Reducing severe intraventricular haemorrhage rates in <26-week preterm infants with bedside assessment and care bundle implementation

IF 2.4 4区医学 Q1 PEDIATRICS

Acta Paediatrica Pub Date : 2024-12-12 DOI:10.1111/apa.17542

Ian Tang, Simone Huntingford, Lindsay Zhou, Catherine Fox, Taryn Miller, Mohan B. Krishnamurthy, Flora Y. Wong

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引用次数: 0

Abstract

Aim

To assess staff adherence to a ‘Preterm Brain Injury Prevention Bundle’, and its effectiveness in reducing severe intraventricular haemorrhage (IVH) rates and risk factors in extremely preterm infants born at <26 weeks' gestation.

Methods

Adherence to the bundle was assessed using a novel bedside assessment tool, with immediate feedback to bedside staff post-assessment. Data on IVH rates and associated risk factors were stratified by IVH severity, and compared between pre- and post-bundle implementation.

Results

Of 203 bedside assessments, good adherence was observed in 12/28 items (43%), while the remaining items required improvement. Rates of grade 3/4 IVH reduced (39.2% pre-bundle vs. 19.0% post-bundle, p = 0.13). Thermoregulation and base excess improved (p = 0.02 and p = 0.04 respectively) after bundle implementation.

Conclusion

Reduced severe IVH rates post-bundle implementation may be attributed to staff education and improved clinical parameters. Adherence to the bundle interventions varied which highlighted target areas for future education.

查看原文本刊更多论文

通过床边评估和护理包的实施降低<26周早产儿严重脑室内出血的发生率。

目的：评估工作人员对“早产儿脑损伤预防捆绑包”的依从性，以及其在降低在该医院出生的极早产儿严重脑室内出血（IVH）率和危险因素方面的有效性。方法：使用一种新的床边评估工具来评估对捆绑包的依从性，并在评估后立即反馈给床边工作人员。IVH率和相关危险因素的数据按IVH严重程度分层，并在实施前和实施后进行比较。结果：203项床边评估中，有12/28项（43%）依从性良好，其余项目有待改善。3/4级IVH发生率降低（捆绑治疗前39.2% vs捆绑治疗后19.0%,p = 0.13）。捆绑实施后，体温调节和碱性过剩得到改善（p = 0.02和p = 0.04分别）。结论：实施捆绑治疗后严重IVH发生率的降低可能与工作人员的教育和临床参数的改善有关。对一揽子干预措施的依从性各不相同，突出了未来教育的目标领域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Paediatrica 医学-小儿科

CiteScore

6.50

自引率

5.30%

发文量

384

审稿时长

2-4 weeks

期刊介绍： Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including: neonatal medicine developmental medicine adolescent medicine child health and environment psychosomatic pediatrics child health in developing countries