1. Reducing intraventricular hemorrhage following the implementation of a prevention bundle for neonatal hypothermia.
- Author
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Chiu WT, Lu YH, Chen YT, Tan YL, Lin YC, Chen YL, Chou HC, Chen CY, Yen TA, and Tsao PN
- Subjects
- Cerebral Hemorrhage epidemiology, Cerebral Hemorrhage prevention & control, Humans, Infant, Infant, Newborn, Infant, Premature, Infant, Very Low Birth Weight, Intensive Care Units, Neonatal, Hypothermia prevention & control, Infant, Premature, Diseases epidemiology, Infant, Premature, Diseases prevention & control
- Abstract
Introduction: In very low birth weight (VLBW) infants, hypothermia immediately following birth is common even in countries rich in medical resources. The purpose of this study is to design a standard prevention bundle that decreases the rate of hypothermia among infants after birth and to investigate efficacy of the bundle and short-term outcomes for VLBW infants., Methods: This quality improvement project was conducted from February 2017 to July 2018 on all VLBW preterm infants admitted at a single referral level III neonatal intensive care unit. The infants were classified into the pre-intervention (February to September 2017) and post-intervention (October 2017 to July 2018) groups according to the time periods when they were recruited. During the pre-intervention period, we analyzed the primary causes of hypothermia, developed solutions corresponding to each cause, integrated all solutions into a prevention bundle, and applied the bundle during the post-intervention period. Afterwards, the incidence of neonatal hypothermia and short-term outcomes, such as intraventricular hemorrhage (IVH), acidosis, and shock requiring inotropic agents, in each group were compared., Results: A total of 95 VLBW infants were enrolled in the study, including 37 pre-intervention, and 58 post-intervention cases. The incidence of hypothermia in preterm infants decreased significantly upon the implementation of our prevention bundle, both in the delivery room (from 45.9% to 8.6%) and on admission (59.5% to 15.5%). In addition, the short-term outcomes of VLBW infants improved significantly, especially with the decreased incidence of IVH (from 21.6% to 5.2%, P = 0.015)., Conclusions: Our standardized prevention bundle for preventing hypothermia in VLBW infants is effective and decreased the IVH rate in VLBW infants. We strongly believe that this prevention bundle is a simple, low-cost, replicable, and effective tool that hospitals can adopt to improve VLBW infant outcomes., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2022
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