Improvement Science Virtual Expo

Registered Posters for 2020

Please see the list of posters that have been registered for the Improvement Science Virtual Expo and find your reference number by filtering the columns or using the search function.

Reference Number	Primary Author	Center	Title	Description
20018	Dr. Bethany Kaemingk	Mayo Foundation	Improving Efficiency and Timeliness of Discharge from the Neonatal Intensive Care Unit	Using DMAIC methodology, this quality improvement project aims to increase the percent of patients discharged from the NICU prior to 11 AM from 7% to 50% without adversely impacting parent readiness to discharge. PDSA cycles targeting key drivers are underway and have included establishing a goal unit discharge time, testing a discharge checklist, and prioritized rounding on discharging patients.
20019	Ms. Lisa Davis	Carle Foundation Hospital	ET Takes Two: A Targeted Approach to Decreasing Unplanned Extubations in High Risk Infants	Mechanical ventilation is frequently used in the NICU and many premature infants - especially in SBU - require prolonged support. Unplanned extubations have been associated with increased ventilator days and hospital stay and increased complications, including chronic lung disease. Our project takes a targeted approach to improve mechanical ventilation safety and decrease rate of UEs.
20020	Dr. Tracey Harris	Einstein Medical Center Philadelphia	Improving Neonatal Nutrition in the NICU	There is great variation in feeding management among providers in the EMCP NICU. Additionally, our 2018 VON data suggest that 58% of our VLBW infants are discharged at a weight less than the 3rd percentile, as compared to a national average of 31%. Our goal is to create a feeding guideline in the EMCP NICU to allow for more consistency among providers and to improve infant nutritional management.
20021	Mrs. Denise Cornell	CHOI at OSF St. Francis Medical Center	The More You Read, The More You'll Know	Lack of consistency and poor communication was a common “touch point” found during EBCD interviews. Inadequate hand off tools lead to increased errors. These errors ultimately lead to increased mortality and morbidity. Our process poster will demonstrate how we are combining the touch points, along with data demonstrating the flaws in our current patient report process to improve our handoffs.
20023	Dr. Colby Day	UF Health Jacksonville	Improving Outpatient Development Follow Up in Infants After Neonatal Intensive Care Unit (NICU) Discharge	Infants discharged from the NICU are at an increased risk for developmental disabilities and require complex care coordination due to their fragility and complexity. Early identification and intervention has been shown to improve outcomes for children at risk for delays. This project will implement multiple PDSA cycles to improve the follow up rates at the various outpatient follow up clinics.
20024	Mrs. Cheryl Colgan	CHOI at OSF St. Francis Medical Center	Continuing Our Journey to Improve the Growth in the NCCU	We recognize our Nightingale data indicates a gap between performance and desired performance in the nutritional management of our patients. We believe standardized feeding guidelines, education, and increasing the dose of mother’s milk received by our patients will contribute to improved rates of growth, reduce the risk of NEC while increasing parent satisfaction.
20025	Mrs. Kim Sheffield	Merit Health River Oaks	Growing Healthier Premies	Due to our high rates of NEC and less than optimal rates of use of maternal milk at discharge, we used several interventions, such as pumping earlier that included education for staff and parents, initiating feedings earlier, and discontinued the checking of gastric residuals in hoping to proceed to full feedings faster. We also revised our infant nutrition policy and began the use of probiotics.
20026	Mrs. Rachel Zugschwert	Children's Minnesota - Minneapolis	Family Poster	Family poster sharing the story of our now-8-year-old 25-weeker.
20027	Ms. Mary Harrington	St. Luke's Hospital - Anderson Campus	Fragile: Handle with Care - the Journey of Developing our Small Baby Unit	Reflecting on our journey in creating our SBU which included a move to a new campus. We will follow up on our Small Baby Certification project and how we are undertaking 4-handed care with the help of our RTs. Prior projects will be shared focusing on how we continue to improve in our new environment and how our efforts have also led to a decreased LOS and improved morbidity and mortality.
20028	Dr. Caitlin Nichols	Yale-New Haven Children's Hospital	A Quality Improvement Initiative to Improve Time to Enteral Feeding in VLBW Infants	Unit guidelines at Yale New Haven Children’s Hospital NICU recommend establishment of enteral feeds within the first 12 hours of life. At baseline, 43% of VLBW infants received feeds within this time frame. A multidisciplinary team was formed and several PDSA cycles were implemented with the goal to increase the percentage of VLBW infants receiving feeds within 12 hours of life to 65% in 6 months.
20029	Dr. Miheret Yitayew	Children's Hosp of Richmond at VCU	Comparison of Fenton and Intergrowth-21 For Postnatal Growth Assessment and Prediction of Associated Morbidities In Preterm Infants	Impaired neurodevelopment remains a significant morbidity in the preterm infant population. Early nutrition has been shown to play an important role in helping infants achieve adequate postnatal growth and optimal neurodevelopment. This study explores the value of two different growth assessment tools in identification of growth abnormalities and prediction of adverse neurodevelopmental outcomes.
20030	Mrs. Sharon Liska	Children's Hospital at Providence, Alaska, The	Improving Growth in the NICU, Total Premie Nutrition (TPN) Team	The TPN team is comprised of bedside and advanced practice nurses, RDs, lactation consultants, and neonatologists whose focus is to improve nutritional outcomes in the NICU while minimizing risks associated with parenteral and enteral nutrition.
20031	Dr. Yolanda Brown-Madan	Cedars-Sinai Medical Center (CSMC)	Early discharge planning meetings and their impact on parental readiness and expectations for discharge	Early on we identified a need to improve the discharge preparedness of our NICU families who had preterm babies. With the implementation of a discharge prep meeting at 32 weeks GA we addressed issues such as possibility of home O2, criteria for G-tube, possible transfusions, and more. We found that by addressing these topics early parents felt better prepared when the time for discharge arrived.
20032	Ms. Ilene (Sue) Wolf	Evanston Hospital	A Quality Improvement Safety Initiative for the Prevention of Sudden Unexpected Postnatal Collapse (SUPC)	We have created an educational program for our staff on competently educating parents about fatigue self-awareness and proper infant positioning during distraction free infant contact. Evanston will share the quality safety bundle with collaborating sites, in return sites will contribute their de-identified SUPC events to our secure Registry leading to a better understanding of SUPC risk factors
20033	Ms. Kristen Earl	Oregon Health and Science University	Fall Into Reading: Family Centered Early Literacy in the NICU	Growing from a twice yearly one day event (September/March) Fall Into Reading 2020 is a month long celebration and education around literacy/reading/purposeful vocal sounds in the NICU. Designed by the NICU Family Advisory Council and with the support of the nurse managers and nursing team, "Fall Into Reading" gifts books and education to families.
20034	Ms. Nikou Pishevar	Nationwide Children's Hospital	Characteristics of Patients with Unrelieved Postoperative Pain in Surgical Neonates	Neonates in the NICU undergo numerous procedures and operations. Repetitive pain exposure in neonates can have adverse neurodevelopmental and behavioral outcomes for the infant. This is a quality improvement project to decrease the average number of consecutive pain episodes from the current baseline of 2 episodes/patient to 1 episode/patient in our NICU by November 1st 2020.
20035	Mrs. Betsy Knappen	Shawnee Mission Medical Center	Kansas State Neonatal Abstinence Syndrome (NAS) Initiative: Improving Outcomes of at Risk Infants	The KPQC NAS initiative has focused on education and policy implementation standardizing care for infants at risk for NAS. Thirty-three Centers, accounting for over 85% of Kansas births, joined the KPQC initiative. We are progressing on our smart aims; LOS has decreased from 31.9 days to 17.2 days, direct NICU admission decreased from 19% to 5.7% and 76% of Centers received designation.
20036	Dr. Amy McBee	Barbara Bush Children's at Maine Medical	A Multidisciplinary approach to the Golden Hour Leads to Sustained Improvements in Care for Infants <28 Weeks Gestation	Our goal for 2020 was to sustain or build upon our previous outcomes in infants <28 weeks. We will present the last 5 years of data looking at specific outcomes as well as survival without morbidity, sustained progress, and successive gains. We will also present a new set of PDSA cycles that focus on increasing the diversity of ways that we provide information to families.
20037	Ms. Lisa Davis	Carle Foundation Hospital	Graduation: Improving the NICU Discharge Process for Families & Staff	Our aims for this project were focused on improving the discharge process for families and staff in the NICU. Primary aims of the project were to improve family preparation and perception of readiness pre-discharge. Aims also included improving the staff satisfaction with the process by implementing care maps, classes, complex discharge care conferences and discharge appointments.
20038	Mrs. Ginny Shaffer	Children's Hospital at Providence, Alaska, The	NICU Graduate Poster, Holland	Poster showcasing NICU graduate Holland, former 23 weeker
20039	Dr. Andrew Dylag	Golisano Children's Hospital at Strong	An Initiative to Reduce Bronchopulmonary Dysplasia	Over a several year period the incidence of BPD in VLBW infants in our NICU steadily increased to rates well above the VON average. In response, our unit began a multi-year QI initiative in 2018 with an aim to reduce BPD to a rate consistent with the VON average. Our results suggest sustained improvement that exceeded our goal; additional tests of change are planned to target further improvement.
20040	Dr. Elizabeth Fong-DeLeon	Virtua Hospital Systems	Reducing Severe Intraventricular Hemorrhage in the Virtua Voorhees NICU	Infants born at <30 weeks gestation are at risk for severe (grade 3-4) intraventricular hemorrhage. We created an evidence-based bundle of interventions to address positioning, intravascular stability, euthermia and environmental conditions. After bundle implementation, we observed a 348 day interval between severe IVH cases. Our rate of severe IVH decreased by 57% from 2018 to 2019.
20041	Mrs. Laura Oltmann	Legacy Salmon Creek Hospital	KOALA Blocks: Creating a bridge to breastfeeding	Breastfeeding is associated with lifelong nutrition and health. Preterm mother-infant dyads have risks to establishing breastfeeding. We enabled infant-driven breastfeeding by suspending scheduled feedings for designated time around Kangaroo care. We found increased infant-driven breastfeeding evidenced by increased breastfeeding occurrences and adequate growth compared to standard regimen.
20042	Mrs. Jessica Haas	Cabell Huntington Hospital, Inc.	Optimize family integrated perinatal care in a high risk regional perinatal center in West Virginia.	We seek to optimize perinatal-newborn care in all our institution while addressing diverse systems and patient needs. Minimizing practice variation, optimizing perinatal/neonatal outcomes and being sensitive to cost and the family experience, inclusive of access. Our SMART Aim is to implement standardized family integrated care to minimize mother-infant separation between by December 2020.
