Standardizing early cerebral palsy detection in high-risk infants: reducing age at diagnosis through a quality improvement initiative.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-09-09 DOI:10.1038/s41372-025-02412-z

Sylvan Ryder, Mallory Kerner-Rossi, Sandhya Brachio, Lisa Yoon, Kathleen Brennan, Jennifer Hammond, Gabriella Paskin, Annette Zygmunt, Anketil Abreu, Shelagh O'Neill, Patricia Ryan, Joan Wagner, Anna Penn, Faith Kim

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引用次数: 0

Abstract

Objective: To screen high-risk infants for CP in a level IV NICU and high-risk infant follow-up (HRIF) clinic.

Study design: By using quality improvement methodology, we implemented the General Movement Assessment (GMA) and Hammersmith Infant Neurological Examination (HINE) to screen for CP and lower age at diagnosis. Main balancing measures included no-show rates.

Results: Within the first year, 89% of infants had a GMA in the NICU, 100% in HRIF and 87% had a HINE in HRIF. Median age at diagnosis decreased from 18.5 months adjusted [16.7,19.4] in 2021 to 7.5 months [5.9,14.4; p = 0.01] in 2022 and 8.9 months [6.6,12.2; p = 0.01] in 2023. No-show rates increased in 2022 compared to 2021 (24% vs 17%, p = 0.02).

Conclusions: By implementing and continuously improving a standard process in the NICU and HRIF, we demonstrated a successful increase in screening for CP leading to a lower age at diagnosis sustained for two years.

查看原文本刊更多论文

规范高危婴儿早期脑瘫检测：通过提高质量倡议降低诊断年龄。

目的：筛选IV级NICU和高危婴儿随访（HRIF）门诊的高危婴儿CP。研究设计：通过质量改进方法，我们实施了一般运动评估（GMA）和Hammersmith婴儿神经检查（HINE）来筛查CP和较低的诊断年龄。主要的平衡措施包括缺勤率。结果：在第一年，NICU有89%的婴儿有GMA， HRIF有100%，HRIF有87%的婴儿有HINE。诊断时的中位年龄从2021年调整后的18.5个月[16.7,19.4]降至7.5个月[5.9,14.4]；P = 0.01] 2022年和8.9个月[6.6,12.2；P = 0.01]。与2021年相比，2022年的缺席率有所上升（24%比17%，p = 0.02）。结论：通过在NICU和HRIF实施并不断改进标准流程，我们证明了CP筛查的成功增加，导致持续两年的较低诊断年龄。

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

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.