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 NumberPrimary AuthorCenterTitleDescription
20018Dr. Bethany KaemingkMayo FoundationImproving Efficiency and Timeliness of Discharge from the Neonatal Intensive Care UnitUsing 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.
20019Ms. Lisa DavisCarle Foundation HospitalET Takes Two: A Targeted Approach to Decreasing Unplanned Extubations in High Risk InfantsMechanical 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.
20020Dr. Tracey HarrisEinstein Medical Center PhiladelphiaImproving Neonatal Nutrition in the NICUThere 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.
20021Mrs. Denise CornellCHOI at OSF St. Francis Medical CenterThe More You Read, The More You'll KnowLack 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.
20023Dr. Colby DayUF Health JacksonvilleImproving Outpatient Development Follow Up in Infants After Neonatal Intensive Care Unit (NICU) DischargeInfants 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.
20024Mrs. Cheryl ColganCHOI at OSF St. Francis Medical CenterContinuing Our Journey to Improve the Growth in the NCCUWe 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.
20025Mrs. Kim SheffieldMerit Health River OaksGrowing Healthier PremiesDue 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.
20026Mrs. Rachel ZugschwertChildren's Minnesota - MinneapolisFamily PosterFamily poster sharing the story of our now-8-year-old 25-weeker.
20027Ms. Mary HarringtonSt. Luke's Hospital - Anderson CampusFragile: Handle with Care - the Journey of Developing our Small Baby UnitReflecting 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.
20028Dr. Caitlin NicholsYale-New Haven Children's HospitalA Quality Improvement Initiative to Improve Time to Enteral Feeding in VLBW InfantsUnit 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.
20029Dr. Miheret YitayewChildren's Hosp of Richmond at VCUComparison of Fenton and Intergrowth-21 For Postnatal Growth Assessment and Prediction of Associated Morbidities In Preterm InfantsImpaired 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.
20030Mrs. Sharon LiskaChildren's Hospital at Providence, Alaska, TheImproving Growth in the NICU, Total Premie Nutrition (TPN) TeamThe 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.
20031Dr. Yolanda Brown-MadanCedars-Sinai Medical Center (CSMC)Early discharge planning meetings and their impact on parental readiness and expectations for dischargeEarly 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.
20032Ms. Ilene (Sue) WolfEvanston HospitalA 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
20033Ms. Kristen EarlOregon Health and Science UniversityFall Into Reading: Family Centered Early Literacy in the NICUGrowing 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.
20034Ms. Nikou PishevarNationwide Children's HospitalCharacteristics of Patients with Unrelieved Postoperative Pain in Surgical NeonatesNeonates 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.
20035Mrs. Betsy KnappenShawnee Mission Medical CenterKansas State Neonatal Abstinence Syndrome (NAS) Initiative: Improving Outcomes of at Risk InfantsThe 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.
20036Dr. Amy McBeeBarbara Bush Children's at Maine MedicalA Multidisciplinary approach to the Golden Hour Leads to Sustained Improvements in Care for Infants <28 Weeks GestationOur 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.
20037Ms. Lisa DavisCarle Foundation HospitalGraduation: Improving the NICU Discharge Process for Families & StaffOur 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.
20038Mrs. Ginny ShafferChildren's Hospital at Providence, Alaska, TheNICU Graduate Poster, HollandPoster showcasing NICU graduate Holland, former 23 weeker
20039Dr. Andrew DylagGolisano Children's Hospital at StrongAn Initiative to Reduce Bronchopulmonary DysplasiaOver 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.
20040Dr. Elizabeth Fong-DeLeonVirtua Hospital SystemsReducing Severe Intraventricular Hemorrhage in the Virtua Voorhees NICUInfants 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.
20041Mrs. Laura OltmannLegacy Salmon Creek HospitalKOALA Blocks: Creating a bridge to breastfeedingBreastfeeding 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.
20042Mrs. Jessica HaasCabell 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.
20043Ms. Erin HannonConnecticut Children's Medical CenterEvaluating the Effectiveness of a Formal Care Path for Discharge of Infants with Bronchopulmonary Dysplasia (BPD) from the NICU: A Pilot StudyStudy 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.
20044Ms. Beth HuizingaHelen DeVos Children's HospitalReducing Suction Frequency in Patient Recieving Non-Invasive Ventilation2 PDSA cycles aimed at decreasing suction frequency based on assessment versus routine suctioning.