20043	Ms. Erin Hannon	Connecticut Children's Medical Center	Evaluating the Effectiveness of a Formal Care Path for Discharge of Infants with Bronchopulmonary Dysplasia (BPD) from the NICU: A Pilot Study	Study investigates the effectiveness of a BPD Care Path improving parents’ knowledge (K) and confidence (C) to care for infants after discharge. Prospective pre-post education intervention study was conducted at CCMC NICU. Parents surveyed and scored at baseline, discharge & follow up. Results show a formal CP increased K and C prior to discharge without significant drop in K at follow up.
20044	Ms. Beth Huizinga	Helen DeVos Children's Hospital	Reducing Suction Frequency in Patient Recieving Non-Invasive Ventilation	2 PDSA cycles aimed at decreasing suction frequency based on assessment versus routine suctioning.
20045	Mrs. Allison Diaz	Baptist Children's Hospital	Can Noninvasive Ventilation Decrease Chronic Lung Disease?	Baptist Childrens Hospital has been working on increasing the use of CPAP in the delivery room for VLBW infants. One of our goals has been to reduce the ventilator days which we have expanded on this year. For those infants that are in need of intubation we have implemented purposeful rounding to extubate in a timely manner.
20046	Ms. Alexa O'Dell	Benefis Healthcare	SUBJECT TO CHANGE - Covid19 and Partnering with Families	This poster will explore support to NICU families from the Parent Partner perspective, including challenges related to the Covid-19 pandemic.
20047	Dr. Amy Cohen	Virtua Hospital Systems	Improving Timing of Care in the Golden Hour	Care of the extremely premature infant in the Golden Hour (GH) to prevent hypothermia, hypoglycemia and cardiorespiratory compromise is crucial. We created a process map coded by provider-type and identified key areas to optimize. We improved from 0% of infants with fluids infusing by 1 hour (used as a proxy for end of GH tasks) to 32% of infants in the last 6 months.
20048	Dr. Beatrice Stefanescu	Riley Hospital for Children at IU Health	EEG-Electrodes Pressure Ulcer Prevention QI Study	Pressure ulcers (PUs) can be associated with prolonged vEEG monitoring and can be a source of serious systemic infections. Our study aimed to lengthen the “days between PU events” to a minimum of 100 PU-free days by 1 year of intervention. This project implemented multiple PDSA cycles with interventions targeting vEEG-electrode level and skin assessment.
20049	Dr. Stephanie Napolitano	Children's Hospital Medical Center Cincinnati	Improving Early and Consistent Safe Sleep Practices in the NICU: a Regional NICU Quality Improvement Project	We aimed to improve the percentage of eligible infants consistently in safe sleep environments prior to discharge in a regional cohort of Level III/IV NICUs from baseline by 20% in a 5 month period. There was no previous uniform safe sleep criteria. At baseline, 37% of our defined population were in safe sleep. We surpassed our goal, increasing consistent safe sleep compliance to 71%.
20050	Dr. Nina Menda	Meriter Hospital	Examining NICU outcomes through the lens of equity	Previous literature has demonstrated significant racial variation in the quality of care within NICUs. This alarming data caused us to examine our NICU outcomes based on race to identify gaps. The Baby-MONITOR metrics, admissions, readmissions and morbidity and mortality were reviewed to identify racial variation and develop a disparities dashboard to drive improvement.
20051	Dr. Maika Manalastas	Loyola University Medical Center	Implementation of Dexamethasone Checklist in Loyola University Medical Center NICU	Corticosteroids should be judiciously administered to VLBW infants due to many adverse effects. In 2018, 11.3% VLBW infants admitted to Loyola NICU received dexamethasone for prevention of BPD while comparable NICUs within the first quartile had 5% use. We implemented a checklist of parameters/interventions to reduce systemic dexamethasone use for the prevention of BPD from 11% to 5% at Loyola.
20052	Dr. Beatrice Stefanescu	Riley Hospital for Children at IU Health	MRI Hypothermia Prevention QI Project	The close association of neonatal hypothermia with increased morbidity and mortality has been well documented. Our study aimed to reduce the proportion of infants who were hypothermic during MRI scan by 50% within 1 year. Our poster will demonstrate how judicious use of process mapping and the use of an temperature assessment form during the MRI scanning can prevent the incidence of hypothermia.
20053	Dr. Beatrice Stefanescu	Riley Hospital for Children at IU Health	Reduction of CLABSIs at Riley NICU – It Takes A Village and A Continuous QI Process!	CLABSI prevention requires continuous QI monitoring and a strong interdisciplinary, multipronged approach. Our poster will show the many challenges and successes our NICU experienced from 2008 to present during our fight to reach “ZERO CLABSI”.
20054	Dr. Lauren Tucker	Children's Hospital at U. of MS Health Care	A Quality Improvement Initiative to Improve Hepatitis B immunization in neonates with birth weight < 2kg	Infants discharged from NICUs tend to be under-immunized at the time of discharge. Our newborn center instituted a multidisciplinary quality improvement initiative to increase timely Hepatitis B immunization rates in neonates with birth weight < 2kg.
20055	Dr. Shehla Siddiqui	Doylestown Hospital	Implementation of team based quality initiative to maintain euthermia in newborns ≤ 2kg newborns.	Neutral thermal environment (NTE) is essential to prevent cold stress, minimize oxygen consumption and reduce caloric expenditure. We targeted newborns ≤2kg to maintain body temperature in euthermic range (36.5-37.5C) within 1 hour of age. Multiple PDSA cycles were initiated to develop golden hour policy, staff education, delivery room checklist, ICN admission checklist.
20056	Dr. Adriana Restrepo-Ormsby	Children's Hospital of Philadelphia Newborn Center	Implementation of Early Surfactant Recommendation in Late Preterm Infants (34 – 36 6/7 Weeks Gestational Age) With Suspected Respiratory Distress Syndrome to Reduce Respiratory Morbidity in 7 Centers at CHOP Care Network, Newborn Care.	We noted wide discrepancy in management of RDS in late preterm infants in our network and higher incidence of pneumothorax in infants receiving surfactant after 4hours compared to at ≤4hrs of age. Guidelines were established for close observation and early surfactant recommendation. We increased early surf administration from 59% to 72% without complications.
20057	Dr. Anna DiCarlo	University of Vermont Children's Hospital	Improving Discharge Anthropometric Data and Implementation of the Infant Stadiometer in the NICU	A QI initiative to help improve anthropometric data collection to improve nutritional decision making outpatient. This included implementation of an infant stadiometer to obtain more accurate length measurements during NICU admission and at time of discharge. These measures are part of a larger initiative in the NICU guiding improved nutritional management in a multidisciplinary approach.
20058	Dr. Nichole Adiletta	CHOC Children's Hospital	Standardizing Initiation of Steroid Treatments for Preterm Infants at Risk of Developing Severe Bronchopulmonary Dysplasia	BPD is common complication with long term morbidity. Targeted steroids administration to at risk infants can modulate BPD with minimizing side effects. Project global aim is to decrease BPD by safe and timely steroid administration to very preterm infants at significant risk of severe BPD. SMART aim is to establish an evidence based risk stratified protocol with compliance of 80% by December 2020.
20060	Mrs. Alison Wolf	UCSD Health La Jolla - Jacobs Medical Center	Utilizing Technology to Advance Effective Communication in a Complex Healthcare System	As healthcare continues to make technological advances to improve patient care, current communication styles are quickly becoming outdated. A QI project was implemented to improve communication between nurses and providers integrating secure messaging within an EHR. Number of pages, secure messages, and qualitative user feedback was solicited before and after implementation.
20064	Dr. Steven Conlon	Rainbow Babies & Children's Hospital	Less Invasive Surfactant Administration (LISA) can be successfully introduced into a Level IV NICU not actively performing Intubation-Surfactant-Extubation (INSURE)	Less Invasive Surfactant Administration (LISA) allows for early surfactant administration in respiratory distress syndrome, while avoiding invasive mechanical ventilation. Unfamiliarity with the technique has prevented widespread adoption of LISA. This project used quality improvement methodology to successfully implement LISA in a level IV NICU not currently practicing INSURE or LISA.
20065	Mrs. Kim Deynaka	St. Joseph Medical Center	Using the Eat, Sleep, Console Method to Better the Care of Babies Suffering from Neonatal Opiate Withdrawal (NOW) in the NICU	The primary reasons for moving to Eat Sleep Console (ESC) were to reduce length of stay (LOS), the number of morphine doses, and cost of hospitalization with hopes that promoting daily participation in care will promote bonding between baby and parents and possibly decrease LOS and morphine doses by a greater amount.
20066	Mrs. julia.taylor@nationwidechildrens.org julia.taylor@nationwidechildrens.org	NCH at Grant Medical Center	Minimally- Invasive Surfactant Therapy (MIST)	Since the 1980’s Surfactant has been “Gold Standard” in treating RDS & leading to the decreasing BPD. The question remains “How do we administer Surfactant to infant’s spontaneous breathing with surfactant deficiency?” My goal is to determine if MIST is as affective in treating RDS than the INSURE method of "In & Out" Surfactant therapy.
20067	Dr. Gita Jani	Doylestown Hospital	Respiratory Distress Severity assessment tool to identify the Late Preterm Infants 34 - 36 6/7 weeks (LPT) with suspected Respiratory Distress Syndrome (RDS) that might benefit from Surfactant Administration	As part of our QI project to establish guidelines for early surfactant to LPT with suspected RDS, we developed respiratory severity score to define severity of RDS based on clinical (RR, grunting, resp support, retractions, FiO2) or clinical plus lab/x ray (pH, PCO2, haziness/lung expansion) results. The scores at 4hrs were higher in newborns who received surfactant compared to no surfactant.
20068	Dr. Scottie Paitl	Loyola University Medical Center	Volume Guarantee Ventilation during Surfactant Administration Window	Decrease number of intubated days requiring mechanical ventilation by using volume guarantee mode in the first 72 hours of life while up to 3 doses of surfactant are indicated. Surfactant administration while on VG mode is believed to improve lung compliance by auto weaning peak pressures. Our AIM is to have 100% of babies be on VG mode during surfactant administration window.
20069	Dr. Lisa Bain	Lucile Packard Children's Hospital Stanford	Reducing Unplanned Extubations in the NICU	An unplanned extubation (UE) is any removal of an ETT which the medical team did not plan to occur at the time it occurred. Patients who experience a UE suffer significant harm. Through education, increased awareness and implementation of a bundle, we have reduced our UE rate by 50% in the past year.
20070	Ms. Erin Kays	NHRMC-Betty H.Cameron Women & Children's Hospital	Getting Better at Going Home: We're in this Together	Our primary aim is to increase the percentage of discharges where all education/screening is done the day prior to discharge. Most of our PDSA cycles related to the creation and implementation of a detailed transition to home checklist. Other PDSA cycles: discharge class via zoom (planned) and development of a resource book to assist RNs in making follow-up pediatric appointments.
