Peterson D, Hoffman S B, El-Metwally D, Martino-Gomez M, Chinta D R, Hughes Driscoll C
University of Maryland School of Medicine, Office of Student Affairs, Baltimore, MD, USA.
University of Maryland School of Medicine, Department of Pediatrics, Baltimore, MD, USA.
J Perinatol. 2017 Nov;37(11):1236-1241. doi: 10.1038/jp.2017.120. Epub 2017 Sep 7.
Evaluate the safety of a change in care setting for asymptomatic neonates born to mothers with chorioamnionitis from the neonatal intensive care unit to the well baby nursery.Local problem:The neonatal intensive care unit evaluation and management of babies born to mothers with chorioamionitis often involves separation of the mother-baby dyad and more invasive interventions.
A single-center pre/post-intervention study of neonates born from January 2011 to November 2016, comparing safety outcomes in the neonatal intensive care unit (pre-intervention) and well baby nursery (post-intervention), following initiation of a triage protocol.
A protocolized, systematic change was done in the practice location.
Groups were similar for time to first antibiotic administration, sepsis symptom development and positive blood cultures. Length of stay (median 73.5 vs 64.4 h, P=0.0192) and % of neonates with intravenous fluid exposure (50.4% vs 7.6%, P<0.0001) were lower in the post-intervention group. Exclusive breastfeeding rates improved (pre-7.3% vs post-46.1%, P<0.0001).
Asymptomatic neonates born to mothers with chorioamnionitis were safely treated in a well baby nursery under the guidance of a protocol for triage, thereby reducing NICU exposure for these neonates.
评估患有绒毛膜羊膜炎的母亲所生无症状新生儿从新生儿重症监护病房转至健康婴儿护理室这一护理环境变化的安全性。
新生儿重症监护病房对患有绒毛膜羊膜炎的母亲所生婴儿的评估和管理通常涉及母婴分离以及更多侵入性干预措施。
一项针对2011年1月至2016年11月出生的新生儿的单中心干预前后研究，在启动分诊方案后，比较新生儿重症监护病房（干预前）和健康婴儿护理室（干预后）的安全结果。
在实践地点进行了标准化、系统性的改变。
两组在首次使用抗生素的时间、败血症症状发展和血培养阳性方面相似。干预后组的住院时间（中位数73.5小时对64.4小时，P = 0.0192）和接受静脉输液的新生儿比例（50.4%对7.6%，P < 0.0001）较低。纯母乳喂养率有所提高（干预前7.3%对干预后46.1%，P < 0.0001）。
患有绒毛膜羊膜炎的母亲所生无症状新生儿在分诊方案的指导下在健康婴儿护理室得到了安全治疗，从而减少了这些新生儿在新生儿重症监护病房的暴露时间。
