Am J Perinatol 2018; 35(S 01): S1-S26
DOI: 10.1055/s-0038-1646969
Abstracts
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Efficacy of a Safety Bundle in the Prevention of Severe Intraventricular Hemorrhages in Preterm Infants  < 34 Weeks’ GA—A Single-Center Experience

V. Pokhylko
1   Department of Pediatrics #1 with Propedeutics and Neonatology, Ukrainian Medical Stomatological Academy, Poltava, Ukraine
,
O. Kovalova
1   Department of Pediatrics #1 with Propedeutics and Neonatology, Ukrainian Medical Stomatological Academy, Poltava, Ukraine
,
T. Znamenska
2   Department of Neonatology, Institute of Pediatrics, Obstetrics and Gynecology of NAMS Ukraine, Kyiv, Ukraine
,
D. Dobryanskyy
3   Department of Pediatrics #2, Lviv National Medical University, Lviv, Ukraine
,
N. Artiomova
1   Department of Pediatrics #1 with Propedeutics and Neonatology, Ukrainian Medical Stomatological Academy, Poltava, Ukraine
,
A. Bielorus
4   NICU, Poltava Regional Perinatal Center, Poltava, Ukraine
› Author Affiliations
Further Information

Publication History

Publication Date:
27 April 2018 (online)

Also available ateRefHebammen
 

Introduction: Severe intraventricular hemorrhages (IVH) in premature infants are an important pediatric public health problem, as these conditions are one of the main causes of mortality and cognitive developmental disorders in extremely premature infants. The goal of this study was to analyze the impact of a newly designed Safety Bundle on reducing the development of severe IVH and their effects in extremely premature newborns.

Materials and Methods: A pre-/postinterventional study was conducted on the efficiency of a Safety Bundle application in prematurely born children in the Poltava Regional Perinatal Center (referral center with around 2,000 births per year) during the years 2014 to 2016. The Safety Bundle included: an interdisciplinary communication checklist (between an obstetrician–gynecologist and a neonatologist), an algorithm for determining which infants were at high risk for the development of IVH, a checklist for monitoring the child’s condition immediately after birth, and a cross-professional checklist (between a physician and a medical nurse) regarding the details of surveillance and care of children belonging to the high-risk group. The primary end points of the study were the incidence of IVH, the survival of premature infants, and their disability rate.

Results: Infants enrolled had a mean weight of 1,037.8 g ± 4.3, and a mean gestational age of 27.1 weeks ± 0.272. After the implementation of the Safety Bundle in the daily practice of the perinatal center, the survival of preterm infants  < 1,000 g increased from 50% in 2014 to 81.2% in 2017 (p = 0.034), the incidence of IVH decreased from 18.9 to 11.4% (p = 0.038), and the rate of disability decreased from 9.6 to 2.4% in 2016 (p = 0.046).

Conclusion: The Safety Bundle that we designed and tested proved to be an effective tool for preventing the development of IVH and their adverse effects in our center. Generalizability of this practice should be assessed in future studies.

Keywords: safety bundle, premature infants, intraventricular hemorrhages, checklist