20045Mrs. Allison DiazBaptist Children's HospitalCan 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.
20046Ms. Alexa O'DellBenefis HealthcareSUBJECT TO CHANGE - Covid19 and Partnering with FamiliesThis poster will explore support to NICU families from the Parent Partner perspective, including challenges related to the Covid-19 pandemic.
20047Dr. Amy CohenVirtua Hospital SystemsImproving Timing of Care in the Golden HourCare 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.
20048Dr. Beatrice StefanescuRiley Hospital for Children at IU HealthEEG-Electrodes Pressure Ulcer Prevention QI StudyPressure 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.
20049Dr. Stephanie NapolitanoChildren's Hospital Medical Center CincinnatiImproving Early and Consistent Safe Sleep Practices in the NICU: a Regional NICU Quality Improvement ProjectWe 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%.
20050Dr. Nina MendaMeriter HospitalExamining NICU outcomes through the lens of equityPrevious 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.
20051Dr. Maika ManalastasLoyola University Medical CenterImplementation of Dexamethasone Checklist in Loyola University Medical Center NICUCorticosteroids 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.
20052Dr. Beatrice StefanescuRiley Hospital for Children at IU HealthMRI Hypothermia Prevention QI ProjectThe 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.
20053Dr. Beatrice StefanescuRiley Hospital for Children at IU HealthReduction 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”.
20054Dr. Lauren TuckerChildren's Hospital at U. of MS Health CareA Quality Improvement Initiative to Improve Hepatitis B immunization in neonates with birth weight < 2kgInfants 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.
20055Dr. Shehla SiddiquiDoylestown HospitalImplementation 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.
20056Dr. Adriana Restrepo-OrmsbyChildren's Hospital of Philadelphia Newborn CenterImplementation 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.
20057Dr. Anna DiCarloUniversity of Vermont Children's HospitalImproving Discharge Anthropometric Data and Implementation of the Infant Stadiometer in the NICUA 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.
20058Dr. Nichole AdilettaCHOC Children's HospitalStandardizing Initiation of Steroid Treatments for Preterm Infants at Risk of Developing Severe Bronchopulmonary DysplasiaBPD 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.
20060Mrs. Alison WolfUCSD Health La Jolla - Jacobs Medical CenterUtilizing Technology to Advance Effective Communication in a Complex Healthcare SystemAs 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.
20064Dr. Steven ConlonRainbow Babies & Children's HospitalLess 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.
20065Mrs. Kim DeynakaSt. Joseph Medical CenterUsing the Eat, Sleep, Console Method to Better the Care of Babies Suffering from Neonatal Opiate Withdrawal (NOW) in the NICUThe 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.
20066Mrs. julia.taylor@nationwidechildrens.org julia.taylor@nationwidechildrens.orgNCH at Grant Medical CenterMinimally- 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.
20067Dr. Gita JaniDoylestown HospitalRespiratory 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 AdministrationAs 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.
20068Dr. Scottie PaitlLoyola University Medical CenterVolume Guarantee Ventilation during Surfactant Administration WindowDecrease 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.
20069Dr. Lisa BainLucile Packard Children's Hospital StanfordReducing Unplanned Extubations in the NICUAn 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.
20070Ms. Erin KaysNHRMC-Betty H.Cameron Women & Children's HospitalGetting Better at Going Home: We're in this TogetherOur 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.
20071Mrs. Ema UrbanskiVirtua Hospital SystemsDecreasing Time to Oral Immune Therapy in the Virtua Voorhees NICUFor 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.
20072Dr. Deborah TomPhoenix Children's HospitalImproving Discharge Readiness and Patient Satisfaction in a Level IV NICUWe 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.
20073Dr. KAREN BEATTIEMcMaster Children's Hospital Neonatal NurseriesThe McMaster NICU in the time of COVID-19Changes 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.
20074Mrs. Ruth RitzemaChildren's Hospital at BronsonRebecca Ritzema - NICU Grad to collegeThis poster will describe the journey of a 23 week surviving twin and the community resources used to become a successful college student.
20075Mrs. Lisa SampsonSunnybrook Health Sciences CentreIncreasing 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.
20076Dr. Barry WeinbergerCohen Children's Medical Center of New YorkReducing 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.
20077Mrs. Brenda MaschmeyerBaptist Memorial Hospital for WomenReducing Infection during a PandemicExplore past, current and future efforts at infection reduction in the NICU VLBW population, particularly the micropremie population.
