June 26, 2017

New standardized clinical practices reduce premature infant morbidity and mortality in first week of life

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clinical practice awardsFrom left: Kimberly Nichols, Vivek Lal, M.D., Donna Purvis, Anthony PattersonThe University of Alabama at Birmingham Regional Neonatal Intensive Care Unit created the Golden Week program to improve outcomes for infants born prematurely at 28 weeks’ gestation or earlier. The program has resulted in a 30 percent relative risk reduction in infant mortality or severe intraventricular hemorrhage within the first week of life.

“Our goal is to provide the best care for each of our patients,” said Vivek Lal, M.D., assistant professor in the University of Alabama Division of Neonatology and director of the Golden Week program. “Through the Golden Week program, we have standardized care that infants receive during their first week of life, ultimately improving their survival rates. The program provides guidance for physicians and nurses on clinical and nonclinical aspects of caring for an extremely preterm newborn.”

The Golden Week core committee at UAB developed a standardized set of orders to establish consistency among care for premature infants born at 28 weeks’ gestation or less. The program includes clinical guidance on respiratory support, thermoregulation, nutrition and fluid management, infection prevention, and neurological status. Standardized orders were set for nonclinical practices, including parent support and satisfaction, as well as staff and team building.

Recently, UAB’s Golden Week program was recognized by the Gage Awards for Innovation and Excellence, which honors the outstanding work of members of America’s Essential Hospitals. The strategic priorities of America’s Essential Hospitals include identifying and disseminating evidence-based best practices that enhance the quality of care for all — especially vulnerable people.

“Recognition from the Gage Awards solidifies the work that we are doing with the Golden Week program,” Lal said. “We hope practitioners across the nation recognize that the caregiving during the first week of a preemie’s life is crucial.”

Over a 50-day span, physicians and nurses participated in phased educational programs with monthly follow-up classes to continue training on the Golden Week program and its protocols to follow while caring for preterm infants in the UAB RNICU.

“Knowing and following these guidelines decrease morbidity rates in preterm infants and could ultimately save a young life,” Lal said.

The Golden Week core committee is composed of a multidisciplinary staff, who meet monthly to discuss staff feedback, review data and make needed improvements. The UAB RNICU and core committee are currently looking at short-term and long-term outcomes of the program in relation to an infant’s health in order to continue the advancement of care for preterm infants.