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Published on: December 31, 2015
"Golden Hour" quality improvement intervention and short-term outcome among preterm infants
Ben Peleg1,2, Omer Globus1,2, Maya Granot1,2
1Department of Neonatology, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.
Insights
Implementing a "Golden Hour" quality improvement intervention significantly benefited preterm neonates, improving temperature and reducing sepsis and bronchopulmonary dysplasia. Further research is needed for long-term outcomes.
Area of Science:
- Neonatal Medicine
- Pediatric Quality Improvement
- Perinatal Care
Background:
- Preterm infants face significant short-term morbidities.
- The "Golden Hour" is critical for neonatal stabilization.
- Quality improvement initiatives can enhance neonatal outcomes.
Purpose of the Study:
- To assess the impact of a "Golden Hour" quality improvement intervention on short-term outcomes in preterm neonates.
- To evaluate the effectiveness of a comprehensive protocol for initial stabilization and treatment of preterm infants.
Main Methods:
- A matched case-control study compared infants before and after protocol implementation.
- The intervention included cord blood sampling, a dedicated resuscitation room, and Crew Resource Management (CRM) for team communication.
- 194 infants were in the intervention group and 194 in the control group.
Main Results:
- Admission temperatures significantly improved in the intervention group (35.26°C to 36.26°C, P < 0.001).
- Rates of late-onset sepsis and bronchopulmonary dysplasia were significantly reduced (P = 0.035 and P = 0.028, respectively).
- Trends towards reduced early blood transfusion and ventilation duration were observed.
Conclusions:
- The "Golden Hour" quality improvement intervention demonstrated significant benefits for preterm neonates.
- The protocol enhanced initial stabilization and reduced key morbidities.
- Long-term follow-up is recommended to fully assess the intervention's effects.
Objective:
To evaluate the impact of a quality improvement intervention during the first hour of life ("Golden Hour") on short-term preterm neonatal outcome.
Study Design:
A comprehensive protocol designed for initial stabilization and treatment of preterm infants that included cord blood sampling, use of a dedicated resuscitation room and improved team communication using Crew Resource Management tools. The infants admitted before and after implementation of the protocol were retrospectively compared in a matched case-control design.
Results:
There were 194 infants in the intervention group and 194 controls. Admission temperatures improved significantly from a mean of 35.26 °C to 36.26 °C (P < 0.001), and late-onset sepsis and bronchopulmonary dysplasia rates lowered significantly (P = 0.035 and P = 0.028, respectively) in the intervention group. There was trend towards reduction in early blood transfusion and ventilation duration.
Conclusions:
A "Golden Hour" quality improvement intervention was of significant benefit for preterm neonates. Further follow-up to assess long-term effects is warranted.
