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Quality initiatives related to moderately preterm, late preterm, and early term births

Andrea N Trembath1, Jay D Iams, Michele Walsh

  • 1Division of Neonatology, Department of Pediatrics, UH Rainbow Babies & Children's Hospital, 11100 Euclid Avenue, RBC Suite 3100, Cleveland, OH 44106-6010, USA.

Clinics in Perinatology
|November 5, 2013
PubMed

Insights

Quality improvement initiatives can reduce morbidities in moderately preterm (MPT) and late preterm (LPT) infants. Applying lessons from extremely low-gestational-age newborns can decrease variation in MPT and LPT infant care practices.

Area of Science:

  • Neonatal care
  • Pediatric quality improvement
  • Perinatal medicine

Background:

  • Most premature infants are moderately preterm (MPT) or late preterm (LPT).
  • Variations in care and lack of evidence-based practices contribute to prematurity morbidities.
  • Current quality improvement (QI) initiatives focus on extremely low-gestational-age newborns.

Purpose of the Study:

  • To highlight the need for QI in MPT and LPT infant care.
  • To suggest applying QI lessons from extremely low-gestational-age newborns to MPT and LPT populations.
  • To identify key areas for QI in MPT and LPT infant care.

Main Methods:

  • Review of current QI practices in neonatal care.
  • Analysis of potential application of QI strategies across different preterm infant groups.
  • Identification of specific clinical practice variations requiring QI.

Main Results:

  • QI initiatives for extremely low-gestational-age newborns offer transferable lessons.
  • Significant practice variations exist in MPT and LPT infant care.
  • Key areas for QI include timing of nonindicated preterm delivery, progesterone use, respiratory care, feeding, and discharge planning.

Conclusions:

  • QI initiatives are crucial for reducing morbidities in MPT and LPT infants.
  • Adapting existing QI strategies can improve care for a larger preterm population.
  • Targeted QI efforts in specific practice areas are needed to optimize outcomes for MPT and LPT infants.

Keywords:
Delaying preterm birthHuman milkInfection reductionPreterm birthsQuality improvement

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