质量改进外展教育对早产儿转运后急性脑损伤发生率的影响。

Impact of quality improvement outreach education on the incidence of acute brain injury in transported neonates born premature.

机构信息

Department of Pediatrics, Section of Neonatology, University of Calgary, Calgary, Alberta, Canada.

Department of Diagnostic Imaging, Division of Neuroradiology, University of Calgary, Calgary, Alberta, Canada.

出版信息

J Perinatol. 2022 Oct;42(10):1368-1373. doi: 10.1038/s41372-022-01409-2. Epub 2022 May 4.

DOI:10.1038/s41372-022-01409-2

PMID:35508716

Abstract

OBJECTIVE

To evaluate impact of a quality improvement (QI) outreach education on incidence of acute brain injury in transported premature neonates.

STUDY DESIGN

Neonates born at <33 weeks gestation outside the tertiary center were included. The QI intervention was a combination of neuroprotection care bundle, in-person visits, and communication system improvement. Descriptive and regression (adjusting for Gestational Age, Birth Weight, Gender, and antenatal steroids, Mode of delivery, Apgars at 5 minutes, Prophylactic indomethacin, PDA, and Inotropes use) analyses were performed. The primary outcome was a composite of death and/or severe brain injury on cranial ultrasound using a validated classification.

RESULTS

181 neonates studied (93 before and 88 after). The rate and adjusted odds of death and/or severe brain injury reduced significantly post intervention (30% vs 15%) and (AOR 0.36, 95%CI, 0.15-0.85, P = 0.02) respectively.

CONCLUSION

Implementation of outreach education targeting neuroprotection can reduce acute brain injury in transported premature neonates.

摘要

目的

评估质量改进（QI）外展教育对转运早产儿急性脑损伤发生率的影响。

研究设计

纳入在三级中心以外出生的 <33 周胎龄的新生儿。QI 干预措施包括神经保护护理包、现场访问和沟通系统改进。进行描述性和回归（调整胎龄、出生体重、性别和产前类固醇、分娩方式、5 分钟时的 Apgar 评分、预防性吲哚美辛、PDA 和使用血管活性药物）分析。主要结局是使用经过验证的分类，通过头颅超声评估死亡和/或严重脑损伤的复合结果。