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Quality Improvement in NICU May Cut Morbidity in Preemies

Practice changes linked to increase in survival without major morbidity for infants born at 23 to 32 weeks

MONDAY, Jan. 27, 2020 (HealthDay News) — Implementation of network-wide quality improvement activities may improve survival without morbidity in very preterm infants, according to a study published in the Jan. 27 issue of CMAJ, the journal of the Canadian Medical Association.

Shoo K. Lee, M.B.B.S., Ph.D., from the University of Toronto, and colleagues conducted a retrospective study of infants born at 23 to 32 weeks of gestation who were admitted to tertiary neonatal intensive care units that participated in the Evidence-based Practice for Improving Quality program from 2004 to 2017. Changes in neonatal outcomes and care practices were examined. Data were included for 50,831 infants.

The researchers found that survival without major morbidity increased significantly as a result of practice changes from 56.6 to 70.9 percent (adjusted odds ratio, 1.08 per year). There was also an increase noted in survival of infants born at 23 to 25 weeks of gestation from 70.8 to 74.5 percent (adjusted odds ratio, 1.03 per year). Increased use of antenatal steroids (83.6 to 88.1 percent), increased rates of normothermia at admission (44.8 to 67.5 percent), and reduced use of pulmonary surfactant (52.8 to 42.7 percent) were included as changes in care practices.

“The key lessons from the program are that a scientifically rigorous self-learning system is an effective and sustainable way to improve quality of care, and patient outcomes can be improved by doing better with what we already know and have,” the authors write.

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