Improving preoperative identification of infants at risk for severe retinopathy of prematurity

J Perinatol. 2019 Sep;39(9):1309-1314. doi: 10.1038/s41372-019-0383-0. Epub 2019 May 14.

Abstract

Objective: To increase preoperative identification of at-risk infants for severe Retinopathy of prematurity (ROP) to >95% by August 2016, with a secondary aim of reducing the number of infants with 100% intraoperative peripheral oxygen saturation (SpO2) during the same time.

Study design: Prospective quality improvement project centered on preterm surgical infants admitted to Primary Children's Hospital (n = 41). Preoperative ROP risk identification rates were analyzed using an annotated run chart, intraoperative SpO2 and laser intervention were compared using un-paired t test.

Results: Preoperative identification of ROP risk increased from 60 to 100% and no infant was exposed to 100% SpO2 intraoperatively during the study period. The incidence of laser intervention in this population decreased by 45% from 22 to 12% (p = 0.21).

Conclusion: Simplifying our preoperative handoff increased our rates of correct identification and communication ROP risk in preterm infants while decreasing exposure to 100% SpO2.

MeSH terms

  • Checklist
  • Humans
  • Hyperoxia / complications
  • Hyperoxia / diagnosis
  • Infant, Newborn / blood
  • Oxygen / blood
  • Prospective Studies
  • Quality Improvement
  • Retinopathy of Prematurity / diagnosis
  • Retinopathy of Prematurity / etiology
  • Retinopathy of Prematurity / prevention & control*
  • Risk
  • Surgical Procedures, Operative / adverse effects*

Substances

  • Oxygen