Why the Delay? A Quality Improvement Initiative for Delayed Cord Clamping in Preterm Infants

Area of Science:

• Neonatal Medicine
• Clinical Quality Improvement
• Perinatal Care

Background:

• Delayed cord clamping (DCC) is recommended for preterm infants.
• Implementation of DCC as standard practice for preterm infants (≤34 weeks gestation) can be challenging.
• Quality improvement (QI) initiatives are effective in optimizing clinical practices.

Purpose of the Study:

• To enhance delayed cord clamping (DCC) rates for preterm infants.
• To establish DCC as routine care for preterm infants using quality improvement (QI) methodologies.
• To identify and address barriers to DCC implementation in a neonatal setting.

Main Methods:

• A multi-departmental QI initiative was implemented.
• Audits of DCC rates and cord clamping documentation were conducted before, during, and after the intervention.
• Data surveillance monitored the impact of QI interventions on DCC rates and admission hypothermia.

Main Results:

• DCC rates for preterm infants increased from a baseline of 12% to 70% post-intervention.
• Documentation of cord clamp time improved from 16% to 92.6%.
• Admission hypothermia decreased from 76% to 43.2%.

Conclusions:

• A structured QI approach and interdepartmental collaboration significantly improved DCC rates for preterm infants.
• The observed improvements in DCC rates were sustained over time.
• QI methods are crucial for establishing and maintaining best practices in neonatal care.