Fight­ing to re­duce brain in­juries in pre­ma­ture ba­bies

Modern Healthcare - - NEWS - —Shelby Liv­ingston

Af­ter find­ing that more than a quar­ter of pre­ma­ture ba­bies de­liv­ered in the re­gional neona­tal in­ten­sive-care unit at Spar­row Health Sys­tem in 2013 de­vel­oped some de­gree of in­tra­ven­tric­u­lar hem­or­rhage—which can lead to cog­ni­tive im­pair­ment and de­vel­op­men­tal dis­abil­i­ties—the nurses and neona­tol­o­gists set out to elim­i­nate IVH en­tirely.

To­day, they’ve dra­mat­i­cally re­duced the chances of brain in­jury in small in­fants by de­sign­ing and ini­ti­at­ing the “Small Baby Pro­to­col” based on ev­i­dence-based best prac­tices. Just 9.6% of ba­bies de­liv­ered at Spar­row in 2016 suf­fered from IVH, which can lead to long-term med­i­cal prob­lems and co­mor­bidi­ties. That’s down from 27.4% in 2013.

“The goal was to not have them get the IVH, and then if they do, to min­i­mize bleed­ing” said Sarah Collins, depart­ment man­ager of the NICU and spe­cial care nurs­ery at Lans­ing, Mich.-based Spar­row.

Un­der the new care pro­to­col im­ple­mented in July 2014, care team mem­bers de­layed clamp­ing the um­bil­i­cal cord and min­i­mized blood trans­fu­sions. Nurses were charged with keeping the in­fant’s blood pres­sure steady, re­duc­ing stim­u­la­tion and prop­erly po­si­tion­ing the baby’s head and bed, among other tasks.

More­over, nurse “cham­pi­ons” were des­ig­nated to teach the new guide­lines to the staff. To do so, they photographed vis­ual re­minders of the pro­to­col and put to­gether an ed­u­ca­tional video.

“The more we have pos­i­tive re­sults, the more peo­ple are re­ally in­vested in do­ing it,” Collins said.

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