通过实施护理集束策略来降低早产儿严重脑室内出血发生率的质量改进举措。

Quality improvement initiative to decrease severe intraventricular hemorrhage rates in preterm infants by implementation of a care bundle.

作者信息

Peltola Samantha D, Akpan Uduak S, Tumin Dmitry, Huffman Penni

机构信息

College of Nursing, University of South Alabama, Mobile, AL, USA.

Brody School of Medicine at East Carolina University, Greenville, NC, USA.

出版信息

J Perinatol. 2025 Mar 27. doi: 10.1038/s41372-025-02274-5.

OBJECTIVE

To decrease the incidence of severe Intraventricular Hemorrhage (sIVH) rates in preterm infants in a Neonatal Intensive Care Unit (NICU) to 10% over eight months.

POPULATION

All infants born less than 30 gestational weeks.

METHODS

Targeted interventions focus on the first 72 h of life and include minimizing disturbance in cerebral blood flow and minimal stimulation. Data were collected from a review of electronic medical records from September 2023 - April 2024.

OUTCOME MEASURES

A decrease in sIVH (grade III-IV), an increase in head-of-bed elevation rate, and an evaluation of pedal/pelvic edema due to head-of-bed elevation.

RESULTS

The rate of sIVH decreased over the eight-month implementation period from 24.4% in the baseline period to 9.3% in the intervention period.

CONCLUSION

Standardization of care using a sIVH prevention bundle was instrumental in the success of this project.

目的

在八个月内将新生儿重症监护病房（NICU）中早产儿的重度脑室内出血（sIVH）发生率降至10%。

研究对象

所有孕周小于30周出生的婴儿。

方法

针对性干预措施集中在出生后的前72小时，包括尽量减少脑血流干扰和最小化刺激。数据收集自对2023年9月至2024年4月电子病历的回顾。

观察指标

sIVH（III-IV级）发生率降低、床头抬高率增加以及对因床头抬高导致的足部/盆腔水肿进行评估。

结果

在八个月的实施期内，sIVH发生率从基线期的24.4%降至干预期的9.3%。

结论

使用sIVH预防综合措施实现护理标准化对该项目的成功起到了重要作用。