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Standardizing Care of the Late Preterm Infant
Insights
Improving care for late preterm infants (born 34-36 weeks) is crucial. A quality improvement project increased nurse adherence to care policies from 64% to 90% through targeted interventions.
Area of Science:
- Neonatal care
- Pediatrics
- Quality Improvement in Healthcare
Background:
- Late preterm infants (34-36 6/7 weeks gestation) face higher risks for complications like hypoglycemia and feeding issues compared to term infants.
- Physiological and metabolic immaturity contribute to these increased risks in late preterm infants.
Purpose of the Study:
- To enhance adherence to the established late preterm infant care policy within a level III maternal and newborn hospital.
- The project aimed to increase nurse adherence to the late preterm infant policy from a baseline of 64% to a target of 80%.
Main Methods:
- Implementation of an education program for maternal-child nurses and support clinicians.
- Introduction of a specialized breastfeeding log for late preterm infants.
- Updates to the electronic medical record system to support policy adherence.
Main Results:
- Nurse adherence to the late preterm infant policy significantly improved, reaching 90% by the project's conclusion.
- The interventions successfully surpassed the initial adherence goal of 80%.
Conclusions:
- Establishing comprehensive late preterm infant care protocols in all newborn nurseries is recommended.
- Electronic medical record prompts, dedicated breastfeeding logs, and ongoing education are effective strategies to support policy adherence for late preterm infant care.
Background:
Late preterm infants are infants born between 34 and 36 6/7 weeks gestation. Compared to term infants, late preterm infants are at increased risk for breastfeeding difficulties, hypoglycemia, hyperbilirubinemia, and hypothermia due to their relative physiologic and metabolic immaturity.
Problem:
Medical record reviews performed at a level III maternal and newborn hospital in central Illinois revealed only 64% of late preterm infants admitted to the newborn nursery received care per the unit late preterm infant policy. The aim of this quality improvement project was to increase nurse adherence to the policy to 80%.
Methods:
Between May 2022 and September 2022, several interventions were implemented for maternal-child nurses and support clinicians: an education offering, creation of a late preterm infant-specific breastfeeding log, and electronic medical record updates. Post-intervention medical record reviews measured policy adherence through documentation of feeding sessions, hypoglycemia, hypothermia, and hyperbilirubinemia. Descriptive statistics were performed to determine improvement.
Results:
Nurse adherence to the late preterm infant policy increased to 90% over the period of the project.
Clinical Implications:
Late preterm infant care protocols should be in place in all newborn nurseries. Late preterm infant policy adherence can be supported through electronic medical record prompts, use of a late preterm infant-specific breastfeeding log, and continuing education.
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