Evaluation and development of potentially better practices for the prevention of brain hemorrhage and ischemic brain injury in very low birth weight infants

Pediatrics. 2003 Apr;111(4 Pt 2):e489-96.

Abstract

Objective: Neonatal care providers from 5 institutions formed a multidisciplinary focus group with the purpose of identifying potentially better practices, the implementation of which would lead to a reduction in the incidence of intracranial hemorrhage and periventricular leukomalacia in very low birth weight infants.

Methods: Practices were analyzed, 4 benchmark neonatal intensive care units were identified and evaluated, and the literature was assessed using an evidence-based approach. The work was also reviewed by a nationally respected expert.

Results: Ten potentially better clinical practices were identified. In addition, variability in cranial ultrasound practice, related to both procedural process and interpretation, was identified as a confounding problem in evaluating quality. Using the same process, potentially better cranial ultrasound practices were also identified.

Conclusions: Implementation of these practices will improve clinical outcomes as well as the reliability of sonogram interpretation, the basis for evaluating the quality of the team's work.

Publication types

  • Evaluation Study

MeSH terms

  • Benchmarking*
  • Brain Ischemia / prevention & control*
  • Cooperative Behavior
  • Echoencephalography / standards*
  • Evidence-Based Medicine
  • Focus Groups
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Very Low Birth Weight*
  • Intensive Care Units, Neonatal / organization & administration*
  • Intensive Care Units, Neonatal / standards
  • Intensive Care, Neonatal / methods*
  • Intensive Care, Neonatal / organization & administration
  • Intensive Care, Neonatal / standards
  • Intracranial Hemorrhages / prevention & control*
  • Organizational Innovation
  • Organizational Objectives
  • Patient Care Team / organization & administration
  • Program Development
  • Program Evaluation
  • Surveys and Questionnaires
  • Total Quality Management / methods
  • United States