Staff awareness and bundling reduce skin breaks and blood tests in neonatal intensive care.

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Abstrakt

Tytuł:: Staff awareness and bundling reduce skin breaks and blood tests in neonatal intensive care.
Autorzy:: Zhou L; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
Taylor J; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
Kidman A; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
Stewart A; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
Bhatia R; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
Źródło:: Journal of paediatrics and child health [J Paediatr Child Health] 2021 Sep; Vol. 57 (9), pp. 1485-1489. Date of Electronic Publication: 2021 May 02.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Melbourne ; Boston : Blackwell Scientific Publications, c1990-
MeSH Terms:: Intensive Care Units, Neonatal*
Intensive Care, Neonatal*
Birth Weight ; Gestational Age ; Hematologic Tests ; Humans ; Infant ; Infant, Newborn
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Contributed Indexing:: Keywords: anaemia; neonatology; pain; preterm; sampling
Entry Date(s):: Date Created: 20210503 Date Completed: 20211021 Latest Revision: 20211021
Update Code:: 20240104
DOI:: 10.1111/jpc.15532
PMID:: 33938084
: Czasopismo naukowe

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Aim: Skin breaks (SBs) for procedures and blood sampling are common in neonatal intensive care units (NICU), contributing to pain, infection risk and anaemia. We aimed to document their prevalence, identify areas for improvement and, through staff awareness, reduce their frequency.
Methods: Quality improvement project via prospective audit at a tertiary-level NICU in Australia was conducted. All infants admitted to the NICU for >24 h during two audit periods were included in the study. A specifically designed bedside audit tool was used to prospectively document all SB and blood tests performed on infants during a 4-week audit period (audit 1). Results were reviewed to identify areas for improvement, and disseminated to staff at unit meetings, shift handover and email. Following education and awareness, the audit was repeated (audit 2), and data were compared. Frequency of SB and blood tests performed was measured. Data were tested for normality and analysed using parametric or non-parametric tests where appropriate.
Results: There were 52 NICU admissions during each audit period (104 total), with 34 (65%) and 31 (60%) having audit sheets completed, respectively. Median (interquartile range) gestational age and mean (standard deviation) birthweight were 29 (26.3-35) weeks and 1836 (1185) g for audit 1, 30 (28.5-31.5) weeks and 1523 (913) g for audit 2. The reduction in total blood tests (mean) was 36.3%, skin breaks per admitted baby day reduced by 60% and total blood volume sampled (mean) by 37.7%.
Conclusions: A quality improvement project by prospective audit and staff education was associated with reductions in frequency of skin breaks and blood tests in the NICU.
(© 2021 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

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