Pediatric quality & safety最新文献

{"title":"Variation in the Management of Test Results after Hospital Discharge: A Pediatric Safety Concern.","authors":"Meenu Krishnasamy, Rhiya Sharma, Lydia Nashed, Khoa Luong, Courtney Port","doi":"10.1097/pq9.0000000000000871","DOIUrl":"10.1097/pq9.0000000000000871","url":null,"abstract":"<p><strong>Introduction: </strong>Delay or failure to follow up tests pending at discharge (TPAD) is a major safety concern and a focus in the literature, but few studies exist in the pediatric context. We aimed to explore pediatric hospital medicine physicians' practices and perceptions of the management of TPAD.</p><p><strong>Methods: </strong>Surveys were provided to hospitalists and residents at a single institution using selected questions from a published national adult primary care survey and newly developed questions. Results were analyzed using descriptive statistics and Fisher's exact tests.</p><p><strong>Results: </strong>Surveys were completed by 25 hospitalists (89%) and 25 residents (68%). Forty-four percent (n = 11) of hospitalists reported missing test results, yet only 18% (n = 2) agreed that this error led to a delay in care. Seventy-six percent (n = 19) of hospitalists reported lacking adequate assistance to manage TPAD. There is uncertainty about who is responsible for managing TPAD among 88% (n = 22) of hospitalists and 92% (n = 23) of residents. Hospitalists were more likely than residents to use cognitive reminders (72% versus 20%, <i>P</i> = 0.0005). Many hospitalists (80%, n = 20) and residents (80%, n = 20) agreed that TPAD management is a safety issue, and nearly all hospitalists (88%, n = 22) and residents (96%, n = 24) want a standardized process. Residents were more likely to desire a shared responsibility (68% versus 32%, <i>P</i> = 0.02). Only 56% (n = 14) of hospitalists had formal education in result management; 76% (n = 19) of residents desired training.</p><p><strong>Conclusions: </strong>Pediatric hospitalists and residents are concerned about TPAD management, and there is considerable variability in current practices. Developing a standard process is supported by nearly all.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 1","pages":"e871"},"PeriodicalIF":1.2,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Teletherapy Enrollment Using Quality Improvement Methodology for Psychiatry Patients Boarding on Acute Care Services.","authors":"Katherine A Ritter, Mahdieh Bodaghi, Padmaja Pavuluri, Stacey Stokes","doi":"10.1097/pq9.0000000000000872","DOIUrl":"10.1097/pq9.0000000000000872","url":null,"abstract":"<p><strong>Introduction: </strong>In 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association declared a state of emergency in children's mental health. Responding to this emergency, our freestanding children's hospital began a novel teletherapy program to provide teletherapy services to patients admitted to acute care units while awaiting inpatient psychiatric care. The global aim of this quality improvement project was to improve access to inpatient teletherapy. The specific aim was to increase the number of patients who completed at least 1 teletherapy session from a median of 2-4 per month and sustain this increase for 3 months.</p><p><strong>Methods: </strong>Using the Model for Improvement framework, multidisciplinary stakeholders created process maps and Ishikawa diagrams, followed by key driver diagrams, to outline areas for improvement in the teletherapy enrollment process. Interventions included staff education, improved communication techniques, and enhancements to the electronic health record (EHR). We implemented interventions as Plan-Do-Study-Act cycles, collected data via a custom EHR report, and analyzed data using a run chart.</p><p><strong>Results: </strong>After completing 3 Plan-Do-Study-Act cycles, the median number of patients with teletherapy orders increased from 2 to 4 per month, a level we sustained for 5 months.</p><p><strong>Conclusions: </strong>Implementing and sustaining a novel group teletherapy workflow on acute care units is a multidisciplinary and complex process that requires multistakeholder coordination. We achieved a sustained increase in teletherapy enrollment through staff engagement, team member education, and EHR clinical decision support.