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J Perinatol. 2019 Feb;39(2):256-262. doi: 10.1038/s41372-018-0283-8. Epub 2018 Dec 5.

Survey of preterm neuro-centric care practices in California neonatal intensive care units.

Author information

1
Department of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. handleys@email.chop.edu.
2
Leonard Davis Institute of Health Economics, The Wharton School, The University of Pennsylvania, Philadelphia, PA, USA. handleys@email.chop.edu.
3
Department of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
4
Center for Perinatal and Pediatric Health Disparities Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
5
Leonard Davis Institute of Health Economics, The Wharton School, The University of Pennsylvania, Philadelphia, PA, USA.
6
Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA.
7
California Perinatal Quality Care Collaborative (CPQCC), Stanford, CA, USA.

Abstract

OBJECTIVE:

Examine the adoption and presence of preterm, neuro-centric care practices across neonatal intensive care units (NICUs).

STUDY DESIGN:

Statewide, cross-sectional survey of California NICUs. Data were collected surrounding the timing of adoption and presence of delivery room practices, nursing protocols, provider management practices and quality improvement initiatives.

RESULT:

Among the 95 NICUs completing the survey (65%), adoption of all surveyed practices increased between 2005 and 2016, though rates of uptake changed over time and varied by practice. Adoption of indomethacin prophylaxis increased 1.8-fold, whereas delayed cord clamping increased 78-fold. Adoption of premedication for intubation and a patent ductus arteriosus management algorithm differed by unit level. Additionally, two underlying practice domains were identified; adoption of delivery room practices and adoption of any preterm practice.

CONCLUSION:

Adoption of preterm, neuro-centric care practices across California NICUs has increased, though uptake patterns vary by practice and level.

PMID:
30518797
PMCID:
PMC6351217
[Available on 2019-06-05]
DOI:
10.1038/s41372-018-0283-8

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