20071	Mrs. Ema Urbanski	Virtua Hospital Systems	Decreasing Time to Oral Immune Therapy in the Virtua Voorhees NICU	For low gestational age infants, early use of colostrum oral care (aka Oral Immune Therapy-OIT) impacts time to full feeding volume, boosts immune markers, and in theory, helps to protect from NEC. We improved our delivery of OIT by 12 hours of life to >50% of infants born at <29weeks gestation within 6 months of starting the project. Our median time to OIT decreased from 26 hours to 17 hours.
20072	Dr. Deborah Tom	Phoenix Children's Hospital	Improving Discharge Readiness and Patient Satisfaction in a Level IV NICU	We aim to improve our patient satisfaction scores on the Picker Scale for discharge process in the NICU by 20%. 67%-80% from March 2019-March 2020. After several change ideas were implemented, It became evident that a more detailed measurement tool was needed. We created a ipad survey for families to take on discharge to evaluate readiness and existing discharge tools.
20073	Dr. KAREN BEATTIE	McMaster Children's Hospital Neonatal Nurseries	The McMaster NICU in the time of COVID-19	Changes to the McMaster NICU have significantly impacted families during their baby's stay in the unit. I will describe the changes that have occurred and discuss their impact on parents and families.
20074	Mrs. Ruth Ritzema	Children's Hospital at Bronson	Rebecca Ritzema - NICU Grad to college	This poster will describe the journey of a 23 week surviving twin and the community resources used to become a successful college student.
20075	Mrs. Lisa Sampson	Sunnybrook Health Sciences Centre	Increasing Nurturing Encounters experienced by micropremature infants in the NICU setting(2)	While neuroprotective strategies have lowered rates of severe IVH, our NICU aims to increase nurturing encounters (NE) to optimize neuronal connectivity in the micropremature brains to improve their long-term outcomes. Through standardized NE documentation, we can accurately quantify NE and measure improvement by ongoing education, promotion, and to audit consistency of practice and documentation.
20076	Dr. Barry Weinberger	Cohen Children's Medical Center of New York	Reducing Noise in NICU	Noise adversely affects preterm infants. We found that sound levels in NICU rooms were > 65 dB for a mean 32% of the time. We conducted in-services, placed wall displays, and installed a traffic light-like device in rooms, which decreased this. Additional strategies include quiet-time hours and altering practices for rounding, consultation, and conversation with parents.
20077	Mrs. Brenda Maschmeyer	Baptist Memorial Hospital for Women	Reducing Infection during a Pandemic	Explore past, current and future efforts at infection reduction in the NICU VLBW population, particularly the micropremie population.
20078	Dr. Barry Weinberger	Cohen Children's Medical Center of New York	A QI Project to Prevent Intraventricular Hemorrhage by Minimizing Invasive Procedures	Minimal stimulation during the 1st wk reduces IVH. We identified procedures (admission 4-extremity blood pressure, early head ultrasound, and frequent cuff blood pressures with arterial catheters) that cause agitation but rarely yield actionable data. Several cycles of improvement (including staff education and alterations to work flow) have significantly reduced these unnecessary procedures.
20079	Dr. Erlita Gadin	Virtua Hospital Systems	Improving Consistency of Information for Families of Extremely Premature Infants	Partnering with families to care for their extremely preterm infant is crucial for infant and parental wellbeing. Verbal feedback and results of Press Ganey and internal discharge surveys, showed consistency of communication needed improvement. Through multiple interventions, consistency of information and overall satisfaction ratings in our internal discharge survey increased.
20080	Ms. C. Janine Hester	Benefis Healthcare	Golden Hour Care: An Improvement Journey	We focused our efforts on Golden Hour care for infants <32 weeks of gestation and/or <1500 grams at birth. We focused on the prevention of heat loss and/or excess and the support of normothermia during the initial transition period. We also included promoting lung protective strategies, like surfactant administration, the early use of nasal CPAP, in addition to saturation limits.
20081	Dr. Barry Weinberger	Cohen Children's Medical Center of New York	Improving Iron Supplementation for Preterm Infants	Preterm infants are at risk for both iron deficiency and for oxidative stress from overload. Our prior practice was standard supplementation for all VLBW infants on full human milk feeds. This project is to titrate based on ferritin levels, consistent with expert recommendations. In initial data, 50% of infants had baseline serum ferritin >300 ug/L, and early iron supplementation has decreased.
20082	Ms. Karen Kopischke	Overland Park Regional Medical Center	Improving thermoregulation and electrolyte stability though limited topical emoliant use and plastic shielding	We have watched incubator temperatures closely when we noted some skin lesions in very immature micropremies. These lesions appeared to be burn-like & tended to occur in infants who had high incubator temperatures. We were concerned because we felt this phenomena indicated insensible water and heat loss. We developed a strategy to limit this problem.
20083	Ms. Amy Atwater	Helen DeVos Children's Hospital	Transport Documentation: Using Wireless Connectivity and the Electronic Health Record to Optimize Charting	Transport charting for patients in the NICU was being done on paper and after the patients arrival to the unit leading to decreased document efficiency, overtime, data mining issues, and lost revenue due to missed charges. Using our current EHR and technology. We were able to solve the issue.
20084	Ms. Karen Bong	Sunnybrook Health Sciences Centre	Impacts on Families in the NICU Due to COVID-19	The poster will highlight the changes affecting families in our NICU due to COVID-19 and how we adapted to continue to provide support to our NICU families.
20085	Dr. Gianina Davila	Joe DiMaggio Children's Hospital	Promoting Neuroprotective Care With More Skin to Skin Contact	Skin to Skin Care (SSC) is evidence-based that improves infant outcomes and parent-infant attachment. SSC was being practiced in our unit, but lack consistency. In addition, we had variation in practice. Our AIM was that all babies admitted into the NICU receive their first skin to skin within in 2 weeks of life. We also developed sub-aims. We conducted several PDSA cycles to achieve our goals.
20086	Dr. Gelila Asefa	Cohen Children's Medical Center of New York	Decreasing Hypothermia for VLBW Infants	VLBW infants are susceptible to hypothermia, which contributes to adverse outcomes such as 28% increased mortality/1°C. Our baseline rate of admission hypothermia was 29% for those <31 wks. We introduced a new practice bundle, including standard use of hats, thermal mattresses, bags, and transporters. The hypothermia rate decreased after educational programs and specific adjustments to work flow.
20087	Dr. Doron Kahn	Joe DiMaggio Children's Hospital	Toward a Further Reduction in Antibiotic Use in a Level III and Two level II NICUs: Setting New Goals	In 2018 we presented a QI project showing reduced antibiotic use in our NICUs. In 2018 we set goals of reducing antibiotic use further by 2020. From 2014 to 2020, admission antibiotics decreased from 55.3-56.8% to 32.9-38.6%, antibiotics continued beyond 72 hours decreased from 18.9-32.2% to 7.8-14.3%, and antibiotic utilization rate (AUR) decreased from 20.5-23.5% to 13.1-14.9% at our 3 hospitals
20088	Mrs. Beckett Perkins	Joe DiMaggio Children's Hospital	Development of a Neonatal Late Onset Sepsis Assessment Tool and Code Sepsis Checklist to Reduce Time to Administration of Antibiotics	We developed a QI project aimed at earlier detection of neonatal late onset sepsis (nLOS) and antibiotic administration. We created a nLOS assessment tool and code sepsis checklist to standardize the process of sepsis detection and management. Pilot use in our NICUs elicited positive feedback from staff, with ongoing PDSA cycles to improve implementation and timely antibiotic administration.
20089	Dr. Hormuz Nicolwala	Stony Brook University Medical Center	The impact of antibiotic stewardship program in reducing the antibiotic utilization ratio in a neonatology intensive care unit	Updating our antibiotic guidelines and monitoring for compliance, our goal was to decrease our antibiotic utilization rates (AUR) by 10% from January 2018 to December 2019 in patients at risk for early-onset sepsis (EOS) and to decrease number of patients exposed to a 4th dose of Ampicillin by 25%. Our AUR decreased by 12% and the duration of antibiotic treatment lowered by 20% decrease.
20090	Dr. Rebecca Carter	Rady Children's Hospital San Diego (RCHSD)	Reducing Length of Stay in Neonatal Abstinence Syndrome	We conducted a QI project to reduce LOS in infants with NAS requiring pharmacologic treatment across our hospital system of seven Level II-IV NICUs from 22 days to 18 days over a 12 month period. We implemented standardized pharmacologic and non-pharmacologic treatment protocols, nursing education, and NAS care champions. We exceeded our goal by reducing LOS by 30% from 22 days to 15 days.
20091	Ms. Shiloh Lueschow	University of Iowa Children's Hospital	Bifidobacterium longum subspecies infantis EVC001 decreases injury in a murine NEC model	Treatment strategies for NEC are limited, but probiotics may be preventive. Studies show B. infantis EVC001 may generate a better microbiome for at risk infants. NEC was induced in P14 mice with a subset given EVC001. Inflammation, injury and the microbiome were examined. Mice given EVC001 had significantly lower injury supporting the beneficial properties of B. infantis EVC001 in NEC prevention.
20092	Dr. Charles Mercier	Adventist Health - White MemorialUniversity of Vermont Children's Hospital	Virtual Adaptations to Family education and their transitions home during Covid and beyone	The University of Vermont Children’s Hospital will be sharing our continued work on improving family education and their transitions home focused on the criteria of Safe, Timely, Efficient, Effective, Equitable, Patient/Family-Centered and Socially Responsible criteria. We will be highlighting how this work has adapted with virtual technology during the impact of COVID-19.
20093	Dr. Susan Dotzler	North Central Baptist Hospital	Developing a Culture of Safety: Preventing Errors in the NICU	Critical Transitions happen with every encounter in the NICU. Ensuring the safety with every encounter begins with appropriate identification and measures to prevent errors even in encounters that would seem mundane. Our project focuses on a culture of safety in all daily activities. The smart aim is to reduce errors (regardless of whether it reached the patient) by 20% in a 9-month period.
20094	Mrs. Kaylee Hurt	Children's Mercy Kansas City	Family Advisor	With the challenges of COVID this year we were able to expand our family support by adding telehealth between parents and support staff and NICView cameras to every bedside. We made family education improvements by expanding our Developmental Care Rounds to 32 weekers and improving our transition out of the SBU.