20078Dr. Barry WeinbergerCohen Children's Medical Center of New YorkA QI Project to Prevent Intraventricular Hemorrhage by Minimizing Invasive ProceduresMinimal 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.
20079Dr. Erlita GadinVirtua Hospital SystemsImproving Consistency of Information for Families of Extremely Premature InfantsPartnering 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.
20080Ms. C. Janine HesterBenefis HealthcareGolden Hour Care: An Improvement JourneyWe 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.
20081Dr. Barry WeinbergerCohen Children's Medical Center of New YorkImproving Iron Supplementation for Preterm InfantsPreterm 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.
20082Ms. Karen KopischkeOverland Park Regional Medical CenterImproving thermoregulation and electrolyte stability though limited topical emoliant use and plastic shieldingWe 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.
20083Ms. Amy AtwaterHelen DeVos Children's HospitalTransport Documentation: Using Wireless Connectivity and the Electronic Health Record to Optimize ChartingTransport 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.
20084Ms. Karen BongSunnybrook Health Sciences CentreImpacts on Families in the NICU Due to COVID-19The 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.
20085Dr. Gianina DavilaJoe DiMaggio Children's HospitalPromoting Neuroprotective Care With More Skin to Skin ContactSkin 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.
20086Dr. Gelila AsefaCohen Children's Medical Center of New YorkDecreasing Hypothermia for VLBW InfantsVLBW 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.
20087Dr. Doron KahnJoe DiMaggio Children's HospitalToward a Further Reduction in Antibiotic Use in a Level III and Two level II NICUs: Setting New GoalsIn 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
20088Mrs. Beckett PerkinsJoe DiMaggio Children's HospitalDevelopment of a Neonatal Late Onset Sepsis Assessment Tool and Code Sepsis Checklist to Reduce Time to Administration of AntibioticsWe 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.
20089Dr. Hormuz NicolwalaStony Brook University Medical CenterThe impact of antibiotic stewardship program in reducing the antibiotic utilization ratio in a neonatology intensive care unitUpdating 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.
20090Dr. Rebecca CarterRady Children's Hospital San Diego (RCHSD)Reducing Length of Stay in Neonatal Abstinence SyndromeWe 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.
20091Ms. Shiloh LueschowUniversity of Iowa Children's HospitalBifidobacterium longum subspecies infantis EVC001 decreases injury in a murine NEC modelTreatment 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.
20092Dr. Charles MercierAdventist Health - White MemorialUniversity of Vermont Children's HospitalVirtual Adaptations to Family education and their transitions home during Covid and beyoneThe 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.
20093Dr. Susan DotzlerNorth Central Baptist HospitalDeveloping a Culture of Safety: Preventing Errors in the NICUCritical 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.
20094Mrs. Kaylee HurtChildren's Mercy Kansas CityFamily AdvisorWith 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.
20096Mrs. Kelly LoomisWest Virginia University School of MedicineNICU Jumanji: Taking Nutrition to the Next LevelWVU 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.
20097Mrs. Beckie PalmerChildren's Mercy Kansas CitySmall Baby Unit Patient Meetings - Multidisciplinary Collaboration to Improve Care of the Smallest BabiesWe 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.
20098Mrs. Shayla GordonMercy Children's Hospital , St. LouisBuzzing about Brains: Swarming around Severe IVHMercy'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.
20099Dr. Katherine WeissRady Children's at Rancho Springs Medical CenterQuality improvement initiative to reduce antibiotic exposure of asymptomatic infants born to mothers with intraamniotic infectionInfants 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.
20100Dr. Kimberly MitchellMeriter HospitalDIFFERENCE IN EFFICACY BETWEEN BUBBLE CPAP AND VENTILATOR CPAP TO REDUCE BRONCHOPULMONARY DYSPLASIABronchopulmonary 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.
20104Ms. Debora MannUniversity of Louisville HospitalStandardizing Respiratory Management and Reducing Chronic Lung Disease in the NICUThere 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%.
20105Dr. Maria Pane PaneGreater Baltimore Medical CenterImproving Discharge Process for babies and families in a community hospitalWe 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.
20106Mrs. Monica SmithAkron Children's HospitalDecreasing NICU Readmissions Within 14 Days of DischargeEvery 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.
20107Mrs. Connie TealAkron Children's HospitalHumidity Management and Skin Integrity In The SBUOur 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.
