Reducing necrotizing enterocolitis in very low birth weight infants using quality-improvement methods.
J Perinatol
; 34(11): 850-7, 2014 Nov.
Article
em En
| MEDLINE
| ID: mdl-25010221
ABSTRACT
OBJECTIVE:
Owing to a rise in necrotizing enterocolitis (NEC, stage ⩾ 2) among very low birth weight (VLBW, birth weight <1500 g) infants from 4% in 2005 to 2006 to 10% in 2007 to 2008, we developed and implemented quality improvement (QI) initiatives. The objective was to evaluate the impact of QI initiatives on NEC incidence in VLBW infants. STUDYDESIGN:
In September 2009, we developed an NEC QI multidisciplinary team that conducted literature reviews and reviewed practices from other institutions to develop a feeding protocol, which was implemented in December 2009. The team tracked intervention compliance and occurrence of NEC stage ⩾ 2. In May 2010, we reviewed our nasogastric tube practice and relevant literature to develop a second intervention that reduced nasogastric tube indwelling time. The infants were divided into three groups baseline (January 2008 to Novovember 2009, n219), QI phase 1 (December 2009 to May 2010, n62) and QI phase 2 (June 2010 to November 2011, n170).RESULT:
The NEC incidence did not decrease after implementation of the feeding protocol in QI phase 1 (19.4%) but did decline significantly after changing nasogastric tube management in QI phase 2 (2.9%). Multivariable logistic regression analysis demonstrated a significant relationship between QI phase and the incidence of NEC.CONCLUSION:
QI initiatives were effective in decreasing NEC incidence in our high human milk-feeding NICU. Nasogastric tube bacterial contamination may have contributed to our peak in NEC incidence.
Texto completo:
1
Coleções:
01-internacional
Temas:
Promover_ampliacao_atencao_especializada
Base de dados:
MEDLINE
Assunto principal:
Recém-Nascido de muito Baixo Peso
/
Enterocolite Necrosante
/
Melhoria de Qualidade
Tipo de estudo:
Guideline
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Implementation_research
Limite:
Female
/
Humans
/
Male
/
Newborn
Idioma:
En
Revista:
J Perinatol
Ano de publicação:
2014
Tipo de documento:
Article