Implementation Methods for Delivery Room Management: A Quality Improvement Comparison Study

PEDIATRICS ◽  
2014 ◽  
Vol 134 (5) ◽  
pp. X27-X27 ◽  
Keyword(s):  
Quality Improvement ◽  
Delivery Room ◽  
Comparison Study ◽  
Delivery Room Management

scholarly journals Implementation Methods for Delivery Room Management: A Quality Improvement Comparison Study

PEDIATRICS ◽  
2014 ◽  
Vol 134 (5) ◽  
pp. e1378-e1386 ◽  
Author(s):  
H. C. Lee ◽  
R. J. Powers ◽  
M. V. Bennett ◽  
N. N. Finer ◽  
L. P. Halamek ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Delivery Room ◽  
Comparison Study ◽  
Delivery Room Management

scholarly journals A Quality Improvement Initiative to Reduce Bronchopulmonary Dysplasia in a Level 4 NICU—Golden Hour Management of Respiratory Distress Syndrome in Preterm Newborns

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 301
Author(s):  
Andrew M. Dylag ◽  
Jamey Tulloch ◽  
Karen E. Paul ◽  
Jeffrey M. Meyers
Keyword(s):  
Quality Improvement ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Control Charts ◽  
Fluid Management ◽  
Delivery Room ◽  
Quality Improvement Initiative ◽  
Statistical Process ◽  
Golden Hour ◽  
Surfactant Administration

Background: Prevention of chronic lung disease (CLD) requires a multidisciplinary approach spanning from the delivery room to Neonatal Intensive Care Unit (NICU) discharge. In 2018, a quality improvement (QI) initiative commenced in a level 4 NICU with the goal of decreasing chronic lung disease rates below the Vermont Oxford Network (VON) average of 24%. Methods: Improvement strategies focused on addressing the primary drivers of ventilation strategies, surfactant administration, non-invasive ventilation, medication use, and nutrition/fluid management. The primary outcome was VON CLD, defined as need for mechanical ventilation and/or supplemental oxygen use at 36 weeks postmenstrual age. Statistical process control charts were used to display and analyze data over time. Results: The overall CLD rate decreased from 33.5 to 16.5% following several interventions, a 51% reduction that has been sustained for >18 months. Changes most attributable to this include implementation of the “golden hour” gestational age (GA) based delivery room protocol that encourages early surfactant administration and timely extubation. Fewer infants were intubated across all GA groups with the largest improvement among infants 26–27 weeks GA. Conclusions: Our efforts significantly decreased CLD through GA-based respiratory guidelines and a comprehensive, rigorous QI approach that can be applicable to other teams focused on improvement.

scholarly journals Delivery Room Management of Asphyxiated Term and Near-Term Infants

Neonatology ◽  
2021 ◽  
pp. 1-13
Author(s):  
Marlies Bruckner ◽  
Gianluca Lista ◽  
Ola D. Saugstad ◽  
Georg M. Schmölzer
Keyword(s):  
Preterm Infants ◽  
Newborn Infants ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Delivery Room ◽  
Temperature Management ◽  
Term Infants ◽  
Term Newborn ◽  
Resuscitation Guidelines ◽  
Delivery Room Management

Approximately 800,000 newborns die annually due to birth asphyxia. The resuscitation of asphyxiated term newly born infants often occurs unexpected and is challenging for healthcare providers as it demands experience and knowledge in neonatal resuscitation. Current neonatal resuscitation guidelines often focus on resuscitation of extremely and/or very preterm infants; however, the recommendations for asphyxiated term newborn infants differ in some aspects to those for preterm infants (i.e., respiratory support, supplemental oxygen, and temperature management). Since the update of the neonatal resuscitation guidelines in 2015, several studies examining various resuscitation approaches to improve the outcome of asphyxiated infants have been published. In this review, we discuss current recommendations and recent findings and provide an overview of delivery room management of asphyxiated term newborn infants.

scholarly journals Delivery Room Management of Meconium-Stained Newborns and Respiratory Support

PEDIATRICS ◽  
2018 ◽  
Vol 142 (6) ◽  
pp. e20181485 ◽  
Author(s):  
Arpitha Chiruvolu ◽  
Kimberly K. Miklis ◽  
Elena Chen ◽  
Barbara Petrey ◽  
Sujata Desai
Keyword(s):  
Delivery Room ◽  
Respiratory Support ◽  
Delivery Room Management

Suctioning habits in the delivery room and the influence on postnatal adaptation – a video analysis

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Dimitrios Konstantelos ◽  
Sascha Ifflaender ◽  
Jürgen Dinger ◽  
Mario Rüdiger
Keyword(s):  
Total Duration ◽  
Face Mask ◽  
Delivery Room ◽  
Respiratory Support ◽  
Term Infants ◽  
Postnatal Adaptation ◽  
Recorded Delivery ◽  
Preterm Newborns ◽  
Time Point ◽  
Delivery Room Management

AbstractTo determine how often infants are suctioned during delivery and how it affects the neonate.Single-center analysis of video-recorded delivery room management after c-section from January 2012 until April 2013. Time point, duration, and frequency of suctioning in term and preterm newborns were analyzed along with vital parameters (heart rate (HR) and saturation values).Three hundred forty-six videos were analyzed. Twenty-three percent of term and 66% of preterm newborns were suctioned. Newborns were suctioned up to 14 times; total duration spent for suctioning was between 2 and 154 s. Suctioning before face mask application occurred in 31% of the suctioned newborns requiring respiratory support. No severe bradycardia (<60 bpm) was noticed. Suctioning did not have an effect on HR and saturation in preterm infants but was associated with significantly higher HR in term infants requiring respiratory support. Term infants who did not require respiratory support showed significantly higher saturation values at 3, 5, 6, 7, 8, 9, and 10 min if they were not suctioned.Suctioning of newborns in the delivery room does not adhere to recommendations of international guidelines. However, previously described side effects of suctioning could not be confirmed.

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