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 1","pages":"e872"},"PeriodicalIF":1.2,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Structured Handoff Documentation in a Pediatric Emergency Department.","authors":"Deborah Hammett, Rebecca Matta, Jody Kieffer, Jillian Savage, Courtney Nelson","doi":"10.1097/pq9.0000000000000870","DOIUrl":"10.1097/pq9.0000000000000870","url":null,"abstract":"<p><strong>Introduction: </strong>The I-PASS handoff tool guides provider handoffs and reduces adverse events in the inpatient setting. Transitions of care occur frequently in the emergency department (ED), and the unpredictable environment can lead to less structured handoffs. Our goal was to increase the percentage of handoff notes that include all 4 I-PASS components by 20% within 6 months.</p><p><strong>Methods: </strong>We developed a handoff note template for the pediatric ED that included 4 key I-PASS elements: illness severity, patient care summary, action list, and situational awareness/contingency planning. Our primary outcome measure was the percentage of handoff notes that contained all 4 I-PASS elements. Our process measure was the percentage of handoff notes that used the template. Our balancing measure was the percentage of handoffs with no note. We analyzed a random sample of 20 charts monthly during our preimplementation (August 2021-July 2022) and postimplementation (August 2022-January 2024) phases. We completed monthly Plan-Do-Study-Act cycles to review note usage and identify obstacles to use. Process improvements included modifying the note template, enhancing accessibility within the electronic medical record, and designating computer workstations for completing handoff notes.</p><p><strong>Results: </strong>We assessed 240 handoff notes to determine the preimplementation baseline and evaluated 360 handoff notes postimplementation. Following implementation, 63.0% of handoff notes contained 4 I-PASS elements, compared with 0% before our intervention. Similarly, use of handoff templates increased to 82.0% from 0%. There was no change in handoffs without documentation.</p><p><strong>Conclusions: </strong>Using a standardized note template for provider handoff improved adherence with the I-PASS handoff tool in the pediatric ED.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 1","pages":"e870"},"PeriodicalIF":1.2,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building an Adaptable Pediatric Intensive Care Unit Simulation Portfolio: Advancing Efficiency, Flexibility, and Team-based Training.","authors":"Daniel Loeb, Kelly Ely, Kelly Collins, Zachary Paff, Corey Eyer, Maya Dewan, Matthew W Zackoff","doi":"10.1097/pq9.0000000000000864","DOIUrl":"10.1097/pq9.0000000000000864","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation-based education enhances patient safety and team performance in high-acuity environments, such as the pediatric intensive care unit (PICU). However, many units struggle to implement scalable, dynamic simulation programs adaptable to fluctuations in patient volume, clinical acuity, and staffing demands. This quality improvement initiative aimed to develop and implement a comprehensive PICU simulation portfolio, integrating predictive analytics, multidisciplinary collaboration, and real-time clinical data to increase the frequency of simulations and training exposures.</p><p><strong>Methods: </strong>The PICU simulation portfolio underwent iterative improvement via a structured quality improvement initiative. Guided by a specific, measurable, achievable, relevant, and time-bound aim and key driver diagram, targeted interventions were implemented through iterative plan-do-study-act cycles. These interventions included introducing standardized simulation encounter types, a simulation encounter decision tree informed by real-time predictive analytics, incorporating a multidisciplinary team, centralizing simulation resources, and streamlining the setup process. Primary outcomes included simulation frequency and cancelations. Secondary outcomes included participation, facilitator workload, and safety event monitoring.</p><p><strong>Results: </strong>Over the intervention period (July 2022 through June 2024), the simulation program demonstrated increased training capacity, improved efficiency, and heightened participation. Annual simulations increased by 128%, incorporating 1,256 staff, whereas cancelations decreased by 25%. Simulation setup and takedown time were reduced by 58% and 64%, respectively. There were no reported safety events.</p><p><strong>Conclusions: </strong>This scalable PICU simulation training model led to measurable gains in efficiency, training capacity, and multidisciplinary collaboration. Its adaptable framework offers a promising approach for other clinical settings aiming to enhance simulation-based education and training to improve patient care outcomes.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 6","pages":"e864"},"PeriodicalIF":1.