title: The impact of a regional care bundle on maternal breast milk use in preterm infants: outcomes of the East of England quality improvement programme.
abstract: OBJECTIVE
  To evaluate a quality improvement (QI) programme to increase the use of maternal breast milk (MBM) in preterm infants.
  
  
  METHODS
  Interrupted time series analysis.
  
  
  METHODS
  17 neonatal units in the East of England (EoE) Perinatal Network; 144 in the rest of the UK Neonatal Collaborative (UKNC).
  
  
  METHODS
  Infants born ≤32(+6) weeks gestation admitted to neonatal care between 2009 and 2012.
  
  
  METHODS
  A 'care bundle' to promote MBM in the EoE.
  
  
  RESULTS
  Percentage of infants receiving exclusive or any MBM at discharge and care days where any MBM was received.
  
  
  METHODS
  Data were extracted from the National Neonatal Research Database; outcomes were compared preintervention and postintervention, and in relation to the rest of the UKNC.
  
  
  RESULTS
  Exclusive and any MBM use at discharge increased from 26% to 33% and 50% to 57% respectively in the EoE, though there was no evidence of a step or trend change following the introduction of the care bundle. Exclusive MBM use at discharge improved significantly faster in EoE than the rest of the UKNC; 0.22% (95% CI 0.11 to 0.34) increase per month versus 0.05% (95% CI 0.01 to 0.09, p=0.007 for difference). The percentage of infants receiving MBM at discharge and care days where any MBM was received was not significantly different between EoE and the rest of the UKNC.
  
  
  CONCLUSIONS
  This QI programme was associated with some improvement in MBM use in preterm infants that would not have been evident without the use of routinely recorded national comparator data.
authors.affiliation: Neonatal Data Analysis Unit, Imperial College, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Battersby
authors.affiliation: Neonatal Data Analysis Unit, Imperial College, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Santhakumaran
authors.affiliation: East of England Operational Delivery Network, UK.
authors.forename: M
authors.initials: M
authors.lastname: Upton
authors.affiliation: East of England Operational Delivery Network, UK.
authors.forename: L
authors.initials: L
authors.lastname: Radbone
authors.affiliation: Luton and Dunstable University Hospital, UK.
authors.forename: J
authors.initials: J
authors.lastname: Birch
authors.affiliation: Neonatal Data Analysis Unit, Imperial College, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Modi
mesh_terms: D001724:Birth Weight; D004739:England; D005260:Female; D005865:Gestational Age; D006801:Humans; D007224:Infant Care / Q000379:methods* / Q000592:standards; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D065186:Interrupted Time Series Analysis; D008297:Male; D008895:Milk, Human; D017063:Outcome Assessment, Health Care / Q000379:methods; D064872:Patient Care Bundles; D010351:Patient Discharge; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration*; D006113:United Kingdom
keywords: Nutrition; breast milk; care bundle; preterm; quality improvement