Improving Delayed Cord Clamping Across Tennessee Through a Statewide Quality Collaborative.

IF 6.2 2区 医学 Q1 PEDIATRICS
Scott O Guthrie,Howard E Herrell,Patricia A Scott,Bonnie J Miller,Sharon Wadley,Brenda Barker
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Abstract

OBJECTIVE The objective of this initiative was to increase the proportion of infants born in participating hospitals receiving the benefits of delayed cord clamping (DCC) for at least 60 seconds to a minimum of 90% for each facility. METHODS In January 2022, a quality improvement (QI) initiative was launched across 5 pilot hospitals, later expanding to 22 additional hospitals in May 2022. The goal of the initiative was to ensure that all newborns at each facility experienced a delay of at least 60 seconds before umbilical cord clamping. Monthly data collection continued through June 2023, tracking the number of live births, the number of infants whose cords were clamped after 60 seconds, and race/ethnicity. Balancing measures, including the number of infants with a 5-minute appearance, pulse, grimace, activity, and respiration (Apgar) score of up to 3 and hypothermia (temperature of <36.5 °C), were recorded monthly. Structure and process measures critical for improving DCC rates were also identified and monitored. RESULTS At project completion, 61 642 out of 74 241 (83%) infants received a delay of at least 60 seconds in cord clamping. The aggregate baseline mean for DCC was 76%. Special cause variation (a favorable shift) was observed, resulting in an adjusted mean rate of 87% for DCC. The impact was consistent across both level I/II and level III/IV facilities. CONCLUSIONS This report highlights the successful implementation of DCC practices through the state's perinatal QI collaborative. Evidence-based QI initiatives can significantly enhance uptake of recommended practices and improve infant care during birth.
通过全州质量协作改善田纳西州的延迟脐带夹紧。
该倡议的目标是提高在参与医院出生的婴儿接受延迟脐带夹(DCC)至少60秒的好处的比例,每家医院的比例至少达到90%。方法2022年1月,在5家试点医院启动了质量改进(QI)计划,随后于2022年5月扩展到另外22家医院。该倡议的目标是确保每个机构的所有新生儿在脐带夹断前至少有60秒的延迟。每月数据收集持续到2023年6月,追踪活产婴儿数量、60秒后脐带被夹住的婴儿数量以及种族/民族。每月记录平衡措施,包括5分钟外观,脉搏,鬼脸,活动和呼吸(Apgar)评分高达3分和体温过低(温度<36.5°C)的婴儿数量。还确定并监测了对提高DCC率至关重要的结构和工艺措施。结果项目完成后,74 241例婴儿中有61 642例(83%)的脐带夹夹延迟至少60秒。DCC的总基线平均值为76%。观察到特殊原因变化(有利的移位),导致DCC的调整平均率为87%。对I/II级和III/IV级设施的影响是一致的。结论本报告强调了通过国家围产期QI协作,DCC实践的成功实施。以证据为基础的健康指数倡议可以显著提高推荐做法的接受程度,并改善婴儿出生时的护理。
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来源期刊
Pediatrics
Pediatrics 医学-小儿科
CiteScore
12.80
自引率
5.00%
发文量
791
审稿时长
2-3 weeks
期刊介绍: The Pediatrics® journal is the official flagship journal of the American Academy of Pediatrics (AAP). It is widely cited in the field of pediatric medicine and is recognized as the leading journal in the field. The journal publishes original research and evidence-based articles, which provide authoritative information to help readers stay up-to-date with the latest developments in pediatric medicine. The content is peer-reviewed and undergoes rigorous evaluation to ensure its quality and reliability. Pediatrics also serves as a valuable resource for conducting new research studies and supporting education and training activities in the field of pediatrics. It aims to enhance the quality of pediatric outpatient and inpatient care by disseminating valuable knowledge and insights. As of 2023, Pediatrics has an impressive Journal Impact Factor (IF) Score of 8.0. The IF is a measure of a journal's influence and importance in the scientific community, with higher scores indicating a greater impact. This score reflects the significance and reach of the research published in Pediatrics, further establishing its prominence in the field of pediatric medicine.
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