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Recommended Care for Immigrant Children in an Ambulatory Care Network.","authors":"Zachary S Berlant, Mariellen M Lane, Laura E Robbins-Milne, Rajasekhar Ramakrishnan, Ashley B Stephens, Morgan A Finkel","doi":"10.1097/pq9.0000000000000865","DOIUrl":"10.1097/pq9.0000000000000865","url":null,"abstract":"<p><strong>Introduction: </strong>The American Academy of Pediatrics has established recommendations to ensure that the unique needs of immigrant children are addressed in pediatric primary care. A needs assessment of a single institution's pediatric ambulatory network revealed that the majority of recommendations were not provided.</p><p><strong>Methods: </strong>A 1-year quality improvement (QI) project starting in October 2021 used electronic health record aids, education, and provider input to increase the rate of providing recommended care for migrant children 18 years of age or younger in a general pediatrics ambulatory network. The primary outcome was whether providers delivered the majority of the 5 universally recommended aspects of care established by the American Academy of Pediatrics for migrant children. The secondary outcomes included each of the 5 recommended care elements evaluated individually. The process measure was the use of electronic health record aids. Rates of provider compliance with providing a majority of recommended care were tracked with a statistical process control chart and compared with those of 20 months prior.</p><p><strong>Results: </strong>Monthly compliance rates increased from a baseline mean of 24.4% to 56.1%. Following the first QI intervention, a run of 11 consecutive points above the centerline met the statistical process control rules for special cause variation.</p><p><strong>Conclusions: </strong>Using QI methodology, rates of delivering recommended care for all migrant children exceeded the goal and more than doubled from baseline. The shift initiated at the start of the QI project, and the maximal rate of care provision peaked at the end of the QI period.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 6","pages":"e865"},"PeriodicalIF":1.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Food Insecurity in Pediatric Primary Care: Implementation of a Fresh Produce Delivery Pilot.","authors":"Michelle C Gorecki, Esineya N Chigaga, Kayla Hall, Jenny Ciolino, Rachel Uhrig, Cynthia White, Christina Brown, Michael Truitt, Melissa D Klein, Adrienne W Henize, Kristen A Copeland, Mary Carol Burkhardt, Chidiogo U Anyigbo","doi":"10.1097/pq9.0000000000000850","DOIUrl":"10.1097/pq9.0000000000000850","url":null,"abstract":"<p><strong>Introduction: </strong>Food insecurity negatively impacts young children's health and development. Our pediatric primary care practice partnered with a local food bank to connect families experiencing food insecurity to a fresh produce home delivery program, using quality improvement (QI) methodology.</p><p><strong>Methods: </strong>Our multidisciplinary team developed a referral pathway from the pediatric practice to the food bank's produce delivery program. The medical team and the food bank completed a QI training course. Our key driver diagram informed interventions, including electronic health record referrals, clinical staff educational initiatives, office signage promoting the program, and refinement of the produce delivery program by the food bank. Our primary outcome measure was referring more than 3% of all patients aged 5 years or younger seen in primary care to the produce delivery program, with a goal of 200 families within 6 months. Our process measure (the food bank's primary outcome measure) was the number of days from referral to first delivery.</p><p><strong>Results: </strong>Over 6 months, we referred 192 families to the produce delivery program. Our initial outcome measure referral rate was 5% of all patients seen in primary care each week, which later adjusted to a sustainability rate of 3.5%. The food bank improved its delivery approach, reducing the mean days to first delivery from a peak of 74 days to 21 days.</p><p><strong>Conclusions: </strong>Addressing food insecurity in outpatient pediatrics requires a multifaceted approach, including connecting families to community-based resources. A shared commitment to QI by the primary care practice and the partner food bank ensured the success of this fresh produce home delivery pilot program.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 6","pages":"e850"},"PeriodicalIF":1.