BMJ open quality · 2022
Implementation of a temperature bundle improves admission hypothermia in very-low-birth-weight infants in China: a multicentre study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Wang Li, Liu Zhi-Jie, Liu Feng-Min, Yu Yong-Hui, Bi Shu-Yu, Li Bin, Xu Hai-Yan, Yang Chun-Yan
Аннотация
BACKGROUND: Hypothermia is a common problem that is associated with increased mortality and morbidity among preterm infants, especially in China. The objective of this study was to evaluate the efficacy of a targeted quality improvement (QI) project that applied hypothermia prevention measures for very-low-birth-weight (VLBW) infants in three tertiary neonatal intensive care units (NICUs) in China.
PROBLEM: Between January 2018 and December 2018, we conducted a prospective analysis and found that the incidence of AH was 88.2% among VLBW infants.
METHODS: The study enrolled preterm infants born at less than 32 weeks' gestation with a VLBW of less than 1500 g who were delivered at three academic tertiary-care hospitals between January 2018 and December 2019. The primary outcome measure was the incidence of hypothermia. The outcomes of the pre-QI group (1 January-31 December 2018) were compared with those of the post-QI group (1 January-31 December 2019).
INTERVENTIONS: Based on the literature, our preliminary findings and the needs of each unit, a temperature bundle that included a transport incubator, prewarmed hats, polyethylene wrap, team training and education, and temperature documentation and workflows were implemented in consecutive plan-do-study-act cycles.
RESULTS: Of the 530 VLBW infants, 235 infants (36.9%) belonged to the pre-QI group, and 295 infants (46.4%) belonged to the post-QI group. The incidence of hypothermia decreased significantly, from 92.3% to 62% (p<0.001), and the mean body temperature on admission to the NICU increased significantly, from 35.5°C to 36°C±0.7°C (p<0.001). There was one case of hyperthermia during the study period. Infants in the post-QI group had a lower mortality rate (16.1% vs 8.8%, p=0.01).
CONCLUSIONS: Targeted interventions can dramatically reduce admission hypothermia and improve the outcome of VLBW infants in China.
TRIAL REGISTRATION NUMBER: Chi CTR 1900020861.
PROBLEM: Between January 2018 and December 2018, we conducted a prospective analysis and found that the incidence of AH was 88.2% among VLBW infants.
METHODS: The study enrolled preterm infants born at less than 32 weeks' gestation with a VLBW of less than 1500 g who were delivered at three academic tertiary-care hospitals between January 2018 and December 2019. The primary outcome measure was the incidence of hypothermia. The outcomes of the pre-QI group (1 January-31 December 2018) were compared with those of the post-QI group (1 January-31 December 2019).
INTERVENTIONS: Based on the literature, our preliminary findings and the needs of each unit, a temperature bundle that included a transport incubator, prewarmed hats, polyethylene wrap, team training and education, and temperature documentation and workflows were implemented in consecutive plan-do-study-act cycles.
RESULTS: Of the 530 VLBW infants, 235 infants (36.9%) belonged to the pre-QI group, and 295 infants (46.4%) belonged to the post-QI group. The incidence of hypothermia decreased significantly, from 92.3% to 62% (p<0.001), and the mean body temperature on admission to the NICU increased significantly, from 35.5°C to 36°C±0.7°C (p<0.001). There was one case of hyperthermia during the study period. Infants in the post-QI group had a lower mortality rate (16.1% vs 8.8%, p=0.01).
CONCLUSIONS: Targeted interventions can dramatically reduce admission hypothermia and improve the outcome of VLBW infants in China.
TRIAL REGISTRATION NUMBER: Chi CTR 1900020861.