Neonatal Quality Improvement
Neonatal Quality Improvement 3
Amy L. Lembeck, DO (she/her/hers)
Childrens Hospital of Philadelphia
Newtown Square, Pennsylvania, United States
Of all infants admitted to the Post-Partum Unit (PPU), 159 LPIs over a 2 year period had data. NICU admission rates did not decrease consistently over the 2 year period. 32.6% of LPI admitted to PPU required NICU admission at initiation of our interventions. 30% of infants at time of analysis required NICU admission. There were time spans with a lower rate of NICU admission but they were not maintained for greater than 5 months. 59% of NICU admissions were for respiratory distress, a potentially non-modifiable morbidity. 8% were for hypothermia, 8% for hypoglycemia and 25% for other causes. Hypoglycemia in LPI infants remained constant despite modifications in calories and the adoption of glucose gel. Hypothermia is trending towards statistical change. Process measures included LPI order-set use and a LPI educational pamphlet. Both were adopted as process measures after successful implementation as an intervention.
Conclusion(s): Through an improvement bundle utilizing education, formalized orders, and modifications to improve euthermia and euglycemia, our team has been unable to modify the number of LPI admitted to the NICU. Our data is trending towards improvement with less variability but has not indicated sustainable change at this time. A closer look at why the LPI is admitted may help to focus on additional modifiable morbidities. Reporting and sharing this information is helpful for other units seeking to improving their outcomes in the LPI population.