Evaluation and development of potentially better practices for the prevention of brain hemorrhage and ischemic brain injury in very low birth weight infants.
OBJECTIVE
Neonatal care providers from 5 institutions formed a multidisciplinary focus group with the purpose of identifying potentially better practices, the implementation of which would lead to a reduction in the incidence of intracranial hemorrhage and periventricular leukomalacia in very low birth weight infants.


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


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


CONCLUSIONS
Implementation of these practices will improve clinical outcomes as well as the reliability of sonogram interpretation, the basis for evaluating the quality of the team's work.
Carteaux
Patricia
P
Parkview Hospital, Fort Wayne, Indiana, USA.
Cohen
Howard
H
Check
Jennifer
J
George
Jeffrey
J
McKinley
Pamela
P
Lewis
William
W
Hegwood
Patricia
P
Whitfield
Jonathan M
JM
McLendon
Debra
D
Okuno-Jones
Susan
S
Klein
Sharon
S
Moehring
Jim
J
McConnell
Connie
C
D019985:Benchmarking; D002545:Brain Ischemia / Q000517:prevention & control*; D003299:Cooperative Behavior; D004453:Echoencephalography / Q000592:standards*; D019317:Evidence-Based Medicine; D017144:Focus Groups; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration* / Q000592:standards; D015931:Intensive Care, Neonatal / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D020300:Intracranial Hemorrhages / Q000517:prevention & control*; D009936:Organizational Innovation; D009937:Organizational Objectives; D010348:Patient Care Team / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000379:methods; D014481:United States