医学
儿科
低出生体重
低血糖
出生体重
心理干预
胎龄
母乳喂养
新生儿重症监护室
母乳喂养
奶嘴
怀孕
内科学
护理部
胰岛素
生物
遗传学
作者
Rakhi Gupta Basuray,Carrie Cacioppo,Vanessa Inuzuka,Keri Cooper,Charles J. Hardy,Michael Perry
出处
期刊:Hospital pediatrics
[American Academy of Pediatrics]
日期:2023-10-11
卷期号:13 (11): 992-1000
被引量:1
标识
DOI:10.1542/hpeds.2022-007037
摘要
BACKGROUND AND OBJECTIVE Late preterm (LPT) and low birth weight (LBW) infants are populations at increased risk for NICU admission, partly due to feeding-related conditions. This study was aimed to increase the percentage of LPT and LBW infants receiving exclusive nursery care using quality improvement methodologies. METHODS A multidisciplinary team implemented interventions at a single academic center. Included infants were 35 to 36 weeks gestational age and term infants with birth weights <2500 g admitted from the delivery room to the nursery. Drivers of change included feeding protocol, knowledge, and care standardization. We used statistical process control charts to track data over time. The primary outcome was the percentage of infants receiving exclusive nursery care. Secondary outcomes included rates of hypoglycemia, phototherapy, and average weight loss. Balancing measures were exclusive breast milk feeding rates and length of stay. RESULTS Included infants totaled 1336. The percentage of LPT and LBW infants receiving exclusive nursery care increased from 83.9% to 88.8% with special cause variation starting 1 month into the postintervention period. Reduction in neonatal hypoglycemia, 51.7% to 45.1%, coincided. Among infants receiving exclusive nursery care, phototherapy, weight loss, exclusive breast milk feeding, and length of stay had no special cause variation. CONCLUSIONS Interventions involving a nursery feeding protocol, knowledge, and standardization of care for LPT and LBW infants were associated with increased exclusive nursery care (4.9%) and reduced rates of neonatal hypoglycemia (6.6%) without adverse effects. This quality initiative allowed for the preservation of the mother-infant dyad using high-value care.
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