20108Mrs. Connie TealAkron Children's HospitalESC: Implementation and Early OutcomesOur 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.
20109Dr. Lisa BainLucile Packard Children's Hospital StanfordDecreasing malnutrition on discharge from the NICUEarly 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.
20110Ms. Tracy MorrisonMiami Valley HospitalInto the MIST: Implementing Minimally Invasive Surfactant TherapyIt 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.
20111Mrs. Jennifer ThiemanParkview Women's and Children's HospitalDecreasing Chronic Lung Disease in Very-Low Birthweight Infants Born <33 Weeks Gestation with Evidence Based Respiratory Distress GuidelinesA 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.
20112Ms. Cathy MontgomeryDriscoll Children's HospitalOur NICU Standardized Feeding Guidelines and Reducing NEC Project 2016-2020Our 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.
20113Dr. Cheryl MottaChildren's Hospital of San AntonioThe 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.
20114Ms. Deborah Pina-CoronaDriscoll Children's HospitalHand Hygiene and Infection Elimination CampaignOur 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.
20115Dr. Monika PatilTexas Children's Hospital, Baylor College of Med.Probiotic Implementation in a Large Referral NICUOur 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.
20116Mrs. Mary Catherine BurkeRegional One HealthCOVID-19 Impacts on NICU FamiliesEveryone'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.
20117Mrs. Cheryl LairUniversity of Texas Southwestern Med. Ctr. DallasOptimizing use of MoM in the NICUOptimizing 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.
20118Dr. Jan SchrieferGolisano Children's Hospital at StrongA Proposed Technique to Enhance Strategic Plan Implementation Using Continuous Quality Improvement MethodologiesThe 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.
20119Dr. Jan SchrieferGolisano Children's Hospital at StrongThe Value of Family Advisors as Coleaders in Pediatric Quality Improvement Efforts: A Qualitative Theme AnalysisThe 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.
20120Dr. Bethany ChalkJohns Hopkins HospitalIncreasing on-time administration rates of the initial hepatitis B vaccine in the neonatal intensive care unit: A quality improvement initativeThis 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.
20121Dr. Jan SchrieferGolisano Children's Hospital at StrongBuilduing a Pediatric Perioperative Surgical Home for NICU Graduates to Optimize Pre-Operative Health StatusOur 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
20122Dr. Kendall JohnsonConnecticut Children's Medical CenterImproving Time to First Hold for Infants <32 WeeksLevel 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.
20123Mrs. Becky StredniAkron Children's NICU at AultmanGolden HourOur 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.
20124Dr. Benjamine PlanerHackensack University Medical CenterStandardizing practice guidelines improves outcomes in neonates less than 30 weeksImplementation 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.
20125Dr. Madeline KeyesMassachusetts General Hospital for ChildrenDecreasing variation in the management of necrotizing enterocolitis in the MGHfC NICUNEC 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.
20126Mrs. Debra BenderSwedish Medical CenterOur Journey to Decreasing CLD in the Micropremie Population Subtitle: Optimizing Noninvasive Ventilation MethodsThis 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).
20127Ms. Valerie GarrisonSupporting 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.
20128Mrs. Marilyn HyndmanSunnybrook Health Sciences CentreNICU Essentials: Development of a standardized parent orientation to the NICUA 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.
20129Dr. Nina MendaMeriter HospitalFresh Beginnings; Partnering with FamiliesIn 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.
20130Mrs. April MorrisWoman's HospitalReduce CLD in the Micropreemie Population using Voume-targeted mode of VentilationOur 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.
20131Dr. Hellen KoUniversity of New Mexico Health Sciences CenterNeonatal Massive Transfusion ProtocolMy 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.
20132Mrs. Samantha HewittSanta Clara Valley Medical Center (SCVMC)Early recognition of abnormal aEEG tracingsEarly 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.
20133Dr. Kirsti MartinUMass Memorial HealthcareImplementation of Virtual Rounding to Increase Parental Presence on RoundsVisitor 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.
20134Mr. Joseph MongielloHackensack University Medical CenterCOVID-19 Impacts on NICU FamiliesWe will be presenting about a NICU family and their struggles with parenting and getting by during this period of COVID-19
20135Dr. Colby Day RichardsonWolfson Children's HospitalReduction in adverse patient safety events with implementation of bedside shift report guidelinesIn 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.
