A quality improvement initiative to improve management of procedural pain in preterm neonates

2020 ◽  
Author(s):  
Rajendra Prasad Anne ◽  
Saikiran Deshabhotla ◽  
Shaista Waheed Ahmed ◽  
Saadiya Jaleel Ahmed ◽  
Navneeth Reddy ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Procedural Pain ◽  
Preterm Neonates ◽  
Quality Improvement Initiative

A Quality Improvement Initiative: Improving Exclusive Breastfeeding Rates of Preterm Neonates

2017 ◽  
Vol 84 (4) ◽  
pp. 322-325 ◽  
Author(s):  
Amanpreet Sethi ◽  
Meena Joshi ◽  
Anu Thukral ◽  
Jagjit Singh Dalal ◽  
Ashok Kumar Deorari
Keyword(s):  
Quality Improvement ◽  
Exclusive Breastfeeding ◽  
Preterm Neonates ◽  
Quality Improvement Initiative ◽  
Breastfeeding Rates

Impact of a standardised parenteral nutrition protocol: a quality improvement experience from a NICU of a developing country

2021 ◽  
pp. archdischild-2021-321552
Author(s):  
Gul Ambreen ◽  
Vikram Kumar ◽  
Syed Rehan Ali ◽  
Uswa Jiwani ◽  
Waqar Khowaja ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Weight Gain ◽  
Parenteral Nutrition ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Rate Of Change ◽  
Preterm Neonates ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
Z Scores

ObjectiveNutrition societies recommend using standardised parenteral nutrition (SPN) solutions. We designed evidence-based SPN formulations for neonates admitted to our neonatal intensive care unit (NICU) and evaluated their outcomes.DesignThis was a quality improvement initiative. Data were collected retrospectively before and after the intervention.SettingA tertiary-care level 3 NICU at the Aga Khan University in Karachi, Pakistan.PatientsAll NICU patients who received individualised PN (IPN) from December 2016 to August 2017 and SPN from October 2017 to June 2018.InterventionsA team of neonatologists and nutrition pharmacists collaborated to design two evidence-based SPN solutions for preterm neonates admitted to the NICU.Main outcome measuresWe recorded mean weight gain velocity from days 7 to 14 of life. The other outcomes were change in weight expressed as z-scores, metabolic abnormalities, PN-associated liver disease (PNALD), length of NICU stay and episodes of sepsis during hospital stay.ResultsNeonates on SPN had greater rate of change in weight compared with IPN (β=13.40, 95% CI: 12.02 to 14.79) and a smaller decrease in z-scores (p<0.001). Neonates in the SPN group had fewer hyperglycemic episodes (IPN: 37.5%, SPN: 6.2%) (p<0.001), electrolyte abnormalities (IPN: 56.3%, SPN: 21%) (p<0.001), PNALD (IPN: 52.5%, SPN: 18.5%) (p<0.001) and sepsis (IPN: 26%, SPN: 20%) (p<0.05). The median length of stay in NICU was 14.0 (IQR 12.0–21.0) for the IPN and 8.0 (IQR 5.0–13.0) days for the SPN group.ConclusionsWe found that SPN was associated with shorter NICU stay and greater weight gain. In-house preparation of SPN can be used to address the nutritional needs in resource-limited settings where commercially prepared SPN is not available.

Oral Care with Mother’s Own Milk in Sick and Preterm Neonates: A Quality Improvement Initiative

2020 ◽  
Vol 88 (1) ◽  
pp. 50-57
Author(s):  
Kanhu Charan Digal ◽  
Jaya Upadhyay ◽  
Poonam Singh ◽  
Shantanu Shubham ◽  
Rajat Grover ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Oral Care ◽  
Preterm Neonates ◽  
Quality Improvement Initiative ◽  
Mother’S Own Milk

scholarly journals Sustained quality improvement in outcomes of preterm neonates with a gestational age less than 29 weeks: results from the Evidence-based Practice for Improving Quality Phase 3

2019 ◽  
Vol 97 (3) ◽  
pp. 213-221 ◽  
Author(s):  
Prakesh S. Shah ◽  
Michael Dunn ◽  
Khalid Aziz ◽  
Vibhuti Shah ◽  
Akhil Deshpandey ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Necrotizing Enterocolitis ◽  
Gestational Age ◽  
Evidence Based Practice ◽  
Preterm Neonates ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
Composite Outcome ◽  
Phase 3 ◽  
National Quality

Quality improvement initiatives in neonatology have yielded positive results; however, few programs have demonstrated sustainability. We evaluated an ongoing, national quality improvement initiative (Evidence-based Practice for Improving Quality Phase 3 (EPIQ-3)) on outcomes of preterm neonates with a gestational age (GA) of 220–286 weeks (i.e., from 22 weeks and 0 days of gestation to 28 weeks and 6 days of gestation). Data from 7459 neonates admitted to 25 Canadian centers between 2013 and 2017 were studied. Trends in mortality and major morbidities were evaluated. The number of neonates with a GA of 220–236 weeks increased from 90 in 2013 to 139 in 2017 without a significant change in any other GA categories. In the entire cohort, the odds of composite outcome of mortality or any major morbidity (adjusted odds ratio (AOR) 0.72, 95% confidence interval (CI) 0.61–0.84) and of necrotizing enterocolitis (AOR 0.66, 95% CI 0.49–0.89) were lower in 2017 than in 2013. When calculated per year, the odds of composite outcome (AOR 0.93, 95% CI 0.89–0.97) and odds of necrotizing enterocolitis (AOR 0.89, 95% CI 0.82–0.96) decreased significantly. Among the subgroup of neonates with a GA of 260–286 weeks, the odds of composite outcome (AOR 0.63, 95% CI 0.51–0.79), necrotizing enterocolitis (AOR 0.44, 95% CI 0.26–0.73), and nosocomial infection (AOR 0.64, 95% CI 0.49–0.84) were reduced. The collaborative, multidisciplinary, nationwide EPIQ-3 program improved outcomes of preterm neonates, and the improvement was sustainable over 5 years.

Implementing a Quality Improvement Initiative for Asthma Management in a Tribal Clinic

2005 ◽  
Author(s):  
Charlanne J. FitzGerald ◽  
Beverly Hart ◽  
Adrienne Laverdure ◽  
Brian Schafer
Keyword(s):  
Quality Improvement ◽  
Asthma Management ◽  
Quality Improvement Initiative
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