20096	Mrs. Kelly Loomis	West Virginia University School of Medicine	NICU Jumanji: Taking Nutrition to the Next Level	WVU Medicine Children’s NICU set goals to reduce the number of infants discharged below the tenth percentile weight-for-age while increasing use of maternal milk and preventing increases in NEC. During this QI project, multiple levels of PDSA cycles were implemented, each with unique challenges. Outcomes include better growth, increased maternal milk use, earlier enteral feeding and less TPN days.
20097	Mrs. Beckie Palmer	Children's Mercy Kansas City	Small Baby Unit Patient Meetings - Multidisciplinary Collaboration to Improve Care of the Smallest Babies	We opened our Small Baby Unit March 2019, and discovered that there still remained inconsistencies between treatment plans and care delivery with care of the small baby. To help improve consistency and collaboration, we developed bimonthly Patient Meetings in January 2020 in which the multidisciplinary team would gather to discuss each patient in the Small Baby Unit.
20098	Mrs. Shayla Gordon	Mercy Children's Hospital , St. Louis	Buzzing about Brains: Swarming around Severe IVH	Mercy's team aims to improve neurodevelopmental outcomes by decreasing our incidence of severe intraventricular hemorrhage (IVH). Mercy's NICU has established a swarm process for identifying contributing factors for each case and assigning actions that may decrease further incidences of IVH. Swarms provide a rapid response to each occurrence, allowing for immediate action.
20099	Dr. Katherine Weiss	Rady Children's at Rancho Springs Medical Center	Quality improvement initiative to reduce antibiotic exposure of asymptomatic infants born to mothers with intraamniotic infection	Infants born to mothers with intraamniotic infection have been admitted to our NICU for early-onset sepsis evaluation with antibiotic treatment. A QI project was done with the aim to decrease antibiotic exposure rate from 100% to 20% for these infants in six months. There was a shift in our center line (93% to 0%) for antibiotic exposure & NICU admission after implementation of these guidelines.
20100	Dr. Kimberly Mitchell	Meriter Hospital	DIFFERENCE IN EFFICACY BETWEEN BUBBLE CPAP AND VENTILATOR CPAP TO REDUCE BRONCHOPULMONARY DYSPLASIA	Bronchopulmonary dysplasia continues to remain a significant morbidity within the preterm infant population. Our QI project was to investigate if the transition to bubble CPAP affected the rates of BPD in our micro-preemie population.
20104	Ms. Debora Mann	University of Louisville Hospital	Standardizing Respiratory Management and Reducing Chronic Lung Disease in the NICU	There has been a lack of standardization for respiratory managment for infants less than 33 weeks gestation. In 2017, CLD was noted to be 5% above the VON benchmark of 24%. A standardized process was developed and practice changes were made including increase use of CPAP, use of Neo-T vs Ambu bags and when to use surfactant replacement. In June of 2019 CLD decreased to 0%.
20105	Dr. Maria Pane Pane	Greater Baltimore Medical Center	Improving Discharge Process for babies and families in a community hospital	We will show via a PDSA cycle how we identified barriers to timely discharge and how we worked to improve the discharge process and flow in our unit. We worked on the barriers and made discharge planning part of the every day rounding process and within a week or so of discharge made sure we had all providers (doctors, RN’s, RRT’s, social work, SLP and families) on board.
20106	Mrs. Monica Smith	Akron Children's Hospital	Decreasing NICU Readmissions Within 14 Days of Discharge	Every month a multidisciplinary team meets to review documentation surrounding infants that are discharged from our Organization’s local NICUs and readmitted to any unit within our Organization within 14 days. It is our goal to reduce the number of readmissions and to identify areas of opportunity for improvement surrounding our discharge processes.
20107	Mrs. Connie Teal	Akron Children's Hospital	Humidity Management and Skin Integrity In The SBU	Our team wanted to create a humidity management and weaning guideline for use in our small baby population. The goal of this guideline was to optimize skin integrity and minimize trans epidermal water loss.
20108	Mrs. Connie Teal	Akron Children's Hospital	ESC: Implementation and Early Outcomes	Our NICU recently adopted the ESC approach of assessing the needs of our NAS population. We would like to share our journey to implementation and early outcome data.
20109	Dr. Lisa Bain	Lucile Packard Children's Hospital Stanford	Decreasing malnutrition on discharge from the NICU	Early nutrition has large impacts on future growth and neurodevelopment. Recent studies suggest early initiation of feeding, early fortification and faster advancement of feeds is safe and beneficial. We implemented a new feeding pathway in our NICU and tracked malnutrition at discharge. Since its initiation, our malnutrition improved and no infants have been discharged severely malnourished.
20110	Ms. Tracy Morrison	Miami Valley Hospital	Into the MIST: Implementing Minimally Invasive Surfactant Therapy	It has been established that as few as 6 high volume breaths after delivery causes volume trauma to the newborn lung and begins the process toward development of chronic lung disease. Mechanisms to reduce intubations while maintaining the ability to administer surfactant are needed.
20111	Mrs. Jennifer Thieman	Parkview Women's and Children's Hospital	Decreasing Chronic Lung Disease in Very-Low Birthweight Infants Born <33 Weeks Gestation with Evidence Based Respiratory Distress Guidelines	A level 3, 37 bed NICU created a Pulmonary Quality Committee and a custom RDS guideline over 2 years. The guideline covered surfactant administration, non-invasive ventilation strategies, ventilator weaning and extubation criteria, along with several other topics. Through application, auditing and reinforcement of the of the guidelines, CLD rates dropped from 48.8% in 2017 to 26.3% in 2019.
20112	Ms. Cathy Montgomery	Driscoll Children's Hospital	Our NICU Standardized Feeding Guidelines and Reducing NEC Project 2016-2020	Our project began in 2016 with the implementation of standardized feeding guidelines. While our center rates for NEC decreased to 4.3% our "Any Location" rates for NEC are 10.1%. We have built a learning network within our region, for dieticians, lactation support and nurses for education and seminars focused on our quality work and improving the outcomes of our shared patients.
20113	Dr. Cheryl Motta	Children's Hospital of San Antonio	The Journey Home Continues: A multidisciplinary approach to improving the discharge process for infants 32 to 37 weeks gestation.	Our NICU team focused on the discharge of infants born at 32 to 37 weeks gestation. Interventions included development of a comprehensive discharge checklist, development of a family communication board, and implementation of a new feeding protocol to help improve time to full oral feeds. The average length of stay for January through July 2020 has decreased from a baseline of 21 to 18 days.
20114	Ms. Deborah Pina-Corona	Driscoll Children's Hospital	Hand Hygiene and Infection Elimination Campaign	Our project was to increase hand hygiene compliance, with a secondary goal to improve infection rates. We formed a team of 15 bedside nurses with leader support. Nurses researched PBPs for hand hygiene, bedside care and created education to present to peers and families. Peer education was presented at staff meetings, mock code events and a NICU Education Fair for all of DCH.
20115	Dr. Monika Patil	Texas Children's Hospital, Baylor College of Med.	Probiotic Implementation in a Large Referral NICU	Our team researched and selected probiotics, educated staff, and rolled out probiotic administration for inborn VLBWs this year. A multidisciplinary QI team developed guidelines and education to implement changes using PDSA methodology. Our Smart Aim is to decrease the rate of necrotizing enterocolitis (NEC) in our inborn VLBW population to under 5% by the end of December 2020.
20116	Mrs. Mary Catherine Burke	Regional One Health	COVID-19 Impacts on NICU Families	Everyone's lives have been turned upside down with the onset of COVID-19. Share your local challenges, how you overcame them and the lasting impacts on NICU families.
20117	Mrs. Cheryl Lair	University of Texas Southwestern Med. Ctr. Dallas	Optimizing use of MoM in the NICU	Optimizing use of Mother’s Own Milk (MoM) is tandem to the NICU necrotizing enterocolitis (NEC) QI. Objective: to optimize operations and clinical practice to support the receipt of MOM. Three elements were identified: 1. Maximize the utilization of colostrum; 2. Minimize the use of donor breast milk and formula; 3. Establish an effective process that allows use of fresh (never frozen) MoM.
20118	Dr. Jan Schriefer	Golisano Children's Hospital at Strong	A Proposed Technique to Enhance Strategic Plan Implementation Using Continuous Quality Improvement Methodologies	The project used the IHI Model for Improvement to create a framework for monitoring our NICU and overall Children's Hospital Strategic Plan. The project employed the use of improvement science coaches to support teams working on various aspects of the plan including community pediatrics and advocacy, population health, digital health, clinical care, education and research.
20119	Dr. Jan Schriefer	Golisano Children's Hospital at Strong	The Value of Family Advisors as Coleaders in Pediatric Quality Improvement Efforts: A Qualitative Theme Analysis	The project was done to better understand the elements required to elevate family advisors to a leadership level for our quality improvement team. The project used a qualitative approach to study the key elements that embrace family advisors as equal members and at equal status to the quality improvement team leader including attending physicians and residents. Our goal was to flatten hierarchy.
20120	Dr. Bethany Chalk	Johns Hopkins Hospital	Increasing on-time administration rates of the initial hepatitis B vaccine in the neonatal intensive care unit: A quality improvement initative	This was a quality improvement project to increase on-time initial hepatitis B vaccination rates at two neonatal intensive care units. Baseline vaccination rates were evaluated pre-intervention. Interventions to increase rates include institutional vaccination guideline development, staff education, addition of prompts to progress notes, and feedback to providers about current vaccination rates.
20121	Dr. Jan Schriefer	Golisano Children's Hospital at Strong	Builduing a Pediatric Perioperative Surgical Home for NICU Graduates to Optimize Pre-Operative Health Status	Our organization has a very large neonatal and pediatric surgical program. Some of the surgical patients are former NICU graduates with complex medical conditions and often dependent on technology such as tracheostomy and gastric feeding tubes. We created a Pediatric Perioperative Surgical Home to follow up and follow through with patients and caregivers before surgical procedures
20122	Dr. Kendall Johnson	Connecticut Children's Medical Center	Improving Time to First Hold for Infants <32 Weeks	Level IV NICU is focusing on improving the time to parental first hold for infant's born at <32 weeks. Goal is to reduce mean time to first hold from 7 to 3 days. Initial changes included "first hold" crib card, staff education on holding with umbilical lines, patient audits for reasons not being held, and parent pamphlets on benefits of holding. Updated guidelines on holding are in process.
20123	Mrs. Becky Stredni	Akron Children's NICU at Aultman	Golden Hour	Our project addresses the admission process for patients born < 32 weeks. Our goal is to implement the Golden Hour for these patients by completing certain parts of the admission within the first hour of life. These include; erythromycin and vitamin K administration, IV Fluid administration, temperature and glucose, line access, and antibiotic administration.