20136Dr. Colby Day RichardsonWolfson Children's HospitalReduction of severe IVH in neonates <32 weeks with implementation of IVH bundle in 1st 72 hours of lifeWe 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.
20137Dr. Rebecca MillerJacobi Medical CenterImproving Congenital Cytomegalovirus (cCMV) Screening for Newborns in an Urban Municipal HospitalcCMV 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.
20138Dr. Jordan ReisUniversity of Texas Southwestern Med. Ctr. Dallasa. A Quality Improvement Project to Decrease Necrotizing Enterocolitis by Increasing Administration of Breastmilka. 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.
20139Dr. Rita HazbounChildren's Hosp of Richmond at VCUTimely Antibiotics in the NICUThe 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%.
20140Ms. Laura BerrittoSanta Clara Valley Medical Center (SCVMC)Debriefing after NICU Admissions and Critical Incidents to Improve Patient Safety and Team PerformanceWe 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.
20141Dr. Joaquim PinheiroAlbany Medical CenterDecreasing the frequency of transfusion-associated necrotizing enterocolitis with implementation of restrictive feeding guidelinesBecause 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.
20142Dr. Melissa LestiniVirtua Hospital SystemsCreating a Small Baby Program Through Intensive Quality ImprovementCreation 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.
20143Mr. Benjamin OlshinRandall Children's Hospital at Legacy EmanuelInternational Multi-site Read-a-thon: Supporting Early Brain Development and Family Bonding in the Neonatal Intensive Care UnitThis 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.
20144Dr. Malathi BalasundaramEl Camino HospitalImplementation of reading program in a community Level 3 NICUNewborns 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.
20145Mrs. Latisha PicardSanta Clara Valley Medical Center (SCVMC)Establishing A NICU Milk Preparation RoomBreastmilk 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.
20146Dr. Maricarmen Burgos RiosUniversity Pediatric HospitalThe 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 HomeWe 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.
20147Dr. Khawaja WaheedThe Children's Hospital & the Institute of Child HealthImpact of intermittent kangaroo mother care on weight gain of neonate in NICU: randomized control trialPreterm 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.
20148Dr. lama CharafeddineKangaroo Care Practice during COVID 19 Pandemic in a Neonatal Intensive Care Unit of a Middle-Income CountryA 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.
20149Mr. Cagatay CelikColumbia University Medical CenterImproving Developmental Care in a Level IV NICUDevelopmentally 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.
20150Dr. Pradeep AlurUniversity of Mississippi Medical CenterImproving the Use of Length Boards in the NICU to Obtain Accurate Anthropometric MeasurementsMajority 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.
20151Dr. Heather DelaneyNorth Central Baptist HospitalDecreasing the Rate of Late-Onset Sepsis in the Neonatal ICUThe 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.
20152Dr. Heather DelaneyNorth Central Baptist HospitalPracticing Antibiotic Stewardship in the Development of an Institutional Chorioamnionitis AlgorithmHistorically, 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.
20153Dr. Kourtney BettingerUniversity of Kansas Hospital AuthorityOptimizing non-pharmacologic care for babies at risk oOpf neonatal abstinence syndrome in the newborn nurseryIn 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%.
20154Dr. Erin TkachBanner Thunderbird Medical CenterReduction in Severe IVH Rate with Implementation of a Small Baby ProtocolIn 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.
20155Dr. David SinkConnecticut Children's Medical CenterStriving to Improve Discharge Readiness in 2020Our 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.
20156Dr. Sarah PearceProvidence Portland Medical CenterImproving the NICU Experience Through Experience-Based Co-DesignWe 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.
20157Dr. Amit AgrawalBanner Thunderbird Medical CenterUtilizing Real-Time Data to Drive Quality in the NICUThe 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.
20158Mrs. Liz SimmonsSaint Joseph HospitalHow a Small Baby Team Impacts Outcomes for < 30 week InfantsTo 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.
20159Dr. Stephanie PrescottINOVA Children's HospitalReducing Central Line Associated Complications: The Quest for Zero in a Level IV NICUThough 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.
20160Mrs. Margaret BehmAdvocate Children's Hospital - Park RidgeImproving Transitions in NICU Patient CareNICU 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.
20161Dr. Erica WymoreChildren's Hospital ColoradoBreastfeeding 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.
