Newborn Observation Track and Trigger (NOTT) Chart.

Use of early warning system scores and track-and-trigger charts is widespread in adult and paediatric hospitalized patients; but its use in neonatal group is not well recognized. The authors aimed to develop and implement neonatal observation track-and-trigger chart for use in babies on postnatal wards and to assess its efficacy in identifying neonates in need of urgent medical assessment and intervention. Core group developed Newborn Observation Track and Trigger (NOTT) chart for "At-Risk" and "At-High-Risk" Infants. A decision tree was devised based on 'low', 'medium' and 'high' scores. Sensitivity and specificity of NOTT chart's 'medium' and 'high' score was 96% and 90%, respectively. Positive and negative predictive value was 43% and 100%, respectively. NOTT chart is a valuable tool for assessment of neonates on postnatal wards. A prospective study, using large number of participants, would be beneficial to further corroborate this useful tool.