20124	Dr. Benjamine Planer	Hackensack University Medical Center	Standardizing practice guidelines improves outcomes in neonates less than 30 weeks	Implementation of standardized practice guideline and small baby area for infants < 30 weeks gestation. Our survival without morbidity is better than the VON 50th%, however decreasing the NEC rate could improve. Our metrics include provision of colostrum oral care within 12 hours of life and starting trophic feedings with exclusive human milk (mother's or donor milk) by 12 hours of life.
20125	Dr. Madeline Keyes	Massachusetts General Hospital for Children	Decreasing variation in the management of necrotizing enterocolitis in the MGHfC NICU	NEC is a devastating disease in the NICU population, with high morbidity and mortality. Patients evaluated for NEC in our unit from 2016-2019 were managed with significant variability, causing unnecessary feeding delays and communication conflicts. Our project aims to standardize the management of NEC in our unit, with the goal of decreasing NPO days, antibiotic days, and central line days.
20126	Mrs. Debra Bender	Swedish Medical Center	Our Journey to Decreasing CLD in the Micropremie Population Subtitle: Optimizing Noninvasive Ventilation Methods	This poster will describe our journey toward decreasing our incidence of CLD in the micropremie population, including both successful and unsuccessful strategies. The journey began with a broad look at CLD in our unit, and currently we are optimizing noninvasive ventilation and NCPAP. (We have recently instituted an avenue for use of the RAM for provision of NCPAP).
20127	Ms. Valerie Garrison		Supporting Vaginal Delivery for Low-Risk Women (SOAR)	Cesarean delivery is lifesaving in many cases, but there is no evidence that the high instance of cesareans in the United States reduces infant or maternal morbidity and mortality. Evidence shows cesarean sections are overused, putting some patients at risk. The Colorado Perinatal Care Quality Collaborative will report results from the SOAR pilot initiative to promote vaginal delivery.
20128	Mrs. Marilyn Hyndman	Sunnybrook Health Sciences Centre	NICU Essentials: Development of a standardized parent orientation to the NICU	A consistent introduction for families to the NICU was needed. An orientation was developed. Covid-19 then challenged us to deliver content in a different manner. A change to electronic delivery format allowed for consistent, standardized content AND delivery. This allowed families to view at home, be delivered in a variety of languages and shared with extended family. This is our journey.
20129	Dr. Nina Menda	Meriter Hospital	Fresh Beginnings; Partnering with Families	In 2019, Meriter Hospital developed a training program for nurses and providers on Trauma informed care and Eat-Sleep-Console (ESC) as an alternative method for caring for infants affected by Neonatal Abstinence Syndrome (NAS). After implementation in Jan 2020, NICU length of stay decreased from 26 to 10 days. ESC supports family empowerment and functional assessment of infants.
20130	Mrs. April Morris	Woman's Hospital	Reduce CLD in the Micropreemie Population using Voume-targeted mode of Ventilation	Our project focus is to reduce CLD by changing from a pressure-limited mode to a volume-targeted mode of ventilation for infants initially intubated starting in the DR. Additionally, we revised our DR protocol criteria and management protocols to improve our use of non-invasive ventilation for initial stabilization and following extubation.
20131	Dr. Hellen Ko	University of New Mexico Health Sciences Center	Neonatal Massive Transfusion Protocol	My project adapted our institution’s Pediatric Massive Transfusion Protocol (MTP) for the NICU. A survey was sent out to providers and nurses in the NICU to assess current knowledge of MTPs and difficulty with ordering, obtaining, and administering blood products. The next step is to run a mock code situation to help introduce the neonatal MTP.
20132	Mrs. Samantha Hewitt	Santa Clara Valley Medical Center (SCVMC)	Early recognition of abnormal aEEG tracings	Early recognition of abnormal aEEG tracings at the bedside is a key factor to early detection of neurological abnormalities, early escalation to appropriate management of care, and may improve long term neurological outcomes. aEEG tracing interpretation was standardized by a multidisciplinary team through staff education, implementation of a bedside worksheet, and competence evaluation.
20133	Dr. Kirsti Martin	UMass Memorial Healthcare	Implementation of Virtual Rounding to Increase Parental Presence on Rounds	Visitor restrictions in the face of the COVID-19 pandemic pose a challenge for families who want to both spend time with their infant and attend daily rounds. We implemented a virtual rounding workflow to contact families if they could not be physically present in rounds. PDSA cycles are underway to help us optimize workflow and understand family preferences for means and frequency of contact.
20134	Mr. Joseph Mongiello	Hackensack University Medical Center	COVID-19 Impacts on NICU Families	We will be presenting about a NICU family and their struggles with parenting and getting by during this period of COVID-19
20135	Dr. Colby Day Richardson	Wolfson Children's Hospital	Reduction in adverse patient safety events with implementation of bedside shift report guidelines	In 2019, our unit leadership became concerned about the number of adverse patient care events associated with shift report communication. We aimed to decrease the number of these adverse events by developing standardized report sheets and hand-off guidelines. We reduced the rate of adverse patient events from 4.78 per 1000 patient days to 1.25 per 1000 patient days over the course of 8 months.
20136	Dr. Colby Day Richardson	Wolfson Children's Hospital	Reduction of severe IVH in neonates <32 weeks with implementation of IVH bundle in 1st 72 hours of life	We identified a need to improve the Golden Hour in our ELBW inborn population. We standardized stabilization through the creation of a protocol which encompassed respiratory management, thermoregulation, IV access, antibiotics and transport to the NICU. We reduced the rate of severe IVH among inborn infants from 2.5 per 1000 patient days to 0.36 per 1000 patient days from 1/2018 to 9/2019.
20137	Dr. Rebecca Miller	Jacobi Medical Center	Improving Congenital Cytomegalovirus (cCMV) Screening for Newborns in an Urban Municipal Hospital	cCMV is the leading cause of non-hereditary sensorineural hearing loss & developmental delay in childhood while newborns may be asymptomatic at birth. Our global aim was to facilitate early detection & intervention for infants at risk for cCMV infection. A multidisciplinary team co-designed high reliability changes improving detection from 6% Apr-19 to 73% Jan-20.
20138	Dr. Jordan Reis	University of Texas Southwestern Med. Ctr. Dallas	a. A Quality Improvement Project to Decrease Necrotizing Enterocolitis by Increasing Administration of Breastmilk	a. This QI project aims to reduce the frequency of NEC among preterm infants admitted to Parkland NICU by 20% from January 2019 to June 2020. The first two PDSA cycles include 1) increasing administration of mother’s own milk and 2) administration of donor breastmilk to our infants at highest risk of developing NEC.
20139	Dr. Rita Hazboun	Children's Hosp of Richmond at VCU	Timely Antibiotics in the NICU	The 2016 surviving sepsis guideline recommends administering antibiotics within 60 minutes of presentation and recognition. In 2016, the Children’s Hospital of Richmond (CHoR) established a sepsis committee to implement the guideline recommendations. We aimed to improve and maintain the median % of STAT antibiotics administered within 60 min of ordering and Late Onset Sepsis recognition > 70%.
20140	Ms. Laura Berritto	Santa Clara Valley Medical Center (SCVMC)	Debriefing after NICU Admissions and Critical Incidents to Improve Patient Safety and Team Performance	We developed a standardized tool to debrief after all NICU admissions or critical incidents to examine existing processes to improve patient care quality and safety. Process improvement opportunities were identified and addressed weekly. Communication and coordination between departments and units facilitated process changes to improve transition of care.
20141	Dr. Joaquim Pinheiro	Albany Medical Center	Decreasing the frequency of transfusion-associated necrotizing enterocolitis with implementation of restrictive feeding guidelines	Because a significant proportion of NEC events in our setting were transfusion-associated (TANEC), we implemented a more restrictive feeding protocol for 24 hours following a transfusion. This has been followed by the virtual disappearance of TANEC events in the subsequent 2 years.
20142	Dr. Melissa Lestini	Virtua Hospital Systems	Creating a Small Baby Program Through Intensive Quality Improvement	Creation of a small baby program through a “Nuclear QI Option” was effective in mobilizing and motivating more than 80 multidisciplinary members who came together to form the Small Baby Team at Virtua. QI teams focused on 8 clinical areas and all teams implemented projects over the past 18 months which have led to improvement in the care of infants <29weeks in the Virtua Voorhees NICU.
20143	Mr. Benjamin Olshin	Randall Children's Hospital at Legacy Emanuel	International Multi-site Read-a-thon: Supporting Early Brain Development and Family Bonding in the Neonatal Intensive Care Unit	This multi-site NICU read-a-thon encouraged and celebrated shared family reading to support infants and families and improve the NICU experience. We provided participating NICUs with our read-a-thon process guide and also shared our NICU reading program process guide. Our goal for this read-a-thon was to encourage NICUs to start or expand upon a reading program in their unit.
20144	Dr. Malathi Balasundaram	El Camino Hospital	Implementation of reading program in a community Level 3 NICU	Newborns in the NICU especially premature babies are at risk for delayed neurological development. Adult positive vocal interaction is proven to effectively support physiologic stability, neurological development, and improve long-term outcomes. Our goal is for every baby in our NICU to be read to at least 10 minutes per shift for a total of 30 minutes daily and achieving this goal by Dec 2020.
20145	Mrs. Latisha Picard	Santa Clara Valley Medical Center (SCVMC)	Establishing A NICU Milk Preparation Room	Breastmilk misadministration errors prompted a root cause analysis of NICU feeding practices. A bar code scanning system and a centralized milk room were recommended to reduce future errors. A team of medical providers, nurses, lactation consultants, and dietary technicians established a centralized milk preparation room as an aseptic environment for trained staff to prepare infant feedings.
20146	Dr. Maricarmen Burgos Rios	University Pediatric Hospital	The Development of Early Intervention Program in the Neonatal Intensive Care Unit for High-Risk Newborn and their Parents to Ensure Early Parental Identification of Developmental Impairments using of Age and Stages Third edition (ASQ-3) at Home	We will increase the NICU high risk infants parental and pediatric health care professionals’ knowledge and preparedness about ASQ-3 screening tool, to be used at home. Parents who are prepared have a smoother transition assuming the caretaking role and feeling capable of providing home developmental stimulation, ASQ-3 screening tool, and initiating assistance.
20147	Dr. Khawaja Waheed	The Children's Hospital & the Institute of Child Health	Impact of intermittent kangaroo mother care on weight gain of neonate in NICU: randomized control trial	Preterm deaths comprise major fraction of NMR. 25% of preterms require admission in NICUs, survival of whom is a challenge in low-resource set ups. Various methods are applied to address the issue, KMC being one of them. It is associated with a 36% reduced risk of death among LBW babies. The study was planned to measure the impact of intermittent KMC on weight-gain of neonates in admitted in NICU.
