To assess the use of guidelines in neonatology we conducted a survey on hyperbilirubinemia in 185 German pediatric hospitals from June to September 1999. Of these 136 hospitals (73%) treating infants with hyperbilirubinemia responded. Specific standards or guidelines were used by 99% of participating hospitals. 49% of those used a hospital-based guideline, 54% the recommendations of the Gesellschaft für Neonatologie und pädiatrische Intensivmedizin, 24% another not further specified guideline. In 98% of the hospitals paper copies were used. In 21% of the hospitals the implemented guidelines were also electronically available. A coordinator for their guidelines was available in 51% of the hospitals, whereas 49% did not coordinate locally the use of their guidelines. In conclusion, guidelines should be well maintained and regularly updated in order that they do not lose their impact and significance. In addition, the potential of these concise summaries of medical expertise do not seem to be fully exploited.

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