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Increasing length board use in a neonatal intensive care unit: a quality improvement initiative
Yvette Penner1, Sabah Sabir2, Kathleen Quirk2
1Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Boston Children's Hospital, Boston, MA, 02115, USA.
Insights
A quality improvement initiative successfully increased length board use in neonatal intensive care units (NICUs). This enhanced infant measurement safety and accuracy without adverse events.
Area of Science:
- Neonatal care
- Quality improvement in healthcare
- Pediatric measurement techniques
Background:
- Accurate infant growth monitoring is crucial in neonatal intensive care units (NICUs).
- Standardized length measurement techniques ensure reliable data for clinical decision-making.
- Previous methods may have led to inconsistent or inaccurate length assessments.
Purpose of the Study:
- To enhance the utilization of length boards for eligible infants in a level IV neonatal intensive care unit.
- To improve the accuracy and consistency of infant length measurements.
- To implement a standardized protocol for length measurement in the NICU setting.
Main Methods:
- A quality improvement study was conducted with 704 infants in a level IV NICU.
- A multidisciplinary team developed and implemented guidelines for length measurement technique.
- Plan-Do-Study-Act cycles were utilized to refine the process, monitoring length board use and measurement accuracy.
Main Results:
- The weekly proportion of infants measured with length boards significantly increased from 11% to 63% post-implementation.
- No increase in unplanned dislodgements of drains, tubes, or catheters was observed.
- Length board measurements showed a reduced likelihood of negative week-to-week changes (10% vs 18%).
Conclusions:
- A quality improvement initiative effectively increased the safe and appropriate use of length boards in a level IV NICU.
- The implemented guidelines improved measurement consistency and infant safety.
- Standardized measurement protocols are vital for optimizing neonatal care outcomes.
Objective:
To increase length board use for eligible neonatal intensive care unit (NICU) infants.
Study Design:
We implemented a quality improvement study involving 704 infants in our level IV NICU. A multidisciplinary workgroup developed guidelines for length measurement technique and completed Plan-Do-Study-Act cycles. Outcome measure was the weekly proportion of eligible infants who received a length board measurement. Process measures were the weekly proportion of infants with any length measurement or had method documented. Balancing measure was the incidence of unplanned dislodgements of drains, tubes, or catheters.
Results:
After the guideline launch, both process measure proportions increased. Weekly mean percentage of length board increased from 11 to 63%. There were no dislodgement events. Length board measurements were less likely to demonstrate a negative change week-to-week (10% vs 18%, 16/161 vs 59/326, Fisher p = 0.02).
Conclusion:
In a level IV NICU, a quality improvement initiative increased the safe use of length boards.
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