20148	Dr. lama Charafeddine		Kangaroo Care Practice during COVID 19 Pandemic in a Neonatal Intensive Care Unit of a Middle-Income Country	A quality improvement had been initiated in October 2018 to promote Kangaroo Mother Care (KMC) practice. Parental visits were restricted in April 2020 due to COVID-19 pandemic and KMC was withheld. It was resumed intermittently after May 2020. Comparing the before restriction period (January – March) to the one after (May-July), KMC frequency increased from 2.3 to 3.4 sessions/patient/stay.
20149	Mr. Cagatay Celik	Columbia University Medical Center	Improving Developmental Care in a Level IV NICU	Developmentally appropriate care in the NICU is essential to support both physical and neurological development of infants. We aimed to improve positioning and environmental conditions for infants, as measured by the Infant Positioning Assessment Tool (IPAT) and the P&M Environmental Survey, via a nursing education series. Initial data shows that in-service education can improve these scores.
20150	Dr. Pradeep Alur	University of Mississippi Medical Center	Improving the Use of Length Boards in the NICU to Obtain Accurate Anthropometric Measurements	Majority of staff reported using a tape measure to obtain lengths in the NICU, and 1.5% of those polled believed the measurements to be accurate. Multiple interventions were employed in the UMMC NICU to increase the accuracy of length measurement with use of length boards via education and demonstration. Data was obtained to analyze the accuracy of length measurements following each intervention.
20151	Dr. Heather Delaney	North Central Baptist Hospital	Decreasing the Rate of Late-Onset Sepsis in the Neonatal ICU	The NCBH NICU Infection Prevention Team identified through monthly sepsis tracking tools a dramatic increase in the rate of late-onset sepsis among our patient population. We created a multidisciplinary team to strategize process changes and improvements and developed a NICU Infection Control Bundle which lead to a significant decrease in rates of infection.
20152	Dr. Heather Delaney	North Central Baptist Hospital	Practicing Antibiotic Stewardship in the Development of an Institutional Chorioamnionitis Algorithm	Historically, the AAP recommended blood evaluation and IV antibiotics in all infants exposed to maternal chorioamnionitis (MC). It is now recognized that early antibiotic exposure in neonates is not without harm. We adopted an institutional algorithm for all well-appearing, asymptomatic newborns exposed to MC which has significantly decreased the number of infants exposed to antibiotics.
20153	Dr. Kourtney Bettinger	University of Kansas Hospital Authority	Optimizing non-pharmacologic care for babies at risk oOpf neonatal abstinence syndrome in the newborn nursery	In our academic hospital’s newborn nursery, we addressed inconsistent implementation of non-pharmacologic interventions (NPIs) for babies at risk of neonatal abstinence syndrome (NAS) by developing an NAS Bundle with six key NPIs. We also created NAS Checklists, educated residents about NAS, and built an NAS order set. The rate of timely bundle implementation increased from 43% to 89%.
20154	Dr. Erin Tkach	Banner Thunderbird Medical Center	Reduction in Severe IVH Rate with Implementation of a Small Baby Protocol	In early 2019 the incidence of severe IVH in babies <1500g in our level 3 NICU ranged from 15-50% per month. We implemented a small baby protocol in June 2019, decreasing the severe IVH incidence to 0 for the rest of the year. The program includes midline head position, elevated head of bed, minimal stimulation, a sedation protocol, blood pressure guidelines, 4 hand cares, and other interventions.
20155	Dr. David Sink	Connecticut Children's Medical Center	Striving to Improve Discharge Readiness in 2020	Our NICU aimed to improve discharge readiness, assessed by staff & parent surveys. Family integration & communication are key drivers of readiness. We built discharge readiness checklists, 1 for > 32 weeks & 1 for < 32 weeks. Checklists are posted & parents & staff encouraged to review together. We survey nurses on discharge and use parent surveys to assess for improvement in readiness.
20156	Dr. Sarah Pearce	Providence Portland Medical Center	Improving the NICU Experience Through Experience-Based Co-Design	We are using the EBCD process and are working with our co-design team to improve our discharge process as well as promote a positive family centered experience in our NICU. Our poster will include these “pearls” as well as the specific quality improvement projects derived from our change ideas to enhance communication and increase family participation in discharge preparation.
20157	Dr. Amit Agrawal	Banner Thunderbird Medical Center	Utilizing Real-Time Data to Drive Quality in the NICU	The focus on quality in the NICU setting has been the outcome, the key performance measures such as NEC, CLD, mortality and IVH. There remains a large gap in key drivers for those outcomes and the outcome itself. We created a real-time dashboard that takes into account the critical drivers for those outcomes, and allows the team to improve care instantly, which in turn leads to improved metrics.
20158	Mrs. Liz Simmons	Saint Joseph Hospital	How a Small Baby Team Impacts Outcomes for < 30 week Infants	To implement a Small Baby Team approach to improve outcomes for infants < 30 weeks; Improve Golden Hour Measures (time to IV fluids, temperature on admission, time to IV fluid initiation); Improve morbidities, short- and long-term; Improve parental feedback in QI projects by utilizing parent representatives as family liaison; Improve parental readiness for discharge by December 2020.
20159	Dr. Stephanie Prescott	INOVA Children's Hospital	Reducing Central Line Associated Complications: The Quest for Zero in a Level IV NICU	Though central venous lines are of critical importance in the care of preterm and seriously ill neonates, they are associated with complications such as thrombosis, infection, malposition, effusion, phlebitis, breakage, and bleeding. This poster addresses the interventions attempted over 7 years to reduce the complications associated with central line use.
20160	Mrs. Margaret Behm	Advocate Children's Hospital - Park Ridge	Improving Transitions in NICU Patient Care	NICU Patients experience transitions every day. These transitions begin with admission to the NICU and continue through every team member handoff, parent/family interaction, and ultimately discharge to home/outpatient health care. A poor transition or hand off may cause delay of care, harm, or worse for our patients/families. Improvements in the transition process will be shared.
20161	Dr. Erica Wymore	Children's Hospital Colorado	Breastfeeding Experience for Opioid Exposed Neonates from the Colorado Hospitals’ Substance Exposed Newborn Quality Improvement Collaborative (CHoSEN QIC)	CHoSEN QIC aims to improve the care of opioid exposed newborns (OENs), based on Eat, Sleep, Console (ESC) methods for neonatal abstinence. We examine breastfeeding rates in our cohort based on eligibility, race/ethnicity, hospital volume and effects from COVID-19, intending to identify opportunities to improve safe breastfeeding for OENs.
20162	Dr. Vicky Reichman	Lenox Hill Hospital	Stop it!: A Quality Improvement Project to Reduce Antibiotic Utilization in the Neonatal Intensive Care Unit	Our SMART aim was to reduce our unit's antibiotic utilization rate by 60% from 9/2019-12/2020. Our PDSA cycles targeted empiric early onset sepsis treatment, as it comprised 56% of our AUR. We changed the discussion and tracking of antibiotics, and increased pharmacist oversight. We met our goal and identified opportunities for further reduction, and are pursuing further PDSA cycles.
20163	Dr. Delisha Patel	Billings Clinic	Occupational Therapy Implementation of the SENSE Program in the Billings Clinic NICU and its Effects on Caregiver Satisfaction of Infant Care	The Supporting and Enhancing NICU Sensory Experiences (SENSE) program promotes consistent, age-appropriate, responsive, and evidence-based positive sensory exposures for the preterm infant every day of Neonatal Intensive Care Unit. The long term goal of this study is to investigate patient and parent outcomes with the implementation of SENSE at the Billings Clinic NICU.
20164	Ms. Flor Tena	Nicklaus Children's Hospital	Reduction of Unplanned Hypothermia During Perioperative Period	The leadership of the OR and the NICU identify unplanned perioperative hypothermia as a safety issue susceptible for improvement with potential impact to reduce LOS. Evaluation of current recommendations (Potential Better Practices, PBP) for maintaining perioperative euthermia were conducted. A Hand-Off to improve communication NICU-OR was developed and currently being tested using PDSA cycles
20165	Dr. Erica Wymore	Children's Hospital Colorado	Best Practices Alert to Promote Improved Communication Between Providers for Safe Breastfeeding for Opioid Exposed Neonates: Experience from the Colorado Hospitals’ Substance Exposed Newborn Quality Improvement Collaborative (CHoSEN QIC)	CHoSEN QIC aims to improve the care of opioid exposed newborns (OENs), based on Eat, Sleep, Console (ESC) methods for neonatal abstinence. We developed a Best Practices Alert for Epic, an electronic medical record system, to improve communication when infants are identified as having substance exposure to determine safety of breastfeeding.
20166	Mrs. Amanda Carter	Wesley Medical Center	The Power of a Mother's Voice	I am looking to share the effects of reading and speaking to a premature infant during the NICU stay. This will also focus on how caregivers can be involved and engaged in their baby's care even if kangaroo care and holding are not possible.
20167	Dr. luigi gagliardi	UTIN Ospedale Versilia	Variation in procedures and outcomes between hospitals is a form of inequality. We want to measure it right.	Variation in outcomes and procedures between different hospitals is ubiquitous and considered as unavoidable. Yet this variability is not a mere “background noise”, but a bona fide inequality imposed upon neonates. To help evaluate it, we propose to measure it with an index widely used in economics and sociology, the Gini coefficient. We apply this approach to differences between Italian NICUs.
20168	Dr. Tasha Coleman	Children's Hospital at U. of MS Health Care	Improving Pain Control during Bedside Procedures in the NICU	Inadequate treatment of pain is associated with poor neurodevelopmental outcomes. Best practice for infants undergoing invasive procedures includes analgesia prior to as well as ongoing assessment with a validated pain scale. We set out to improve the number of infants receiving appropriate pain control during bedside procedures from a baseline of 25% to 40% in our NICU by June 2021.
20169	Dr. Emily Whitesel	Beth Israel Deaconess Medical Center	Welcome to the NICU	In our EBCD work, we found that families are overwhelmed by information during their admission. Our practice had been to have a family meeting prior to maternal discharge, which reviewed not only clinical outcomes/course, but also logistics (parking, services, etc). In order to address this information overload, we developed a curriculum that addressed only non-clinical aspects of NICU care.
20170	Dr. Brian Scottoline	Oregon Health and Science University	Initial Experience With a New Method of Umbilical Catheter Securement	We measured umbilical catheter (UC) malposition rates with LifeBubble, a novel method of securing and protecting UCs. 40 neonates received LifeBubble: 2 UVCs and 0 UACs removed for malposition after securement (3.5% of UCs). Average literature UC malposition rate is ~50%, with serious complications. LifeBubble was successfully used in our NICU with lower than literature migration rate.
