Scott O Guthrie,Howard E Herrell,Patricia A Scott,Bonnie J Miller,Sharon Wadley,Brenda Barker
{"title":"通过全州质量协作改善田纳西州的延迟脐带夹紧。","authors":"Scott O Guthrie,Howard E Herrell,Patricia A Scott,Bonnie J Miller,Sharon Wadley,Brenda Barker","doi":"10.1542/peds.2024-066158","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\r\nThe 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.\r\n\r\nMETHODS\r\nIn 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.\r\n\r\nRESULTS\r\nAt 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.\r\n\r\nCONCLUSIONS\r\nThis 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.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"16 1","pages":""},"PeriodicalIF":6.2000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Improving Delayed Cord Clamping Across Tennessee Through a Statewide Quality Collaborative.\",\"authors\":\"Scott O Guthrie,Howard E Herrell,Patricia A Scott,Bonnie J Miller,Sharon Wadley,Brenda Barker\",\"doi\":\"10.1542/peds.2024-066158\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\r\\nThe 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.\\r\\n\\r\\nMETHODS\\r\\nIn 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.\\r\\n\\r\\nRESULTS\\r\\nAt 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.\\r\\n\\r\\nCONCLUSIONS\\r\\nThis 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.\",\"PeriodicalId\":20028,\"journal\":{\"name\":\"Pediatrics\",\"volume\":\"16 1\",\"pages\":\"\"},\"PeriodicalIF\":6.2000,\"publicationDate\":\"2025-04-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1542/peds.2024-066158\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1542/peds.2024-066158","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Improving Delayed Cord Clamping Across Tennessee Through a Statewide Quality Collaborative.
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.
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.