Improving neonatal resuscitation in Tennessee

a large-scale, quality improvement project

on behalf of the Tennessee Initiative for Perinatal Quality Care Golden Hour Project Team

Research output: Contribution to journalArticle

Abstract

Objective: We report a statewide collaborative quality initiative to improve resuscitation and stabilization practices following introduction of the 6th edition of the Neonatal Resuscitation Program. Methods: Participants drafted a consensus toolkit of interventions and corresponding measures. Hospital teams collected baseline data, and implemented changes using PDSA-cycles and statistical process control charts. Results: Nine Tennessee NICUs submitted data on 3771 resuscitations. “Special cause” improvements were achieved and sustained for pre-resuscitation checklists (77–90%) and team briefings (80–92%). Time to intravenous access (50–42 min), glucose infusion initiation (73–60 min), and antibiotic dosing (113–98 min) were also significantly reduced. Teams were unable to meet new NRP oxygen saturation targets. Improvements in post-resuscitation debriefing were not sustained, while communication with parents declined significantly (68–60%). Conclusion: Large-scale collaboration facilitated statewide implementation of new guidelines, while highlighting under-appreciated systems challenges among competing resource demands.

Original languageEnglish (US)
JournalJournal of Perinatology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Quality Improvement
Resuscitation
Checklist
Guidelines
Oxygen
Anti-Bacterial Agents
Glucose

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

on behalf of the Tennessee Initiative for Perinatal Quality Care Golden Hour Project Team (Accepted/In press). Improving neonatal resuscitation in Tennessee: a large-scale, quality improvement project. Journal of Perinatology. https://doi.org/10.1038/s41372-019-0461-3

Improving neonatal resuscitation in Tennessee : a large-scale, quality improvement project. / on behalf of the Tennessee Initiative for Perinatal Quality Care Golden Hour Project Team.

In: Journal of Perinatology, 01.01.2019.

Research output: Contribution to journalArticle

on behalf of the Tennessee Initiative for Perinatal Quality Care Golden Hour Project Team 2019, 'Improving neonatal resuscitation in Tennessee: a large-scale, quality improvement project', Journal of Perinatology. https://doi.org/10.1038/s41372-019-0461-3
on behalf of the Tennessee Initiative for Perinatal Quality Care Golden Hour Project Team. Improving neonatal resuscitation in Tennessee: a large-scale, quality improvement project. Journal of Perinatology. 2019 Jan 1. https://doi.org/10.1038/s41372-019-0461-3
on behalf of the Tennessee Initiative for Perinatal Quality Care Golden Hour Project Team. / Improving neonatal resuscitation in Tennessee : a large-scale, quality improvement project. In: Journal of Perinatology. 2019.
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abstract = "Objective: We report a statewide collaborative quality initiative to improve resuscitation and stabilization practices following introduction of the 6th edition of the Neonatal Resuscitation Program. Methods: Participants drafted a consensus toolkit of interventions and corresponding measures. Hospital teams collected baseline data, and implemented changes using PDSA-cycles and statistical process control charts. Results: Nine Tennessee NICUs submitted data on 3771 resuscitations. “Special cause” improvements were achieved and sustained for pre-resuscitation checklists (77–90{\%}) and team briefings (80–92{\%}). Time to intravenous access (50–42 min), glucose infusion initiation (73–60 min), and antibiotic dosing (113–98 min) were also significantly reduced. Teams were unable to meet new NRP oxygen saturation targets. Improvements in post-resuscitation debriefing were not sustained, while communication with parents declined significantly (68–60{\%}). Conclusion: Large-scale collaboration facilitated statewide implementation of new guidelines, while highlighting under-appreciated systems challenges among competing resource demands.",
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