20171	Ms. Daniela Lopez-Vallejo	University Pediatric Hospital	DECREASING ANTIBIOTICS USE IN THE EARLY DAYS OF LIFE, CAN WE KEEP THE TREND?	In 2017, we developed guidelines for initiation and duration of antibiotics during the first week of life. During that year there was a 7% decrease in antibiotics initiation in general and a 9% decrease in term infants. But, were we able to keep the decreasing trend 2 years later? We will present the data on antibiotics use from 2017-2019 and identify areas for improvement.
20172	Mrs. Serena Knoop	Helen DeVos Children's Hospital	Outcomes after implementing restrictive blood transfusion criteria in extremely premature infants	The objective was to assess mortality & morbidities in VLBW infants before & after changing to a restrictive blood transfusion guideline. It was a large, single unit retrospective study. Discussion of findings related to mortality, CLD, PVL, sepsis, ROP, & NEC in relation to restrictive versus liberal transfusion guidelines.
20173	Dr. Nilesh Dankhara	Children's Hospital at U. of MS Health Care	Implementing an Audiovisual Recording Program to Improve Quality of Delivery Room Resuscitation.	A multidisciplinary team is formed to implement an audiovisual recording program in the resuscitation room with the global aim of improving neonatal resuscitation. Phase I: Aim is to increase the quality of recordings from 40% baseline to 90% using PDSA cycles. Phase II: Aim is to improve the compliance of resuscitation as per NRP guideline in the first minute.
20174	Dr. Sangeeta Mallik	Santa Clara Valley Medical Center (SCVMC)	Adaptation of a NICU Family Centered Care program during COVID pandemic	This poster highlights how a level 4 regional NICU was able to adapt its Family Centered Care program during the pandemic to successfully continue supporting families. Modifications included decrease in onsite hours of the FCC team, but increase in 1) weekly phone contact with families, 2) online participation in NICU meetings, and 3) weekly contributions to NICU advocacy around family issues.
20175	Mrs. Tammy Lambert	Dartmouth Hitchcock Medical Center	Family Integrated Growth	Infants who are born at less than 1500 grams or less than 34 weeks gestational age are being discharged from the ICN with complex medical needs. The purpose of the project is to review feeding processes for inpatient ICN infants and review the follow-up that occurs between discharge and first TLC clinic visit.
20176	Dr. Katharine Johnson	Methodist Children's Hospital	Precious Time Out: A Quality Improvement Tool to Improve Critical Transitions of Care in the NICU	In an innovative application of the surgical time out, the "Precious Time Out" tool was developed to ensure effective communication and to establish a shared mental model for critical transitions of care in the NICU. After multiple cycles of improvement and tests of change, the precious time out tool has been expanded for use in all NICU admissions and post-op patients returning to the NICU.
20177	Mr. Alex Zavala	Dell Children's Medical Center of Central Texas	Family Partner/ The NICU Dad	Introduction of myself and the work we are doing for NICU Dad support.
20178	Ms. Flor Tena	Nicklaus Children's Hospital	Telehealth Nursing Intervention to Improve Transition to Home	The transition from hospital to home, a period of increased risk, can result in emergency department visits and re-hospitalization. These risk can be compounded by healthcare access issues. We implemented a Telehealth Nursing Program to assist caregivers in order to improve the transition process.
20179	Mrs. Marybeth Fry	Akron Children's Hospital	Impact to NICU Families During the COVID-19 Crisis	In the spring of 2020, COVID-19 reared its ugly head and sent NICUs scramble for safety measures to protect their patients, patient families and staff. The ripple effect of those decisions impacted NICU families unlike anything we’ve seen in recent years. This poster will share some of the changes that occurred in our NICU, how those changes impacted families and how we’ve adapted since.
20180	Mrs. Marybeth Fry	Akron Children's Hospital	Impact to NICU Families During the COVID-19 Crisis	In the spring of 2020, COVID-19 reared its ugly head and sent NICUs scramble for safety measures to protect their patients, patient families and staff. The ripple effect of those decisions impacted NICU families unlike anything we’ve seen in recent years. This poster will share some of the changes that occurred in our NICU, how those changes impacted families and how we’ve adapted since.
20181	Ms. Sarah Lee	Columbia University Medical Center	Development of the Virtual NICU Program during the COVID-19 Pandemic	Due to the profound early impact of COVID-19 in New York City, our hospital limited visitation policies in our NICU. The Virtual NICU Program allowed parents to bond with their baby via video visits if they were unable to visit in person and also facilitated communication between parents and medical providers. We describe the process of developing and adapting this program during the pandemic.
20182	Ms. Missy Adriazola	Columbia University Medical Center	Family Poster - Mighty Morgan	Mighty Morgan is my amazing 11yo daughter, born at 25 weeks and a surviving twin. For the first 3 months, we weren't sure if she was going to live either. I did not have a lot of resources when Morgan was born. I was dealing with the loss of one child and figuring out how to help another with a disability. I wish I had known there is a giant network of other parents willing to listen and help.
20183	Ms. Joanna Celenza	Dartmouth Hitchcock Medical Center	Pain Awareness Campaign	September is Pain Awareness Month and we began leveraging this opportunity to share within the Intensive Care Nursery (ICN) and beyond, the idea of parents as healing partners in our ICN. Our first campaign was in 2019 and was intended to highlight lessons learned through our Micropreemie Champion Course and engage families in therapeutic touch with their babies. 2020 campaign currently underway.
20184	Dr. Lorraine Bautista	University of Texas Southwestern Med. Ctr. Dallas	Treatment of Infants with Neonatal Abstinence Syndrome at Risk for Longer Length of Treatment	We aimed to decrease average LOT by 20% by December 2020. In PDSA Cycle 1-3 we focused on standardized scoring methods, management of maternal opioid use and NAS treatment and weaning. In PDSA Cycle 4 (current) we are creating a prediction model to identify infants at risk for longer LOT to incorporate a secondary agent in a standardized algorithm.
20185	Dr. Sue Townsend	Memorial Hospital	Shifting the Care Paradigm for Opioid Exposed Newborns in Southern Colorado	For opioid exposed newborns in 2 Southern Colorado hospitals, we implemented the approaches of Eat, Sleep, and Console (ESC) assessment and limited opiate treatment, and assessed birth hospitalization length of stay (LOS), postnatal opiate exposure, and 30-day re-hospitalizations.
20186	Ms. Brenda Miller		Expanding Family Partner Involvement on the NICU Team Post-Covid	Family Partner involvement in our NICUs has undergone challenges this year. I will review Teamwork Family Partner roles that were presented at the beginning of this 3 year collaborative and suggest priorities for these roles, with new avenues for involvement. I will plan a follow-up survey to one done earlier in the year gauging levels of Family Partner activity in the unit pre- and post-Covid.
20187	Mrs. Amie Slaughter	University of Kansas Hospital Authority	Give Them Wings: An Evidence Based Approach to Minimizing Neonatal Lung Injury	Our focus for the last two years has been to improve the respiratory care and the rates of chronic lung disease in infants < 29 weeks. Through 4 PDSA cycles we have standardized respiratory care to minimize exposure to invasive ventilation. Our standardized care guidelines provide guidance across the continuum of respiratory care; from the delivery room until the infant's "fly" on room air.
20188	Dr. Alison LaBadie	Holy Redeemer Hospital and Medical Center	Maintaining Euthermia During the Golden Hour : A QI Project for Infants <1500g or 32 weeks	As part of the CHOP Newborn Care Network , our hospital is participating in this Network-wide QI project to acheive euthermia during the golden hour for infants <1500g or less than or equal to 32 weeks. Since project rollout in January 2019 our Level III unit has enrolled 34 babies, tracking their temperatures and any thermal regulation intervention every 15 minutes from birth.
20190	Dr. Maria Pane Pane	Greater Baltimore Medical Center	Improving Discharge Process for babies and families in a community hospital	We will show via a PDSA cycle how we identified barriers to timely discharge and how we worked to improve the discharge process and flow in our unit. We worked on the barriers and made discharge planning part of the every day rounding process and within a week or so of discharge made sure we had all providers (doctors, RN’s, RRT’s, social work, SLP and families) on board.
20191	Ms. Valerie Garrison	CPQCC	Labor & Delivery Universal Screening Protocols for Substance Use Disorder: Lessons Learned through Pilot Implementation of the AIM Obstetric Care for Women with Opioid Use Disorder Bundle	Opioid overdose is the second leading cause of maternal mortality in Colorado; the Colorado Department of Public Health Maternal Mortality Prevention Program and the Colorado Perinatal Care Quality Collaborative convened a cohort of eight hospitals to pilot implementation the Obstetric Care for Women with Opioid Use Disorder AIM Bundle, beginning with universal screening at admission for birth.
20192	Dr. Justin Josephsen	Ann & Robert H. Lurie Children's Hospital	ILPQC statewide quality improvement strategies to optimize care for opioid exposed newborns: 2 years of lessons learned	ILPQC supports IL hospital teams to implement best practices for OENs through collaborative learning, rapid response data, and QI support to facilitate implementation of the initiative. AIMs are to increase OENs receiving breastmilk at infant discharge, implement non-pharm care as first-line treatment to reduce pharm treatment for NAS, and increase the number of OENs with a coordinated discharge.
20193	Dr. morris cohen	Children's Hospital of New Jersey at NBIMC	Antibiotic Stewardship's Success over 3 Years	Our antibiotic stewardship program initiated in 2017. The goal was to decrease the number of patients receiving antibiotics on admission and a shortened course when used. The focus was on VLBW babies. The antibiotic utilization ratio (AUR) was used for all babies. Results showed a sustained decrease in antibiotics use. Our success was due to simple guidelines and "buy-in" from all disciplines
20194	Dr. Annmarie Golioto	Connecticut Children's Medical Center	A Quality Improvement Initiative to Decrease Delivery Room Intubation in VLBW Neonates	Our center is investigating protective lung strategies to decrease our rate of CLD. We established a delivery room bundle for the VLBW infant outlining parameters for care with nCPAP vs. intubation. We aim to decrease the rate of initial intubation by early use of nasal CPAP. We will compare stabilization route to our historical patients and seek balancing measures for potential areas of harm.
20195	Mrs. Jessica Wolff	Carle Foundation Hospital	Lily's Little Lungs	Our poster will describe a parent's perspective of the NICU experience. It will outline the journey of having a 24 week baby in the Small Baby Unit through discharge to current challenges.
20196	Dr. Meg Kirkley	Denver Health Medical Center	Transition from Continuous Pulse Oximetry in Infants Near Discharge	To increase parental confidence and ability to monitor infant-based feeding signals, and decrease alarm fatigue among staff, our project sought to transition convalescing infants from continuous to daily pulse oximetry. Our SMART aim: By September 2020, the DHMC NICU will increase the % of eligible infants receiving only daily pulse oximetry checks >24h prior to discharge from 0% to 50%.
