Standardizing the diagnosis of necrotizing enterocolitis in infants with congenital heart disease

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY Journal of Perinatology Pub Date : 2024-09-12 DOI:10.1038/s41372-024-02112-0

Margot Hillyer, Michael Fundora, Feifei Williams, Michelle Gleason, Mary Lukacs, Shannon Hamrick, Jonathan Meisel, Shanelle Clarke, Natalie Korcinsky-Tillman, Nikhil Chanani

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Abstract

Objective

This quality improvement initiative aimed to standardize the diagnosis of necrotizing enterocolitis (NEC) in infants with congenital heart disease (CHD).

Study design

A multidisciplinary team developed clinical practice guidelines for the diagnosis and treatment of NEC within the Cardiac Intensive Care Unit (CICU). The diagnosis rate of NEC per 100 at-risk admissions was the primary outcome measure. NEC order set usage was employed as a process measure, and the balancing measures monitored were CICU length of stay (LOS) and mortality.

Result

After guideline development and implementation, the diagnosis rate of NEC decreased from 3% to 1%, sustained over three years. The EMR order set enabled guideline integration into daily workflow. No change was noted in CICU LOS or mortality.

Conclusion

Guideline implementation standardized the diagnosis of NEC in infants with CHD. Establishing a standardized definition and subsequent treatment regimen has enabled us to provide more consistent and appropriate care.

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先天性心脏病婴儿坏死性小肠结肠炎的标准化诊断

研究设计一个多学科团队为心脏重症监护病房（CICU）内坏死性小肠结肠炎（NEC）的诊断和治疗制定了临床实践指南。每 100 例高风险入院患者的 NEC 诊断率是主要的结果测量指标。结果制定和实施指南后，NEC的诊断率从3%下降到1%，并持续了三年。EMR 订单集使指南融入了日常工作流程。结论该指南的实施规范了患有先天性心脏病的婴儿的 NEC 诊断。建立标准化定义和后续治疗方案使我们能够提供更加一致和适当的护理。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.