20162Dr. Vicky ReichmanLenox Hill HospitalStop it!: A Quality Improvement Project to Reduce Antibiotic Utilization in the Neonatal Intensive Care UnitOur 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.
20163Dr. Delisha PatelBillings ClinicOccupational Therapy Implementation of the SENSE Program in the Billings Clinic NICU and its Effects on Caregiver Satisfaction of Infant CareThe 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.
20164Ms. Flor TenaNicklaus Children's HospitalReduction of Unplanned Hypothermia During Perioperative PeriodThe 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
20165Dr. Erica WymoreChildren's Hospital ColoradoBest 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.
20166Mrs. Amanda CarterWesley Medical CenterThe Power of a Mother's VoiceI 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.
20167Dr. luigi gagliardiUTIN Ospedale VersiliaVariation 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.
20168Dr. Tasha ColemanChildren's Hospital at U. of MS Health CareImproving Pain Control during Bedside Procedures in the NICUInadequate 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.
20169Dr. Emily WhiteselBeth Israel Deaconess Medical CenterWelcome to the NICUIn 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.
20170Dr. Brian ScottolineOregon Health and Science UniversityInitial Experience With a New Method of Umbilical Catheter SecurementWe 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.
20171Ms. Daniela Lopez-VallejoUniversity Pediatric HospitalDECREASING 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.
20172Mrs. Serena KnoopHelen DeVos Children's HospitalOutcomes after implementing restrictive blood transfusion criteria in extremely premature infantsThe 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.
20173Dr. Nilesh DankharaChildren's Hospital at U. of MS Health CareImplementing 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.
20174Dr. Sangeeta MallikSanta Clara Valley Medical Center (SCVMC)Adaptation of a NICU Family Centered Care program during COVID pandemicThis 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.
20175Mrs. Tammy LambertDartmouth Hitchcock Medical CenterFamily Integrated GrowthInfants 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.
20176Dr. Katharine JohnsonMethodist Children's HospitalPrecious Time Out: A Quality Improvement Tool to Improve Critical Transitions of Care in the NICUIn 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.
20177Mr. Alex ZavalaDell Children's Medical Center of Central TexasFamily Partner/ The NICU DadIntroduction of myself and the work we are doing for NICU Dad support.
20178Ms. Flor TenaNicklaus Children's HospitalTelehealth Nursing Intervention to Improve Transition to HomeThe 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.
20179Mrs. Marybeth FryAkron Children's HospitalImpact to NICU Families During the COVID-19 CrisisIn 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.
20180Mrs. Marybeth FryAkron Children's HospitalImpact to NICU Families During the COVID-19 CrisisIn 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.
20181Ms. Sarah LeeColumbia University Medical CenterDevelopment of the Virtual NICU Program during the COVID-19 PandemicDue 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.
20182Ms. Missy AdriazolaColumbia University Medical CenterFamily Poster - Mighty MorganMighty 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.
20183Ms. Joanna CelenzaDartmouth Hitchcock Medical CenterPain Awareness CampaignSeptember 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.
20184Dr. Lorraine BautistaUniversity of Texas Southwestern Med. Ctr. DallasTreatment of Infants with Neonatal Abstinence Syndrome at Risk for Longer Length of TreatmentWe 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.
20185Dr. Sue TownsendMemorial HospitalShifting the Care Paradigm for Opioid Exposed Newborns in Southern ColoradoFor 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.
20186Ms. Brenda MillerExpanding Family Partner Involvement on the NICU Team Post-CovidFamily 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.
20187Mrs. Amie SlaughterUniversity of Kansas Hospital AuthorityGive Them Wings: An Evidence Based Approach to Minimizing Neonatal Lung InjuryOur 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.
20188Dr. Alison LaBadieHoly Redeemer Hospital and Medical CenterMaintaining Euthermia During the Golden Hour : A QI Project for Infants <1500g or 32 weeksAs 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.
20190Dr. Maria Pane PaneGreater Baltimore Medical CenterImproving Discharge Process for babies and families in a community hospitalWe 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.
20191Ms. Valerie GarrisonCPQCCLabor & Delivery Universal Screening Protocols for Substance Use Disorder: Lessons Learned through Pilot Implementation of the AIM Obstetric Care for Women with Opioid Use Disorder BundleOpioid 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.
20192Dr. Justin JosephsenAnn & Robert H. Lurie Children's HospitalILPQC statewide quality improvement strategies to optimize care for opioid exposed newborns: 2 years of lessons learnedILPQC 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.
