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Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Sixty golden minutes: a quality improvement bundle reduces morbidities in at-risk preterm infants
Justin Kotliar1, Priyanka Tiwari2, Yafa Davydova3
1Division of Neonatology, The Children's Regional Hospital at Cooper University Health Care, Camden, NJ, USA. kotliar-justin@cooperhealth.edu.
Objective:
Timely interventions during the "Golden Hour" (GH) reduce neonatal morbidity and mortality. We aimed to decrease hypothermia, time to antibiotics and intravenous fluids (IVF) initiation and invasive ventilation by 25%, bronchopulmonary dysplasia (BPD) by 10% and achieve 50% adherence to a GH bundle in our NICU.
Study Design:
We conducted a quality improvement initiative using seven Plan-Do-Study-Act cycles (December 2021-October 2023) for infants <32 weeks gestation and/or ≤ 1500 grams. Outcomes were analyzed using statistical process control charts.
Results:
Over the study period, moderate-severe hypothermia decreased from 25% to 0%, the mean time to antibiotics improved from 132 to 77 min and IVF initiation within GH increased from 30% to 86%. Grade 2/3 BPD decreased from 37% to 19%. GH bundle adherence reached 88%.
Conclusion:
Implementation of a structured golden hour bundle, incorporating standardized admission workflows, improved thermoregulation practices, and optimized early respiratory management, resulted in improved outcomes in at-risk preterm infants.