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based Evaluation to Promote High-value Care in Pediatric Critical Care: It Is Time to Fully Adopt.","authors":"Maya Dewan, Rajit K Basu, Erin Bennett, Lily B Glater-Welt, Mark Hall, Benson S Hsu, Lia Lowrie, Venessa Lynn Pinto, Alexandre T Rotta, Edward Seferian, Linda Siegel, Heather A Wolfe, Vijay Srinivasan","doi":"10.1097/pq9.0000000000000863","DOIUrl":"10.1097/pq9.0000000000000863","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence-based recommendations for high-value care in pediatric critical care are needed. We sought to develop recommendations to identify unnecessary interventions, enhance outcomes, and promote efficient, patient-centered practices.</p><p><strong>Methods: </strong>Using a modified Delphi process, a multi-institutional panel of pediatric intensivists from a national pediatric critical care quality improvement group identified 30 potential topics and selected 20 high- and medium-priority topics for further evaluation, and narrowed them to 10 by consensus voting. A structured scoping review of literature published between 2014 and 2023 identified 10 practices, which were critically assessed using the PICOST framework. The panel selected 5 priority recommendations based on evidence strength, feasibility, and potential impact.</p><p><strong>Results: </strong>The panel developed 5 evidence-based recommendations: (1) prioritize early and progressive mobilization in the pediatric intensive care unit, (2) avoid reflexive culture testing in febrile children without clinical signs of infection, (3) conduct daily tracheal extubation readiness assessments to prevent unnecessary delays, (4) limit red blood cell transfusions in stable, nonbleeding patients with hemoglobin greater than 7 g/dL, and (5) initiate enteral nutrition within 48 hours when clinically safe and feasible. Each recommendation is grounded in current best evidence and aims to minimize harm while optimizing resource use and outcomes.</p><p><strong>Conclusions: </strong>Incorporating high-value care principles into pediatric critical care holds promise for reducing unwarranted variation, minimizing harm, and improving the efficiency and effectiveness of care. Future efforts should focus on implementation strategies, practice integration, and ongoing evaluation to sustain improvements and close the gap between evidence and adoption.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 6","pages":"e863"},"PeriodicalIF":1.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Quality Improvement Project to Limit Perioperative Transfusion During Craniofacial Surgery in Infants and Children.","authors":"Grace Parizek, Annie Drapeau, Jonathan Pindrik, Gregory Pearson, Joseph D Tobias, Ashley Smith","doi":"10.1097/pq9.0000000000000861","DOIUrl":"10.1097/pq9.0000000000000861","url":null,"abstract":"<p><strong>Introduction: </strong>Open surgery for craniosynostosis in infants and children is frequently associated with significant intraoperative blood loss and the need for allogeneic transfusion therapy. A lack of consensus at our institution led to inconsistent transfusion therapy during open cranial vault remodeling. We sought to address this through a multidisciplinary quality improvement approach to decrease variability in transfusion practices.</p><p><strong>Methods: </strong>A streamlined intraoperative transfusion algorithm, from the moment the patient was evaluated in the preoperative holding area on the day of surgery through their departure from the postanesthesia care unit, was implemented during quarter 1 of 2021. We aimed to decrease the percentage of intraoperative transfusions administered at hemoglobin (Hgb) levels greater than 7.5 g/dL in stable patients without massive bleeding undergoing open craniosynostosis surgery from 40% in January 2021 to 0% by December 2023.</p><p><strong>Results: </strong>From January 2018 to December 2023, 118 pediatric patients underwent open cranial vault remodeling for craniosynostosis. Before the implementation of the protocol in quarter 1 of 2021, open cranial vault reconstruction (CVR) intraoperative transfusion rates in cases where the threshold was not met (Hgb >7.5 g/dL) were 32%. After protocol implementation, open CVR intraoperative transfusion rates that did not meet the threshold averaged 5%.</p><p><strong>Conclusions: </strong>In this quality improvement project, we decreased transfusion rates for patients with Hgb greater than 7.5 g/dL from 32% to 5% during 3 years. We have successfully developed and implemented an intraoperative blood transfusion algorithm that is generalizable and requires minimal human and material resources.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 6","pages":"e861"},"PeriodicalIF":1.