20193Dr. morris cohenChildren's Hospital of New Jersey at NBIMCAntibiotic Stewardship's Success over 3 YearsOur 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
20194Dr. Annmarie GoliotoConnecticut Children's Medical CenterA Quality Improvement Initiative to Decrease Delivery Room Intubation in VLBW NeonatesOur 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.
20195Mrs. Jessica WolffCarle Foundation HospitalLily's Little LungsOur 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.
20196Dr. Meg KirkleyDenver Health Medical CenterTransition from Continuous Pulse Oximetry in Infants Near DischargeTo 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%.
20197Dr. Jennifer TwissMcMaster Children's Hospital Neonatal NurseriesImproving use of two person cares for micropremature infantsThis 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.
20198Mrs. Rena RosenthalSunnybrook Health Sciences CentreEnhancing Communication among Neonatal Intensive Care Units (NICU) in OntarioCommunication 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.
20199Dr. Esther RaiMcMaster Children's Hospital Neonatal NurseriesCrushing the Game of Germs in the NICUA 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.
20200Dr. Leslie RuybalSt. Vincent HospitalTransition to Home with Nasogastric Tube Feedings in a Rural Healthcare SettingFeeding 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.
20201Dr. Leslie RuybalSt. Vincent HospitalImproving Communication through Implementation of a NICU to OR Handoff ReportEffective 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.
20202Dr. Kamlesh AthavaleDuke UniversityAre 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.
20203Mrs. Margaret BehmAdvocate Children's Hospital - Park RidgeSustainability 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.
20204Mrs. Joy HilliardTufts Medical CenterNeonatal Intensive Care Unit Emergency EvacuationAfter 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.
20205Mrs. Jessica PelletierSparrow HospitalImproving Discharge TimesIn 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.
20206Mrs. Sharla CrowleyVermont Oxford Network CenterVON's ELBW Follow-Up Project OverviewThe 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.
20207Dr. Amit MukerjiMcMaster Children's Hospital Neonatal NurseriesPRACTICE VARIABILITY REDUCTION TO REDUCE BPD [PRVENT-BPD]: A LONGITUDINAL QUALITY IMPROVEMENT PROJECTBronchopulmonary 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.
20208Dr. Alison RentzSt. Vincent Hospital & Health CenterImproving NICU Parents Readiness for DischargeOn 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.
20209Mrs. Kelley SmithRegional One HealthSmall Babies, Big OutcomesWe 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.
20210Mrs. Ashley WelscherChildren's Memorial Hermann HospitalNICU Lactation Education for Hospitalized Antepartum PatientsWe 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.
20211Mrs. Emma SanchezChildren's Memorial Hermann HospitalTicket to RideTicket 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.
20212Dr. Shikha Gupta-BhatnagarMcMaster Children's Hospital Neonatal NurseriesAntibiotic stewardship and optimization of antibiotic use at McMaster NICUThis 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.
20213Dr. Shikha Gupta-BhatnagarMcMaster Children's Hospital Neonatal NurseriesCrushing the Game of Germs at McMaster NICUThis 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.
20214Dr. Shikha Gupta-BhatnagarMcMaster Children's Hospital Neonatal Nurserieso 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.
20215Mrs. Rebekah WilkinsonChildren's Memorial Hermann HospitalChart Review and the Nursing Report Card - Bringing the Data Back to Bedside StaffWe 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.
20216Dr. Sangeeta BhatiaWestern Pennsylvania HospitalSepsis risk identification decreased the use of antibiotics in infants with maternal diagnosis of ChorioamninitisWe 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.
20217Mrs. Cheryl LairUniversity of Texas Southwestern Med. Ctr. DallasReducing Hypophosphatemia in Preterm InfantsA 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.
20218Ms. Amy AtwaterHelen DeVos Children's HospitalCatheter Realated Blood Stream Infections: Key Processes that Impact CLABSI RatesCatheter 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.
20219Mrs. Nikki WigginsOregon Health and Science UniversityFall Into ReadingNICU 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.
20220Mrs. Nikki WigginsOregon Health and Science UniversityIncluding Families in the First Oral FeedingA 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.
20221Dr. Stefanie RogersProvidence St. Vincent Medical CenterImproving Healthy Survival in Infants <28 weeksThrough 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.
20222Mrs. Lelis Vernon Transforming Family Partnerships in times of CovidThe 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