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Updated: Jan 24, 2026

Imaging Cleared Embryonic and Postnatal Hearts at Single-cell Resolution
Published on: October 7, 2016
Development of a single-center quality bundle to prevent sudden unexpected postnatal collapse
David A Paul1,2, Dawn Johnson3, Neal D Goldstein4
1Division of Neonatology, Department of Pediatrics, Christiana Care Health System, Newark, DE, USA. dpaul@christianacare.org.
Background:
Recent reports suggest a rising awareness of sudden unexpected postnatal collapse (SUPC).
Local Problem:
Five SUPC events during a 17-month period.
Methods:
A multidisciplinary team used a quality-improvement approach to develop the intervention. The smart aim was to develop a bundled intervention to eliminate SUPC from occurring in the delivery room during skin-to-skin care.
Intervention:
A bundled intervention included a standardized assessment tool and measurement of oxygen saturation levels, with prescribed responses to abnormal values, during skin-to-skin care in the delivery room.
Results:
Pre-intervention, there were five SUPC events/9143 live births (incidence 0.54/1000 live births) compared with 0 SUPC events/13,964 live births post intervention, pā=ā0.011. Special cause variation was achieved after implementation when the number of deliveries between SUPC events exceeded 3-sigma.
Conclusion:
A bundled approach to monitoring during skin-to-skin care, including measurement of oxygen saturation, was associated with no additional cases of SUPC.
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