Effect of the EPIQ Quality Improvement Method on Extrauterine Growth Restriction in Preterm Infants: A Before-After Observational Study.

Abstract

A common problem among preterm newborns is extrauterine growth restriction, or EUGR. The Evidence-based Practice for Improving Quality (EPIQ) strategy aims to reduce EUGR and enhance growth outcomes in neonatal intensive care units (NICUs). The objective of this study is to assess whether implementing EPIQ-based quality improvement interventions is associated with reduced EUGR among preterm infants (< 34 weeks gestation) in a before-after observational study. This study used a before-after design, analyzing retrospective baseline data and prospective postintervention data. A total of 817 preterm infants were included: 231 in the control group (admitted between January 1, 2022, and June 30, 2022; data collected retrospectively) and 586 in the experimental group (admitted between July 1, 2022, and December 31, 2023; data collected prospectively) at Shanxi Children's Hospital. The impact of the interventions was assessed using chi-square and t-tests. There was no significant difference in maternal conditions across groups (p > 0.05). The overall incidence of EUGR was significantly lower in the experimental group (37.54%) than in the control group (57.14%) (p < 0.01). Breast milk usage increased from 25.97% to 41.12% (p < 0.05) and human milk fortifier use increased from 9.09% to 28.84% (p < 0.01), indicating significant improvements in average length and weight growth in the experimental group (p < 0.05). Implementation of EPIQ-based interventions was associated with a significant reduction in EUGR incidence and improved growth outcomes in preterm infants under 34 weeks, supporting its role in enhancing neonatal care.