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Updated: Jun 12, 2025
Modeling Neonatal Intraventricular Hemorrhage Through Intraventricular Injection of Hemoglobin
Published on: August 25, 2022
Care bundle for preventing intraventricular hemorrhage in premature infants: a best practice implementation project
Álvaro Solaz García1,2,3, Rosario Ros Navarret2, Marta Aguar Carrascosa1,2
1Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain.
Insights
Preventing intraventricular hemorrhage in premature infants is crucial for better neonatal outcomes. This study improved care practices in a neonatal intensive care unit (NICU) through audits and education.
Area of Science:
- Neonatalogy
- Evidence-based practice
- Clinical audit
Background:
- Intraventricular hemorrhage (IVH) significantly impacts neonatal morbidity, mortality, and long-term neurodevelopmental outcomes.
- Preventing IVH in premature infants is a critical challenge in neonatal intensive care units (NICUs).
Purpose of the Study:
- To implement and evaluate strategies for preventing intraventricular hemorrhage in premature infants within the first days of life.
- To enhance adherence to evidence-based, family-centered care protocols in a neonatal intensive care unit (NICU).
Main Methods:
- A pre- and post-implementation clinical audit using the JBI Evidence Implementation Framework in a tertiary Spanish NICU.
- Baseline and follow-up audits assessed 13 criteria derived from best available evidence.
- Implementation involved a care bundle, healthcare professional education, and improved nursing record-keeping.
Main Results:
- The follow-up audit demonstrated 100% improvement in sleep safety and noise reduction criteria (Criteria 2, 3, 6, 7).
- Improvements were noted in cord clamping and infant positioning (Criteria 12, 13) by 25.99%.
- A modest improvement of 5.56% was observed for antenatal corticosteroid use (Criterion 9).
Conclusions:
- The study successfully increased compliance with evidence-based practices for preventing intraventricular hemorrhage.
- The intervention, including audits and education, improved care for premature infants in the NICU.
- Further research is recommended to evaluate long-term effectiveness and neurodevelopmental outcomes.
Introduction:
Intraventricular hemorrhages remain a major problem in neonatology, as their complications affect neonatal morbidity, mortality, and long-term neurodevelopmental outcomes.
Aim:
The aim of this project was to prevent intraventricular hemorrhage in premature infants during their first days of life in a neonatal intensive care unit (NICU).
Methods:
This pre- and post-implementation clinical audit project used the JBI Evidence Implementation Framework and was conducted in a tertiary-level Spanish NICU with a consecutive sample. A baseline audit was conducted using 13 audit criteria derived from JBI summaries of the best available evidence. This was followed by the implementation of an action plan, which included a care bundle and health care professionals' education. These improvement strategies were then evaluated using a follow-up audit.
Results:
The baseline and follow-up audits evaluated 54 and 56 infants, respectively. The follow-up audit showed 100% improvement for Criteria 2, 3, 6, and 7, which covered sleep safety and noise. Criteria 12 and 13, which covered cord clamping and positioning the infant, improved by 25.99%. Criterion 9, on antenatal corticosteroids, showed a slight improvement of 5.56%.
Conclusions:
This study increased compliance with an evidence-based, family-centered care approach to preventing intraventricular hemorrhage in premature infants. This was achieved by conducting a baseline and follow-up audit, implementing a training program, and keeping more comprehensive nursing records. Further studies could assess the long-term effectiveness of interventions and/or the incidence of intraventricular hemorrhage and neurodevelopmental disorders in premature infants.
Spanish Abstract:
http://links.lww.com/IJEBH/A262.
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