Perinatal Institute, James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
J Perinatol. 2020 Oct;40(10):1546-1553. doi: 10.1038/s41372-020-0720-3. Epub 2020 Jul 14.
Assess practices supporting care transitions for infants and families in the neonatal intensive care unit (NICU) using a model of four key drivers: communication, teamwork, family integration, and standardization.
Single-day audit among NICUs in the Vermont Oxford Network Critical Transitions collaborative addressing policies and practices supporting the four key drivers during admission, discharge, shift-to-shift handoffs, within hospital transfers, and select changes in clinical status.
Among 95 NICUs, the median hospital rate of audited policies in place addressing the four key drivers were 47% (inter-quartile range (IQR) 35-65%) for communication, 67% (IQR 33-83%) for teamwork, 50% (IQR 33-61%) for family integration, and 70% (IQR 56-85%) for standardization. Of the 2462 infants included, 1066 (43%) experienced ≥1 specified transition during the week prior to the audit.
We identified opportunities for improving NICU transitions in areas of communication, teamwork, family integration, and standardization.
使用沟通、团队合作、家庭融合和标准化这四个关键驱动因素的模型，评估新生儿重症监护病房（NICU）中支持婴儿和家庭过渡的实践。
在佛蒙特牛津网络关键过渡合作中，对 NICU 进行为期一天的审核，针对入院、出院、交接班、院内转科和特定临床状态变化期间的四个关键驱动因素，审查支持政策和实践。
在 95 个 NICU 中，四项关键驱动因素的审核政策到位率中位数分别为沟通 47%（四分位距 35-65%）、团队合作 67%（33-83%）、家庭融合 50%（33-61%）和标准化 70%（56-85%）。在纳入的 2462 名婴儿中，有 1066 名（43%）在审核前一周经历了≥1 次指定的过渡。
我们确定了在沟通、团队合作、家庭融合和标准化方面改进 NICU 过渡的机会。
