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Reducing severe intraventricular haemorrhage rates in <26-week preterm infants with bedside assessment and care

Ian Tang1, Simone Huntingford1,2, Lindsay Zhou1,2

  • 1Monash Newborn, Monash Children's Hospital, Monash Health, Melbourne, Victoria, Australia.

Acta Paediatrica (Oslo, Norway : 1992)
|December 13, 2024
PubMed

Insights

Staff adherence to a Preterm Brain Injury Prevention Bundle was assessed. Implementation led to reduced severe intraventricular hemorrhage (IVH) rates in extremely preterm infants, suggesting improved clinical parameters and staff education effectiveness.

Area of Science:

  • Neonatalogy
  • Pediatric Neurology
  • Clinical Quality Improvement

Background:

  • Severe intraventricular hemorrhage (IVH) is a significant complication in extremely preterm infants (<26 weeks' gestation).
  • The Preterm Brain Injury Prevention Bundle aims to mitigate risks associated with IVH.
  • Assessing adherence and effectiveness of such bundles is crucial for improving neonatal outcomes.

Purpose of the Study:

  • To evaluate staff adherence to the Preterm Brain Injury Prevention Bundle.
  • To determine the bundle's effectiveness in reducing severe IVH rates and associated risk factors.
  • To identify areas for improvement in bundle implementation and staff education.

Main Methods:

  • A novel bedside assessment tool was used to monitor adherence to the bundle.
  • Immediate feedback was provided to bedside staff post-assessment.
  • Data on IVH rates and risk factors were compared pre- and post-bundle implementation.

Main Results:

  • Adherence to bundle items varied, with 43% showing good adherence.
  • Rates of grade 3/4 IVH significantly decreased from 39.2% pre-bundle to 19.0% post-bundle.
  • Key clinical parameters, including thermoregulation and base excess, showed significant improvement post-bundle.

Conclusions:

  • The Preterm Brain Injury Prevention Bundle may contribute to reduced severe IVH rates.
  • Improved clinical parameters and staff education are likely factors in the observed outcomes.
  • Varied adherence highlights specific areas for targeted future educational interventions.
Abstract

Keywords:
care bundleintraventricular haemorrhageneuroprotectionpreterm infantsquality improvement

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