Finding treasure in the journey: a single center quality improvement bundle to reduce bronchopulmonary dysplasia.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY Journal of Perinatology Pub Date : 2024-11-26 DOI:10.1038/s41372-024-02190-0

Nichole Adiletta, Anne Denslow, Renee Martinez, Beverly Walti, Pernilla Fridolfsson, Julie Rockey, David Tirol, Kim Kierulff, Kushal Y Bhakta, Michel Mikhael

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Abstract

Background: Reducing bronchopulmonary dysplasia (BPD) utilizing a single intervention has been challenging. The quality improvement (QI) bundle approach may better address BPD multifactorial risk factors.

Methods: A single-center interdisciplinary quality improvement (QI) initiative to enhance respiratory care for preterm infants born less than 30 weeks gestation.

Global aim: To reduce BPD in preterm infants.

Smart aim: Introduce and implement a comprehensive, evidence-based respiratory care bundle within 12 months, targeting areas needing improvement in our practices.

Results: Our preplanned improvement targets were achieved for all process measures. Overall BPD incidence did not change (45% vs. 44.3%). After the QI intervention, inborn infants had a lower BPD rate, though not statistically significant (38.7% vs. 30.3%, p = 0.22), with a significant reduction in grade 1 BPD (24.5% vs. 12.4%, p = 0.032).

Conclusion: Structured interdisciplinary QI work tailored to local settings can improve respiratory care and possibly amend the outcomes of infants at risk for BPD.

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在旅途中寻找宝藏：减少支气管肺发育不良的单中心质量改进捆绑计划。

背景：利用单一干预措施减少支气管肺发育不良（BPD）一直是一项挑战。质量改进（QI）捆绑方法可以更好地应对 BPD 的多因素风险因素：总体目标：减少早产儿 BPD。智能目标：在 12 个月内引入并实施以证据为基础的综合呼吸护理包，针对我们的实践中需要改进的领域：结果：我们在所有流程措施方面都实现了预先计划的改进目标。总体 BPD 发生率没有变化（45% 对 44.3%）。在实施 QI 干预后，新生儿的 BPD 发生率有所降低，但无统计学意义（38.7% vs. 30.3%，p = 0.22），1 级 BPD 显著降低（24.5% vs. 12.4%，p = 0.032）：结论：根据当地情况开展结构化跨学科 QI 工作可改善呼吸系统护理，并有可能改善有 BPD 风险的婴儿的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.