Ashmeade Terri L, Haubner Laura, Collins Sherie, Miladinovic Branko, Fugate Karen
University of South Florida Morsani College of Medicine, Tampa, FL
University of South Florida Morsani College of Medicine, Tampa, FL.
Am J Med Qual. 2016 Jan-Feb;31(1):73-80. doi: 10.1177/1062860614548888. Epub 2014 Sep 5.
The objective of this study was to implement and evaluate a quality improvement project (the golden hour pathway [GHP]) aimed at improving the quality and efficiency of care delivered to extremely low birth weight (ELBW) infants <28 weeks gestation and/or <1000 g birth weight during the first hour of life. Process improvement and patient data collected during the quality improvement cycles were compared with retrospective data for ELBW infants admitted to the study neonatal intensive care unit during the 2 years prior to GHP implementation. GHP implementation resulted in improvements compared with past internal performance in time to surfactant administration, time to administration of dextrose and amino acids, body temperature at admission, odds of developing chronic lung disease, and odds of developing retinopathy of prematurity. A standardized interdisciplinary approach to the care of ELBW infants in the first hour of life can lead to more efficient care delivery and contribute to improved outcomes.
本研究的目的是实施并评估一项质量改进项目（黄金小时路径[GHP]），该项目旨在提高对孕周小于28周和/或出生体重小于1000克的极低出生体重（ELBW）婴儿在出生后第一小时内提供的护理质量和效率。将质量改进周期中收集的过程改进和患者数据与GHP实施前两年入住该研究新生儿重症监护病房的ELBW婴儿的回顾性数据进行比较。与过去的内部表现相比，GHP的实施在以下方面取得了改善：给予表面活性剂的时间、给予葡萄糖和氨基酸的时间、入院时的体温、发生慢性肺病的几率以及发生早产儿视网膜病变的几率。在ELBW婴儿出生后第一小时采用标准化的跨学科护理方法可提高护理效率，并有助于改善治疗结果。
