Quality improvement initiative to decrease severe intraventricular hemorrhage rates in preterm infants by...

Area of Science:

• Neonatal Medicine
• Pediatric Neurology
• Clinical Quality Improvement

Background:

• Severe Intraventricular Hemorrhage (sIVH) is a significant complication in preterm infants.
• Achieving a target incidence of 10% for sIVH in Neonatal Intensive Care Units (NICUs) requires effective interventions.

Purpose of the Study:

• To decrease the incidence of severe Intraventricular Hemorrhage (sIVH) in preterm infants to 10% within eight months.
• To implement and evaluate targeted interventions aimed at preventing sIVH in a Neonatal Intensive Care Unit (NICU) population.

Main Methods:

• Study population included infants born less than 30 gestational weeks.
• Interventions focused on the first 72 hours of life, emphasizing minimized cerebral blood flow disturbance and minimal stimulation.
• Data collected via electronic medical records from September 2023 to April 2024.

Main Results:

• The incidence of severe Intraventricular Hemorrhage (sIVH, grade III-IV) decreased from 24.4% at baseline to 9.3% during the intervention period.
• Head-of-bed elevation rates increased, with evaluation of associated pedal/pelvic edema.

Conclusions:

• Standardization of care through a severe Intraventricular Hemorrhage (sIVH) prevention bundle was key to project success.
• The implemented bundle effectively reduced sIVH rates in preterm infants, meeting the study's objective.