Implementation of a multidisciplinary guideline-driven approach to the care of the extremely premature infant improved hospital outcomes.
OBJECTIVE
To test the hypothesis that implementing guidelines for the standardized care of the extremely premature infant (<27 weeks) in the first week of life would improve patient outcomes in an all referral NICU.


METHODS
Data were collected on all infants <27 weeks gestational age and <7 days of age on admission cared for using these small baby guidelines (SBG), as well as on all age-matched infants admitted the year prior (comparison).


RESULTS
Thirty-seven patients were cared for utilizing the SBG and 40 patients were in the comparison group. There were no differences between the groups in gestational age, birthweight or age on admission. There was no difference in survival to discharge (73% SBG, 70% comparison). The mean length of stay for survivors was 112 +/- 38 days SBG and 145 +/- 76 days (p < 0.05) comparison group. Survival without BPD was greater in the SBG group (24%) than in the comparison group (9%; p < 0.05), and survival without severe IVH was greater in the SBG group (65%) than in the comparison group (38%; p < 0.01).


CONCLUSIONS
These data demonstrate that applying a unified approach to the care of the extremely premature infant in the first week of life resulted in a decrease in the length of hospitalization and improved patient outcomes.
Nankervis
C A
CA
Department of Pediatrics, Ohio State University, Columbus, OH, USA.
Martin
E M
EM
Crane
M L
ML
Samson
K S
KS
Welty
S E
SE
Nelin
L D
LD
D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000628:therapy*; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D015931:Intensive Care, Neonatal / Q000592:standards*; D007902:Length of Stay / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D016019:Survival Analysis; D016896:Treatment Outcome