A Quality Improvement Initiative to Reduce Necrotizing Enterocolitis Across …

Nathan, A.T., Ward, L., Schibler, K. et al. A quality improvement initiative to reduce necrotizing enterocolitis across hospital systems. J Perinatol 38, 742–750 (2018). https://doi.org/10.1038/s41372-018-0104-0

Objective
Necrotizing enterocolitis (NEC) is a devastating intestinal disease in premature infants. Local rates of NEC were unacceptably high. We hypothesized that utilizing quality improvement methodology to standardize care and apply evidence-based practices would reduce our rate of NEC.

Study design
A multidisciplinary team used the model for improvement to prioritize interventions. Three neonatal intensive care units (NICUs) developed a standardized feeding protocol for very low birth weight (VLBW) infants, and employed strategies to increase the use of human milk, maximize intestinal perfusion, and promote a healthy microbiome.

Results
The primary outcome measure, NEC in VLBW infants, decreased from 0.17 cases/100 VLBW patient days to 0.029, an 83% reduction, while the compliance with a standardized feeding protocol improved.

Conclusion
Through reliable implementation of evidence-based practices, this project reduced the regional rate of NEC by 83%. A key outcome and primary driver of success was standardization across multiple NICUs, resulting in consistent application of best practices and reduction in variation.

Disponível Em: <https://www.nature.com/>