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Updated: May 25, 2025

Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
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Quality Improvement Project to Improve Adherence to Best Practices to Decrease Incidence of Necrotizing Enterocolitis

Ahreen Allana1,2, Sidra Bashir1,2, Ivan Hand1,2

  • 1Department of Pediatrics, NYC Health & Hospitals/Kings County, Brooklyn, NY 11203, USA.

Children (Basel, Switzerland)
|February 26, 2025
PubMed
Summary
This summary is machine-generated.

Implementing evidence-based practices significantly reduced necrotizing enterocolitis (NEC) incidence in preterm infants. This quality improvement project enhanced care bundles, leading to a substantial decrease in NEC cases within the neonatal intensive care unit (NICU).

Keywords:
NECNICUPDSA cyclenecrotizing enterocolitispreterm

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Area of Science:

  • Neonatology
  • Pediatric Surgery
  • Quality Improvement Science

Background:

  • Necrotizing enterocolitis (NEC) is a critical gastrointestinal emergency affecting preterm infants.
  • High incidence rates necessitate improved preventative strategies in neonatal intensive care units (NICUs).

Purpose of the Study:

  • To enhance the adoption of evidence-based practices for NEC prevention.
  • To decrease the incidence of NEC in a level III NICU through a quality improvement initiative.

Main Methods:

  • Implementation of a nine-item evidence-based practice bundle for NEC prevention.
  • Utilized two Plan-Do-Study-Act (PDSA) cycles over two years to refine interventions.
  • Monitored adherence to process measures and NEC incidence in infants <1500g or <32 weeks gestation.

Main Results:

  • Adherence to care bundles improved from 78% to 91.6% (p < 0.05).
  • NEC incidence reduced by 24% after the first PDSA cycle (7% to 5.3%).
  • Further reduction to 2.8% (60% from baseline) after the second PDSA cycle, though not statistically significant due to sample size.

Conclusions:

  • Quality improvement initiatives can significantly increase adherence to evidence-based practices for NEC prevention.
  • The implemented bundle demonstrated a notable reduction in NEC incidence in preterm infants.
  • Sustained efforts in QI are crucial for managing and reducing NEC in high-risk infant populations.