Quality Improvement (QI) of Respiratory health in cerebral palsy (CP) children

2016 ◽  
Author(s):  
SOHAIL NASSIR
Keyword(s):  
Cerebral Palsy ◽  
Quality Improvement ◽  
Respiratory Health

scholarly journals Preventing cerebral palsy in preterm labour: a multiorganisational quality improvement approach to the adoption and spread of magnesium sulphate for neuroprotection

2017 ◽  
Vol 6 (2) ◽  
pp. e000189 ◽  
Author(s):  
Anna Burhouse ◽  
Charlotte Lea ◽  
Stephen Ray ◽  
Hannah Bailey ◽  
Ruth Davies ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Quality Improvement ◽  
Magnesium Sulphate ◽  
Preterm Labour

scholarly journals Evaluating an enhanced quality improvement intervention in maternity units: PReCePT trial protocol

2021 ◽  
Vol 10 (2) ◽  
pp. e001204
Author(s):  
Hannah Edwards ◽  
Maria Theresa Redaniel ◽  
Brent Opmeer ◽  
Tim Peters ◽  
Ruta Margelyte ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Quality Improvement ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Quality Improvement Intervention ◽  
Research Database ◽  
National Guidance ◽  
Registration Number ◽  
Randomised Controlled ◽  
Term Labour

The UK’s National Institute for Health and Care Excellence Preterm labour and birth guideline recommends use of magnesium sulfate (MgSO4) in deliveries below 30 weeks’ gestation to prevent cerebral palsy and other neurological problems associated with preterm delivery. Despite national guidance, the uptake of MgSO4 administration in eligible women has been slow. National Health Service England has rolled out the PReCePT (PRevention of Cerebral Palsy in Pre-Term labour) quality improvement (QI) toolkit to increase uptake of MgSO4 in preterm deliveries. The toolkit is designed to increase maternity staff knowledge about MgSO4 and provides training and practical tools to help staff consider use in eligible women. The PReCePT trial compares the effectiveness of two different methods of implementing the QI toolkit (standard versus enhanced support). The standard support arm (control) receives the QI toolkit and regional-level support for a midwife/obstetric ‘champion’. The enhanced support arm (intervention) receives this plus additional clinical backfill funding and unit-level QI microcoaching. It is funded by The Health Foundation. This is a cluster randomised controlled trial designed to include 48 maternity units randomised (2:1 ratio) to standard or enhanced support. Units are eligible for inclusion if they have 10 or more preterm (<30 weeks’ gestation) deliveries annually and MgSO4 uptake of 70% or less. Randomisation is stratified by previous level of MgSO4 uptake. The QI intervention is implemented over 9 months. All units are followed up for a further 9 months. Blinding is not possible due to the nature of the intervention. The primary outcome is the proportion of MgSO4 uptake among eligible women at follow-up, adjusting for uptake before implementation of the toolkit. The effectiveness of the intervention will be assessed using weighted linear regression on data from the National Neonatal Research Database. Semistructured qualitative staff interviews will inform understanding of the process and outcomes. Economic evaluation will describe total costs and cost-effectiveness.Trial registration number SRCTN 40938673.

scholarly journals Evaluating the impact of an enhanced support implementation of the PReCePT (PRevention of Cerebral palsy in Pre-Term labour) quality improvement toolkit to increase the uptake of magnesium sulphate in pre-term deliveries for the prevention of neurodisabilities: study protocol for a cluster randomized controlled trial

2020 ◽  
Author(s):  
Hannah B Edwards ◽  
Maria Theresa Redaniel ◽  
Brent Opmeer ◽  
Tim J Peters ◽  
Ruta Margelyte ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Quality Improvement ◽  
Magnesium Sulphate ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Research Database ◽  
Randomised Controlled ◽  
The Impact ◽  
Standard Support ◽  
Support Model

