Solaz García Álvaro, Ros Navarret Rosario, Aguar Carrascosa Marta, Valles Murcia Nerea, Llorens Roberto, Torrejón Rodríguez Laura, Pinilla González Alejandro, Albornos-Muñoz Laura, Escrig Fernández Raquel
Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain.
Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain.
JBI Evid Implement. 2025 Jul 1;23(3):282-290. doi: 10.1097/XEB.0000000000000464.
Intraventricular hemorrhages remain a major problem in neonatology, as their complications affect neonatal morbidity, mortality, and long-term neurodevelopmental outcomes.
The aim of this project was to prevent intraventricular hemorrhage in premature infants during their first days of life in a neonatal intensive care unit (NICU).
This pre- and post-implementation clinical audit project used the JBI Evidence Implementation Framework and was conducted in a tertiary-level Spanish NICU with a consecutive sample. A baseline audit was conducted using 13 audit criteria derived from JBI summaries of the best available evidence. This was followed by the implementation of an action plan, which included a care bundle and health care professionals' education. These improvement strategies were then evaluated using a follow-up audit.
The baseline and follow-up audits evaluated 54 and 56 infants, respectively. The follow-up audit showed 100% improvement for Criteria 2, 3, 6, and 7, which covered sleep safety and noise. Criteria 12 and 13, which covered cord clamping and positioning the infant, improved by 25.99%. Criterion 9, on antenatal corticosteroids, showed a slight improvement of 5.56%.
This study increased compliance with an evidence-based, family-centered care approach to preventing intraventricular hemorrhage in premature infants. This was achieved by conducting a baseline and follow-up audit, implementing a training program, and keeping more comprehensive nursing records. Further studies could assess the long-term effectiveness of interventions and/or the incidence of intraventricular hemorrhage and neurodevelopmental disorders in premature infants.
脑室内出血仍是新生儿学中的一个主要问题，因为其并发症会影响新生儿的发病率、死亡率和长期神经发育结局。
本项目的目的是在新生儿重症监护病房（NICU）预防早产儿出生后最初几天内发生脑室内出血。
本实施前后的临床审计项目采用了循证卫生保健国际合作中心（JBI）证据实施框架，在一家西班牙三级NICU进行，采用连续抽样。使用从JBI最佳现有证据摘要中得出的13条审计标准进行基线审计。随后实施了一项行动计划，其中包括一个护理集束和医护人员教育。然后通过后续审计对这些改进策略进行评估。
基线审计和后续审计分别评估了54名和56名婴儿。后续审计显示，涵盖睡眠安全和噪音的标准2、3、6和7有100%的改善。涵盖脐带夹紧和婴儿体位的标准12和13改善了25.99%。关于产前使用皮质类固醇的标准9有轻微改善，提高了5.56%。
本研究提高了对基于证据的、以家庭为中心的预防早产儿脑室内出血护理方法的依从性。这是通过进行基线和后续审计、实施培训计划以及保留更全面的护理记录来实现的。进一步的研究可以评估干预措施的长期有效性和/或早产儿脑室内出血和神经发育障碍（疾病）的发生率。
