT

See report for additional recommendations.”

 

 

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