Interdisciplinary Quality Improvement Project Increases Vitamin D Supplementation in Infants

Area of Science:

• Pediatrics
• Public Health
• Quality Improvement

Background:

• The American Academy of Pediatrics recommends 400 IU of vitamin D daily for infants under one year.
• Current supplementation rates at the institution were below the target of 80%.

Purpose of the Study:

• To increase appropriate vitamin D supplementation for infants from 49% to 80% within 24 months.
• To improve vitamin D adherence in infants through 6 months of age.

Main Methods:

• An interdisciplinary quality improvement project focused on bedside vitamin D delivery before nursery discharge and enhanced family/staff education.
• Process measures included vitamin D discharge rates and teaching; outcome measures assessed reported supplementation at 2, 4, and 6 months.
• Statistical Process Control (SPC) charts were used to monitor data and detect special causes.

Main Results:

• Vitamin D discharge rates increased from 24.8% to 98% between 2016 and 2018.
• Reported appropriate vitamin D supplementation at well-child visits rose from 49% to 89% during the same period.
• Infant discharge times remained stable, with 60% of infants discharged by 2 pm.

Conclusions:

• Bedside medication delivery and education in the newborn nursery effectively improved vitamin D supplementation rates in the first six months of life.
• The intervention demonstrated no adverse impact on the timeliness of newborn hospital discharges.