20197	Dr. Jennifer Twiss	McMaster Children's Hospital Neonatal Nurseries	Improving use of two person cares for micropremature infants	This QI initiative sought to understand the barriers to provision of two person care provision for micropremature infants in a tertiary NICU. Our methods included surveys of staff and parents to determine barriers and develop projects to improve the use of this technique.
20198	Mrs. Rena Rosenthal	Sunnybrook Health Sciences Centre	Enhancing Communication among Neonatal Intensive Care Units (NICU) in Ontario	Communication tools have been designed to facilitate neonatal retro-transfers among Ontario hospitals of varying acuity levels. However, no standardized process for transferring accurate and detailed nutrition information among RDs exist. The projects aim was to improve communication of nutrition care plans and enteral feed information amongst Ontario NICU RDs to provide a seamless transition.
20199	Dr. Esther Rai	McMaster Children's Hospital Neonatal Nurseries	Crushing the Game of Germs in the NICU	A multi-disciplinary Hand Hygiene Task Force was established in the NICU at McMaster Children’s Hospital, which aimed to improve hand hygiene compliance rates to >95% by November 1, 2020. Through staff and parent surveys, barriers were identified, and a comprehensive education campaign was launched. To address sustainability and the need for a culture shift, peer-to-peer auditing was implemented.
20200	Dr. Leslie Ruybal	St. Vincent Hospital	Transition to Home with Nasogastric Tube Feedings in a Rural Healthcare Setting	Feeding immaturity in preterm neonates is a common problem in the Neonatal Intensive Care Unit and often results in prolonged hospital stays. Previous studies in adults, and older children, have demonstrated safety with home NG feeds. Our aim is to reduce hospital length of stay by implementing a Home NG Feeding Program in a rural hospital setting.
20201	Dr. Leslie Ruybal	St. Vincent Hospital	Improving Communication through Implementation of a NICU to OR Handoff Report	Effective handoffs have been a National Patient Safety Goal for the Joint Commission since 2006. Checklists can improve communication during patient handoff procedures and provide a tool for shared clinical understanding. Our aim is to improve handoffs and shared clinical understanding of patients requiring surgical care by using a standardized NICU to OR and OR to NICU Handoff Report.
20202	Dr. Kamlesh Athavale	Duke University	Are Unplanned Extubations in the Intensive care nursery preventable?	Our project aims at improving reporting of unplanned extubations (UE) in the NICU, evaluating contributors to UE events and identifying strategies to reduce the UE rates. Most UE were seen to occur around patient movement/repositioning, during patient procedures, or due to inadequate securement of ET tube. With standardization of practices we aim to decrease UE rates from our current rate of 0.8.
20203	Mrs. Margaret Behm	Advocate Children's Hospital - Park Ridge	Sustainability of the Micro-premature Infant Quality Improvement Project	In 2016, our neonatal care team began work on the Micro-premature Infant Quality Improvement Project utilizing the Model for Improvement framework described by Langley (1996). Our poster will focus on sustainability of our work over the course of the collaborative.
20204	Mrs. Joy Hilliard	Tufts Medical Center	Neonatal Intensive Care Unit Emergency Evacuation	After the Boston Marathon Bombing where no formal evacuation plan was in place, we developed an emergency evacuation plan which includes emergency equipment, individual backpacks, pod bags and a communication bag. Online education was created in February for all staff. Mock simulation drills were deferred due to COVID but resumed planning with target start in December for this critical transition.
20205	Mrs. Jessica Pelletier	Sparrow Hospital	Improving Discharge Times	In this Quality Improvement project, we aim to increase the number of infants discharged prior to 11 a.m. to increase parent satisfaction, remove barriers that lead to delayed discharge, and reduce costs associated with extended usage of nursing time.
20206	Mrs. Sharla Crowley	Vermont Oxford Network Center	VON's ELBW Follow-Up Project Overview	The ELBW Follow-Up Steering Committee would like to showcase the work that we've done over the last few years. Specifically, we'd like to share our findings from our annual reports.
20207	Dr. Amit Mukerji	McMaster Children's Hospital Neonatal Nurseries	PRACTICE VARIABILITY REDUCTION TO REDUCE BPD [PRVENT-BPD]: A LONGITUDINAL QUALITY IMPROVEMENT PROJECT	Bronchopulmonary dysplasia (BPD) is the most common morbidity related to preterm birth, and has significant long-lasting health implications. The multi-disciplinary PRVENT-BPD initiative aims to implement eight standardized clinical practices (SCPs) aimed at BPD prevention at McMaster Children's Hospital.
20208	Dr. Alison Rentz	St. Vincent Hospital & Health Center	Improving NICU Parents Readiness for Discharge	On discharge surveys, parents in our NICU did not feel well prepared to care for their baby at home. We aimed to improve parents’ preparation for discharge and create a clear pathway to follow for discharge teaching throughout the baby’s hospitalization. Drivers included a standardized teaching pathway, PO feeding pathways and guidance on readiness and standardizing discharge procedures.
20209	Mrs. Kelley Smith	Regional One Health	Small Babies, Big Outcomes	We will be presenting follow up data on prevention of IVH in micropreemie babies in the first 3 days of life using mid-line head positioning approaches. Our project plan to improve parent-babies bonding in micropremie population via skin-to-skin contact interaction. Improve provider and parent communication during hospitalization care to avoid miscommunication on plan of care and outcome.
20210	Mrs. Ashley Welscher	Children's Memorial Hermann Hospital	NICU Lactation Education for Hospitalized Antepartum Patients	We know it is so important for NICU babies to receive optimal nutrition, ideally mother's own milk. With a goal to increase mother's knowledge and comfort with pumping procedures in order to establish and maintain a full milk supply, a NICU specific prenatal lactation education program was developed for our hospitalized antepartum mothers.
20211	Mrs. Emma Sanchez	Children's Memorial Hermann Hospital	Ticket to Ride	Ticket to Ride is a project created to ensure the right patient is taken to the right procedure every single time. Our team is trialing a form that acts as a "time out" prior to taking any patient off of our unit. Our hope is that this form betters communication between transport team, nurses, and physicians and prevents errors. This form is modeled off of best practices from other spaces.
20212	Dr. Shikha Gupta-Bhatnagar	McMaster Children's Hospital Neonatal Nurseries	Antibiotic stewardship and optimization of antibiotic use at McMaster NICU	This poster will describe the antibiotic stewardship work conducted at McMaster NICU over the last year. The various interventions implemented include initiation of weekly ASP rounds, creation of clinical algorithms (CONS/NEC), enhancement of existing drug formulary and active monitoring of broad-spectrum antibiotic use over time. Preliminary results of these interventions will also be presented.
20213	Dr. Shikha Gupta-Bhatnagar	McMaster Children's Hospital Neonatal Nurseries	Crushing the Game of Germs at McMaster NICU	This poster will describe the reasons for formation of the NI Working Group at McMaster NICU in August 2019. We will share the process with which members were recruited and task forces were formed. We will then share the various QI projects that the NI Working Group has implemented, and the ones planned for the upcoming year, and will also share preliminary results achieved thus far.
20214	Dr. Shikha Gupta-Bhatnagar	McMaster Children's Hospital Neonatal Nurseries	o COVID-19 pandemic preparedness and response plan at McMaster NICU	This poster will describe the QI work conducted at McMaster NICU in response to the COVID-19 pandemic. Measures implemented include the development of a clinical guideline to guide the care of infants with suspected or confirmed COVID-19 infection, formation of task forces to create protocols for attendance at delivery, safe patient transport, infection prevention and control, management of PPE.
20215	Mrs. Rebekah Wilkinson	Children's Memorial Hermann Hospital	Chart Review and the Nursing Report Card - Bringing the Data Back to Bedside Staff	We all have so much data. But what to do with it and how to make it visible and impactful to staff remains elusive. We have been working with our team of surveillance nurses, not just to engage frontline nursing leaders in quality improvement, audit, and feedback, but to bring that data back to staff. We are now trialing a safety report card using measures related to nursing care.
20216	Dr. Sangeeta Bhatia	Western Pennsylvania Hospital	Sepsis risk identification decreased the use of antibiotics in infants with maternal diagnosis of Chorioamninitis	We launched the use of EOS calculator to identify low and intermediate risk of sepsis in neonates born to mother with the diagnosis of Chorioamnionitis. We observed decrease in the antibiotics usage by 25% in the period of 6 months after its implementation and 24% of babies were not separated from mother for sepsis evaluation and antibiotics administration in the NICU.
20217	Mrs. Cheryl Lair	University of Texas Southwestern Med. Ctr. Dallas	Reducing Hypophosphatemia in Preterm Infants	A QI project at Parkland NICU resulted in reduction of incidence of hypophosphatemia from 47% to 24% (p <0.01) and a decrease in serum alkaline phosphatase levels at 36 weeks PMA from 382 +/- 147 to 302 +/- 117 (p > 0.01). Practice changes included earlier initiation of PN and lab evaluation, daily optimization of Ca and P dosing in PN by RDs and a rate based IV hypophosphatemia correction method.
20218	Ms. Amy Atwater	Helen DeVos Children's Hospital	Catheter Realated Blood Stream Infections: Key Processes that Impact CLABSI Rates	Catheter related blood stream infections (CLABSI) are a leading cause of increased morbidity and mortality in the NICU population. After months of being CLABSI free, our rates where rising causing our leadership team to question what changed. Using a common cause analysis (CCA) methadology we were able to identify practice changes that lead to a significant reduction in our CLABSI rates.
20219	Mrs. Nikki Wiggins	Oregon Health and Science University	Fall Into Reading	NICU Family Advisory Council launches a "Fall Into Reading" program in collaboration with Multnomah County Library to promote literacy and reading in the NICU for families despite Covid related visitor restrictions. The "Fall Into Reading" implementation included education for both staff and families about the importance of reading as well as materials from the library, and books for each family.
20220	Mrs. Nikki Wiggins	Oregon Health and Science University	Including Families in the First Oral Feeding	A NICU baby is given their first bottle when they are medically stable and showing feeding cues, whether or not the parent is present. The parents are then missing out on this important milestone and bonding opportunity. This project aims to increase the participation of families in the first oral feed based on family preference.
20221	Dr. Stefanie Rogers	Providence St. Vincent Medical Center	Improving Healthy Survival in Infants <28 weeks	Through a back to basics focus on maximizing respiratory outcomes through early and sustained recruitment strategies as part of a larger respiratory bundle in conjunction with golden hour work, our small babies are experiencing an overall increase in survival without morbidity.
20222	Mrs. Lelis Vernon		Transforming Family Partnerships in times of Covid	The family partners of the MP2, as a group, would like to share their challenges and creative solutions during covid, both in the hospital and at home

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