一项旨在减少婴儿友好型保育室低体温的质量改进举措——我们的算法、K 卡和钥匙卡的故事。
A quality improvement initiative to reduce hypothermia in a Baby-Friendly nursery - our story of algorithms, K-cards, and Key cards.
机构信息
Department of Pediatrics, Le Bonheur Children's Hospital, Memphis, TN, USA.
Department of Pediatrics, NYU Langone Hospital-Long Island, Mineola, NY, USA.
出版信息
J Perinatol. 2021 Jul;41(7):1760-1768. doi: 10.1038/s41372-021-01073-y. Epub 2021 May 13.
BACKGROUND
Baby-Friendly hospitals encourage rooming-in newborns with mothers. In our institution, we noticed increased incidence of hypothermia following Baby-Friendly designation. We aimed to reduce the incidence of hypothermia in the mother-baby-unit to <15% and to decrease the rate of isolated hypothermia admissions to the neonatal intensive care unit (NICU) by 20% over two years.
METHODS
After a retrospective review of newborns ≥35 weeks gestation in the mother-baby-unit with hypothermia, we implemented multiple interventions such as nursing education, hypothermia algorithm, Kamishibai cards, and Key cards.
RESULTS
Hypothermia incidence in the mother-baby-unit decreased from 20.9 to 14.5% (p < 0.001) and infants requiring NICU admission decreased by 71% (p < 0.001) following all interventions. Apart from nursing education, all interventions led to significant reductions in both outcomes from baseline.
CONCLUSION
Instituting a hypothermia algorithm and utilizing K-cards and Key cards reduces the incidence of hypothermia in the mother-baby-unit and NICU admissions for isolated hypothermia.
背景
提倡母婴同室的爱婴医院会让新生儿与母亲同住。在我们的机构中，我们注意到在获得爱婴医院认证后，低体温症的发病率有所上升。我们的目标是将母婴同室单元中低体温症的发病率降低到<15%，并在两年内将新生儿重症监护病房（NICU）中因孤立性低体温症而入院的比例降低 20%。
方法
在对母婴同室单元中≥35 周龄的患有低体温症的新生儿进行回顾性审查后，我们实施了多项干预措施，如护理教育、低体温症算法、Kamishibai 卡片和 Key 卡片。
结果
在所有干预措施实施后，母婴同室单元中的低体温症发病率从 20.9%降至 14.5%（p<0.001），需要入住 NICU 的婴儿减少了 71%（p<0.001）。除了护理教育，所有干预措施都使基线时的这两个结果都显著降低。
结论
实施低体温症算法并利用 K 卡和 Key 卡可降低母婴同室单元中低体温症的发病率和因孤立性低体温症而入住 NICU 的比例。
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