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Improving preoperative identification of infants at risk for severe retinopathy of prematurity

Carrie Torr1, Bradley Yoder2, Joanna Beachy2

  • 1University of Utah School of Medicine, Salt Lake City, UT, United States. Carrie.Torr@hsc.utah.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|May 16, 2019
PubMed

Insights

Improving preoperative identification of Retinopathy of prematurity (ROP) risk in preterm infants increased accuracy to 100%. This initiative also successfully reduced intraoperative exposure to 100% oxygen saturation, enhancing infant safety.

Area of Science:

  • Neonatal care
  • Ophthalmology
  • Quality improvement in healthcare

Background:

  • Retinopathy of prematurity (ROP) is a significant risk for preterm infants.
  • Accurate preoperative identification of ROP risk is crucial for timely intervention.
  • Intraoperative high oxygen saturation (SpO2) is a modifiable risk factor for ROP.

Purpose of the Study:

  • To enhance preoperative identification of infants at risk for severe ROP to over 95%.
  • To decrease intraoperative exposure to 100% SpO2 in preterm infants.
  • To evaluate the impact of a simplified preoperative handoff process.

Main Methods:

  • A prospective quality improvement project was conducted with 41 preterm surgical infants.
  • Preoperative ROP risk identification rates were tracked using an annotated run chart.
  • Intraoperative SpO2 levels and laser intervention rates were compared before and after the intervention.

Main Results:

  • Preoperative ROP risk identification improved from 60% to 100%.
  • No infants experienced 100% intraoperative SpO2 during the study period.
  • The incidence of laser intervention decreased by 45% (from 22% to 12%).

Conclusions:

  • Simplifying the preoperative handoff process significantly improved ROP risk identification and communication.
  • The intervention effectively reduced exposure to 100% SpO2 in preterm infants.
  • Enhanced preoperative risk assessment and communication contribute to better ROP management.
Abstract

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