The UKs National Institute for Health and Care Excellence (NICE) Preterm labour and birth guideline recommends use of magnesium sulphate (MgSO4) in deliveries below 30 weeks gestation to prevent cerebral palsy and other neurological problems associated with preterm delivery. Despite national guidance, the uptake of MgSO4 administration in eligible women has been slow. NHS England has rolled out the PReCePT Quality Improvement (QI) toolkit to increase uptake of MgSO4 in preterm deliveries. The toolkit is designed to increase maternity staff knowledge about MgSO4 and provides training and practical tools to help staff consider use in eligible women. The PReCePT trial will evaluate the effectiveness of an enhanced support model of implementing the QI toolkit, compared with the standard support model. The standard support arm (control) receives the QI toolkit and regional-level support for a midwife/obstetric champion. The enhanced support arm (intervention) receives this plus additional clinical backfill funding and unit-level QI micro-coaching. This is a cluster randomised controlled trial designed to include 48 maternity units randomised (2:1 ratio) to standard or enhanced support. Units are eligible for inclusion if they have ten or more pre-term (<30 weeks gestation) deliveries annually and MgSO4 uptake of 70% or less. Randomisation is stratified by previous level of MgSO4 uptake. The QI intervention is implemented over nine months. All units are followed up for a further nine months. Blinding is not possible due to the nature of the intervention. The primary outcome is the proportion of MgSO4 uptake amongst eligible women at follow-up, adjusting for uptake before implementation of the toolkit. The effectiveness of the intervention will be assessed using weighted linear regression on data from the National Neonatal Research Database. Semi-structured qualitative staff interviews will inform understanding of the process and outcomes. Economic evaluation will describe total costs and cost-effectiveness.

The cerebral palsy research network: Building a learning health network for cerebral palsy

2021 ◽  
pp. 1-11
Author(s):  
Amy F. Bailes ◽  
Jacob Kean ◽  
Paul H. Gross ◽  
Unni Narayanan ◽  
Garey Noritz ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Quality Improvement ◽  
Clinical Decision ◽  
Research Network ◽  
Ordinal Scale ◽  
Primary Data ◽  
Health Network ◽  
Network Building ◽  
Patient Reported ◽  
Reported Data

PURPOSE: The purpose of this study was to measure the growth of the Cerebral Palsy (CP) Research Network towards becoming a Learning Health Network in order to guide future development. METHODS: Thirteen CP Research Network leaders completed the Network Maturity Grid (NMG) which consists of six domains with eight to 10 components each. The six domains are Systems of Leadership, Governance and Management, Quality Improvement, Engagement and Community, Data and Analytics, and Research. Radar mapping was utilized to display mean scores on a 5-point ordinal scale (1 = not started to 5 = idealized state) across domains and for individual components within domains. Consensus was reached for top priorities for the next 3–5 years. RESULTS: Domain scores ranged from 2.4 in Quality Improvement to 3.2 in System of Leadership. The lowest scoring component was clinician clinical decision support and the highest was common purpose. The following priority areas of focus were agreed upon moving forward: development of leaders, financial sustainability, quality improvement education and training, patient reported data, data quality and validation, and primary data collection. CONCLUSION: Results from this project will be utilized for strategic planning to improve the network. Conducting regular self-assessments of the network with the NMG will be useful in achieving the network’s ultimate goal to improve care and outcomes for individuals with CP.

Antenatal magnesium sulfate to prevent cerebral palsy

2021 ◽  
pp. fetalneonatal-2021-321817
Author(s):  
Amy K Keir ◽  
Emily Shepherd ◽  
Sarah McIntyre ◽  
Alice Rumbold ◽  
Charlotte Groves ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Quality Improvement ◽  
Magnesium Sulfate ◽  
Perinatal Care ◽  
Quality Improvement Programme ◽  
Baseline Rate ◽  
Local Quality ◽  
Improvement Programme ◽  
The Impact

Magnesium sulfate given to women before birth at <30 weeks’ gestation reduces the risk of cerebral palsy in their children. Our study aimed to assess the impact of a local quality improvement programme, primarily using plan-do-study-act cycles, to increase the use of antenatal magnesium sulfate. After implementing our quality improvement programme, an average of 86% of babies delivered at <30 weeks’ gestation were exposed to antenatal magnesium sulfate compared with a historical baseline rate of 63%. Our study strengthens the case for embedding quality improvement programmes in maternal perinatal care to reduce the impact of cerebral palsy on families and society.

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