Care bundle for preventing intraventricular hemorrhage in premature infants: a best practice implementation project.

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2024-09-19 DOI:10.1097/xeb.0000000000000464
Álvaro Solaz García,Rosario Ros Navarret,Marta Aguar Carrascosa,Nerea Valles Murcia,Roberto Llorens,Laura Torrejón Rodríguez,Alejandro Pinilla González,Laura Albornos-Muñoz,Raquel Escrig Fernández
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Abstract

INTRODUCTION Intraventricular hemorrhages remain a major problem in neonatology, because their complications affect neonatal morbidity, mortality, and long-term neurodevelopmental outcomes. AIM The aim of this project was to prevent intraventricular hemorrhage in premature infants during their first days of life in a neonatal intensive care unit (NICU). METHODS This pre- and post-implementation clinical audit project used the JBI Evidence Implementation Framework and was conducted in a tertiary-level Spanish NICU with a consecutive sample. A baseline audit was conducted using 13 audit criteria derived from JBI summaries of the best available evidence. This was followed by the implementation of an action plan, which included a care bundle and health care professionals' education. These improvement strategies were then evaluated using a follow-up audit. RESULTS The baseline and follow-up audits evaluated 54 and 56 infants, respectively. The follow-up audit showed 100% improvement for Criteria 2, 3, 6, and 7, which covered sleep safety and noise. Criteria 12 and 13, which covered cord clamping and positioning the infant, improved by 25.99%. Criterion 9, on antenatal corticosteroids, showed a slight improvement of 5.56%. CONCLUSIONS This study increased compliance with an evidence-based, family-centered care approach to preventing intraventricular hemorrhage in premature infants. This was achieved by conducting a baseline and follow-up audit, implementing a training program, and keeping more comprehensive nursing records. Further studies could assess the long-term effectiveness of interventions and/or the incidence of intraventricular hemorrhage and neurodevelopmental disorders in premature infants. SPANISH ABSTRACT http://links.lww.com/IJEBH/A262.
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预防早产儿脑室出血的护理包:最佳实践实施项目。
简介脑室出血仍是新生儿科的一个主要问题,因为其并发症会影响新生儿的发病率、死亡率和长期神经发育结果。本项目旨在预防新生儿重症监护室(NICU)中早产儿出生后最初几天内的脑室出血。方法本临床审计项目在实施前后采用了 JBI 证据实施框架,并在西班牙一家三级重症监护室进行了连续抽样调查。基线审核采用了从 JBI 最佳可用证据摘要中得出的 13 项审核标准。随后实施了一项行动计划,其中包括护理包和医护人员教育。结果基线审核和后续审核分别对 54 名和 56 名婴儿进行了评估。跟踪审核结果显示,标准 2、3、6 和 7(涉及睡眠安全和噪音)的改善率为 100%。标准 12 和 13 涉及脐带夹紧和婴儿定位,改进率为 25.99%。结论这项研究提高了以循证医学为基础、以家庭为中心的护理方法在预防早产儿脑室出血方面的依从性。这项研究通过开展基线和后续审核、实施培训计划以及保存更全面的护理记录,提高了早产儿预防脑室内出血的依从性。进一步的研究可以评估干预措施的长期有效性和/或早产儿脑室内出血和神经发育障碍的发生率。西班牙文摘要http://links.lww.com/IJEBH/A262。
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CiteScore
3.20
自引率
13.00%
发文量
23
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