Survey of preterm neuro-centric care practices in California neonatal intensive care units

J Perinatol. 2019 Feb;39(2):256-262. doi: 10.1038/s41372-018-0283-8. Epub 2018 Dec 5.

Abstract

Objective: Examine the adoption and presence of preterm, neuro-centric care practices across neonatal intensive care units (NICUs).

Study design: Statewide, cross-sectional survey of California NICUs. Data were collected surrounding the timing of adoption and presence of delivery room practices, nursing protocols, provider management practices and quality improvement initiatives.

Result: Among the 95 NICUs completing the survey (65%), adoption of all surveyed practices increased between 2005 and 2016, though rates of uptake changed over time and varied by practice. Adoption of indomethacin prophylaxis increased 1.8-fold, whereas delayed cord clamping increased 78-fold. Adoption of premedication for intubation and a patent ductus arteriosus management algorithm differed by unit level. Additionally, two underlying practice domains were identified; adoption of delivery room practices and adoption of any preterm practice.

Conclusion: Adoption of preterm, neuro-centric care practices across California NICUs has increased, though uptake patterns vary by practice and level.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • California
  • Cross-Sectional Studies
  • Ductus Arteriosus, Patent / therapy
  • Humans
  • Indomethacin / therapeutic use
  • Infant, Newborn
  • Infant, Premature*
  • Intensive Care Units, Neonatal / organization & administration*
  • Neurologic Examination / statistics & numerical data*
  • Outcome Assessment, Health Care / standards*
  • Surveys and Questionnaires

Substances

  • Indomethacin