Hillyer Margot, Fundora Michael, Williams Feifei, Gleason Michelle, Lukacs Mary, Hamrick Shannon, Meisel Jonathan, Clarke Shanelle, Korcinsky-Tillman Natalie, Chanani Nikhil
Emory University School of Medicine, Department of Pediatrics, Division of Critical Care Medicine, Atlanta, GA, USA.
Emory University School of Medicine, Department of Pediatrics, Division of Cardiology, Atlanta, GA, USA.
J Perinatol. 2024 Sep 12. doi: 10.1038/s41372-024-02112-0.
This quality improvement initiative aimed to standardize the diagnosis of necrotizing enterocolitis (NEC) in infants with congenital heart disease (CHD).
A multidisciplinary team developed clinical practice guidelines for the diagnosis and treatment of NEC within the Cardiac Intensive Care Unit (CICU). The diagnosis rate of NEC per 100 at-risk admissions was the primary outcome measure. NEC order set usage was employed as a process measure, and the balancing measures monitored were CICU length of stay (LOS) and mortality.
After guideline development and implementation, the diagnosis rate of NEC decreased from 3% to 1%, sustained over three years. The EMR order set enabled guideline integration into daily workflow. No change was noted in CICU LOS or mortality.
Guideline implementation standardized the diagnosis of NEC in infants with CHD. Establishing a standardized definition and subsequent treatment regimen has enabled us to provide more consistent and appropriate care.
这项质量改进计划旨在规范先天性心脏病（CHD）婴儿坏死性小肠结肠炎（NEC）的诊断。
一个多学科团队制定了心脏重症监护病房（CICU）内NEC诊断和治疗的临床实践指南。每100例高危入院患者的NEC诊断率是主要结局指标。NEC医嘱集的使用作为一项过程指标，监测的平衡指标是CICU住院时间（LOS）和死亡率。
在制定和实施指南后，NEC诊断率从3%降至1%，并持续了三年。电子病历医嘱集使指南能够融入日常工作流程。CICU LOS或死亡率未发现变化。
指南的实施规范了CHD婴儿NEC的诊断。建立标准化定义和后续治疗方案使我们能够提供更一致和适当的护理。