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Pre-X-Ray Safety CHECK in Neonates.","authors":"Debra Armbruster, Megan Barcroft, Michael Stenger, Chance Alvarado, Roopali Bapat","doi":"10.1097/pq9.0000000000000860","DOIUrl":"10.1097/pq9.0000000000000860","url":null,"abstract":"<p><strong>Introduction: </strong>Radiographs are diagnostic tools used in neonatal medicine for diagnosis, reducing harm from vascular devices, and monitoring endotracheal tube placement. The lack of neonatal exposure guidelines and the repetition of radiographs due to poor quality have cumulative effects of radiation overexposure. This project aimed to improve the radiographic quality of films by 15% by using a standardized checklist before radiographic exposure, thus reducing repeat exposures.</p><p><strong>Methods: </strong>Radiographs were classified into 3 groups. The All-X-Ray Group consisted of all abdominal, baby gram, and chest films. Two subgroups included films with an indwelling device (peripherally inserted central catheter or an endotracheal tube). Data were compared from a Baseline Period through an Intervention Period and a Sustain Period (June-July 2022). Three sequential interventions were implemented: the implementation of a standardized safety check, increased unit presence, and hands-on simulation training. The primary outcome was a high-quality diagnostic film that met 4 predefined criteria. Measures were assessed using statistical process control methods through a time-series design to identify changes over time.</p><p><strong>Results: </strong>The quality of films in the All-X-Ray Group improved by 46% (19%-65%), whereas the quality of films in the peripherally inserted central catheter and endotracheal tube subgroups improved by 79% (2%-81%) and 73% (1%-74%), respectively.</p><p><strong>Conclusions: </strong>Standardization of the radiograph process led to improved quality of neonatal films in this unit. Consistent hands-on training enabled sustainable impact. Empowering bedside staff resulted in a positive culture change. A standard pre-x-ray checklist improved the diagnostic quality of films in a neonatal unit when combined with increased provider presence during the x-ray procedure and staff education.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 6","pages":"e860"},"PeriodicalIF":1.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Quality Improvement Project: Providing Music Therapy for Premature Infants in the Neonatal Intensive Care Unit.","authors":"Supriya Bisht, Lan Jiang, Melissa Frascone, Ellen Shatzkin, Kristen Buck, Katie R Forman","doi":"10.1097/pq9.0000000000000856","DOIUrl":"10.1097/pq9.0000000000000856","url":null,"abstract":"<p><strong>Introduction: </strong>Preterm infants require adequate positive auditory stimulation for their development. Music therapy (MT) offers several benefits. Recorded music is recommended when live music is unavailable. This quality improvement project aimed to provide recorded MT to preterm infants.</p><p><strong>Methods: </strong>The team led this quality improvement project in a level IV neonatal intensive care unit from December 2022 to April 2024, with the aim that within 6 months of starting it, 50% of preterm infants born at a gestational age of less than 32 weeks who met physiological stability criteria would receive MT sessions. The Plan-Do-Study-Act model included interventions such as educating neonatal intensive care unit staff and providers about MT, creating memory aids, and streamlining documentation. Recorded Mozart music was played through bedside speakers 3 times a week for 30-minute sessions. The outcome measure tracked the percentage of eligible infants who received MT. Process measures evaluated the percentage of MT sessions provided. Balancing measures included the termination of MT due to clinical instability.</p><p><strong>Results: </strong>Eighty-seven infants received MT. The mean birth gestational age of the infants was 28.4 weeks. MT was initiated at a mean postmenstrual age of 33.4 weeks and continued until a mean age of 39.1 weeks. The percentage of infants receiving MT increased from 50% in the first month to 100% and stayed at a mean of 94.2%. The number of eligible MT sessions received per infant was 41.9% (average of 6.7 sessions). A total of 76.7% of nurses identified no barriers, and parents reported satisfaction with the MT program.</p><p><strong>Conclusions: </strong>Recorded MT can be effectively provided. Multidisciplinary teamwork is required to sustain efforts in providing MT sessions.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 6","pages":"e856"},"PeriodicalIF":1.2,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}