Division of Neonatology, Nationwide Children's Hospital, Columbus, OH, USA.
Research Institute and Center for Perinatal Research, Nationwide Children's Hospital, Columbus, OH, USA.
J Perinatol. 2020 Apr;40(4):681-687. doi: 10.1038/s41372-019-0574-8. Epub 2020 Jan 6.
Bronchopulmonary Dysplasia (BPD) is the most common prematurity complication. Although several practices have been proposed for BPD prevention, none of these in isolation prevent BPD.
Our initiative focused on two key drivers: oxygen management and noninvasive ventilation strategies. We created best practice guidelines and followed outcome measures using Shewhart control charts.
PDSAs of protocols preceded a large-scale rollout of a "0.21 by 28" campaign in 2014 leading to a special cause reduction in the "any BPD" rate, and a decrease in severe BPD (from 57 to 29%). At the end of 2017, we reinvigorated the project, which led to dramatic decreases in the "any BPD" rate to 41% and the "severe BPD" rate to 21%.
A multidisciplinary QI initiative focused on process improvement geared towards the pathophysiological contributors of BPD has successfully reduced the rate of BPD in an all referral level IV NICU.
支气管肺发育不良（BPD）是最常见的早产儿并发症。尽管已经提出了几种预防 BPD 的措施，但没有一种措施可以单独预防 BPD。
我们的举措侧重于两个关键驱动因素：氧管理和无创通气策略。我们制定了最佳实践指南，并使用休哈特控制图跟踪结果。
方案的计划前 PDCA 于 2014 年大规模推出了“0.21 by 28”活动，导致“任何 BPD”率的特殊原因减少，严重 BPD（从 57 例降至 29%）减少。2017 年底，我们重新启动了该项目，这导致“任何 BPD”率显著下降至 41%，“严重 BPD”率下降至 21%。
一项针对 BPD 病理生理原因的多学科质量改进举措成功降低了一家四级转诊新生儿重症监护病房的 BPD 发生率。
