A quality improvement initiative to reduce necrotizing enterocolitis across hospital systems

作者：Nathan Amy T^*; Ward Laura; Schibler Kurt; Moyer Laurel; South Andrew; Kaplan Heather C

来源：Journal of Perinatology, 2018, 38(6): 742-750.

DOI：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.

• 出版日期2018-6