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Elaboration and implementation of a protocol for the Golden Hour of premature newborns using an Implementation
Elizangela Sant'Anna da Silva1, Cândida Caniçali Primo1, Sarah Gimbel2
1Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
Insights
Implementing the Golden Hour protocol for premature newborns improved neonatal care. This quality improvement process requires ongoing training to ensure adherence and optimal infant outcomes.
Area of Science:
- Neonatal care
- Implementation science
- Quality improvement
Background:
- The first hour of life is critical for premature newborns.
- Standardized care protocols can improve neonatal outcomes.
- Implementation science frameworks facilitate the adoption of evidence-based practices.
Purpose of the Study:
- To describe the design and implementation of a neonatal care protocol for the first hour of life.
- To identify implementation drivers and facilitators for the Golden Hour protocol.
- To evaluate the feasibility and impact of the protocol in a university hospital setting.
Main Methods:
- A participatory research study utilizing the Consolidated Framework for Implementation Research (CFIR).
- A multi-professional team engaged in six quality improvement stages.
- Qualitative and monitoring data analyzed using descriptive statistics and content analysis.
Main Results:
- The Golden Hour protocol was collaboratively developed, prioritizing cardiopulmonary stability, and preventing hypothermia, hypoglycemia, and infection.
- The protocol was perceived as high-quality, necessary, low-cost, and not complex.
- Refresher training was recommended to address staff turnover.
Conclusions:
- The Golden Hour protocol represents an appropriate and feasible quality improvement initiative for neonatal care.
- Periodic refresher training is essential for sustained adherence and improved neonatal outcomes.
- This study highlights the successful application of implementation science in a clinical setting.
Objective:
describe the process of designing and implementing a care protocol for the first hour of life of premature newborns.
Method:
a participatory research study using an implementation science framework, the Consolidated Framework for Implementation Research (CFIR) was employed to determine drivers and facilitators of implementation success of the Golden Hour protocol for newborns at a large university hospital in southeastern Brazil. A multi-professional team, including first line providers and managers participated in six stages of quality improvement: situational diagnosis; protocol elaboration; training protocol implementation; barrier and facilitator assessment; and protocol monitoring and review. Qualitative and monitoring data collected across these six stages were analyzed using descriptive statistics and content analysis.
Results:
the institution's Golden Hour protocol was organized by the multi-professional team based on a collective and dialogical approach. The protocol prioritized the infant's cardiopulmonary stability, as well as prevention of hypothermia, hypoglycemia and infection. After four months of implementation, the care team was evaluated the protocol as a good quality intervention, necessary for the service, low-cost and not very complex. One suggested improvement recommended was to carry out refresher training to address staff turnover.
Conclusion:
implementation of the Golden Hour protocol introduced an appropriate and feasible neonatal care quality improvement process, which requires periodic refresher training to ensure greater adherence and better neonatal results.
