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Neonatology pp 251-263 | Cite as

Quality of Neonatal Intensive Care and Outcome for High-Risk Newborn Infants

  • Liz McKechnie
  • Kathryn Johnson
Reference work entry

Abstract

It is generally accepted that neonatal outcome is related to the quality of care an infant receives, and therefore it should be closely monitored in order to improve outcome. Quality in neonatal care is a complex subject, but improving quality is a goal to which all neonatologists should aspire. Ongoing quality assessment needs to be implemented in order to improve care such as audit, benchmarking, and confidential enquiries, which are discussed below. Traditional measures of outcome such as death, neurodevelopmental status, and chronic lung disease are also discussed in detail later in this chapter. Improving quality of care can additionally be achieved by implementing modern, effective, evidence-based methods of knowledge translation in order to increase the use of evidence-based healthcare.

References

  1. Acolet D (2008) Quality of neonatal care and outcome. Arch Dis Child Fetal Neonatal Ed 93:F69–F73CrossRefGoogle Scholar
  2. Acolet D, Allen E, Houston R, Elbourne D (2008) The Bliss Cluster randomised controlled trial of the effect of “active dissemination of information” on the standards of care for premature babies in England (BEADI). Perinatal Medicine Meeting, Harrogate, UK, June 2008Google Scholar
  3. Alexander GR, Kogan M, Bader D et al (2003) US birth weight/gestational age-specific neonatal mortality: 1995–1997 rates for whites, hispanics and blacks. Pediatrics 111:e61–e66CrossRefGoogle Scholar
  4. Ananth C, Vintzileos A (2008) Epidemiology of preterm birth and its clinical subtypes. J Matern Fetal Neonatal Med 21:289–295CrossRefGoogle Scholar
  5. Ancel PY, Goffinet F, Kuhn P et al (2015) Survival and morbidity of preterm children born at 22 weeks through 34 weeks’ gestation in France in 2011: results of the EPIPAGE-2 cohort study. JAMA Pediatr Mar 169(3):230–238CrossRefGoogle Scholar
  6. Baker CD, Lorimer AR (2000) Cardiology: the development of a managed clinical network. BMJ 321:1152–1153CrossRefGoogle Scholar
  7. Bassler D, Stoll BJ, Schmidt B et al (2009) Using a count of neonatal morbidities to predict poor outcome in extremely low birth weight infants: added role of neonatal infection. Pediatrics 123(1):313–318.  https://doi.org/10.1542/peds.2008-0377CrossRefPubMedPubMedCentralGoogle Scholar
  8. Batalden PB, Davidoff F (2007) What is “quality improvement” and how can it transform healthcare? Qual Saf Health Care 16:2–3CrossRefGoogle Scholar
  9. Beck S, Wojdyla D, Say L et al (2010) The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bulletin of the World Health Organization 88:31–38CrossRefGoogle Scholar
  10. Berger TM, Steurer MA, Woerner A et al (2012) Trends and centre-to-centre variability in survival rates of very preterm infants (<32 weeks) over a 10-year-period in Switzerland. Arch Dis Child Fetal Neonatal Ed 97(5):F323–F328CrossRefGoogle Scholar
  11. Berrington JE, Hearn RI, Bythell M et al (2012) Deaths in preterm infants: changing pathology over 2 decades. J Pediatr 160(1):49–53CrossRefGoogle Scholar
  12. Blencowe H, Cousens S, Oestergaard MZ et al (2012) National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 379(9832):2162–2172CrossRefGoogle Scholar
  13. Boyle EM, Johnson S, Manketlow B et al (2015) Neonatal outcomes and delivery of care for infants born late preterm or moderately preterm: a prospective population-based study. Arch Dis Child Fetal Neonatal Ed 100(6):F479–F485CrossRefGoogle Scholar
  14. Branum AM, Schoendorf KC (2002) Changing patterns of low birthweight and preterm birth in the United States, 1981–98. Paediatr Perinat Epidemiol 16:8–15CrossRefGoogle Scholar
  15. Chang HH, Larson J, Blencowe H et al (2013) Preventing preterm births: analysis of trends and potential reductions with interventions in 39 countries with very high human development index. Lancet 381(9862):223–234CrossRefGoogle Scholar
  16. Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) (2003) Project 27/28. An enquiry into quality of care and its effect on the survival of babies born at 27–28 weeks. The Stationary Office, LondonGoogle Scholar
  17. Costeloe K, Hennessy E, Gibson A et al (2000) The EPICure study: outcomes to discharge from hospital for infants born at the threshold of viability. Pediatrics 106:659–671CrossRefGoogle Scholar
  18. Costeloe LK, Hennessy EM, Haider S et al (2012) Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies). BMJ 345, e7976CrossRefGoogle Scholar
  19. Costeloe K, Hardy P, Juszczak E et al (2016) Bifidobacterium breve BBG-001 in very preterm infants: a randomised controlled phase 3 trial. Lancet 387(10019):649–660CrossRefGoogle Scholar
  20. Craig ED, Thompson JMD, Mitchell EA et al (2002) Socioeconomic status and preterm birth: New Zealand trends, 1980 to 1999. Arch Dis Child Fetal Neonatal Ed 86:F142–F146CrossRefGoogle Scholar
  21. Cropper S, Hopper A, Spencer SA, Dodd K (2002) Managed clinical networks. Arch Dis Child 87:1–4CrossRefGoogle Scholar
  22. Dargaville PA, Aiyappan A, Cornelius A (2011) Preliminary evaluation of a new technique of minimally invasive surfactant therapy. Arch Dis Child Fetal Neonatal Ed 96:F243–F248CrossRefGoogle Scholar
  23. de Kleine MJ, Lya den Ouden AL, Kollée LA et al (2007) Lower mortality but higher neonatal morbidity over a decade in very preterm infants. Paediatr Perinat Epidemiol 21:15–25CrossRefGoogle Scholar
  24. Demissie K, Rhoads GG, Ananth CV et al (2001) Trends in preterm birth and neonatal mortality among blacks and whites in the United States from 1989 to 1997. Am J Epidemiol 154:307–315CrossRefGoogle Scholar
  25. Draper ES, Zeitlin J, Field DJ et al (2007) Mortality patterns among very preterm babies: a comparative analysis of two European regions in France and England. Arch Dis Child Fetal Neonatal Ed 92:356–360CrossRefGoogle Scholar
  26. El-Metwally D, Vohr B, Tucker R (2000) Survival and neonatal morbidity at the limits of viability in the mid 1990s: 22 to 25 weeks. J Pediatr 137:616–622CrossRefGoogle Scholar
  27. Fanaroff AA, Stoll BJ, Wright LL et al (2007) Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol 196:147.e1–e8CrossRefGoogle Scholar
  28. Field D, Hyman-Taylor P, Bacon C, Draper ES on behalf of MBRRACE-UK (2014) Perinatal confidential enquiry – congenital diaphragmatic hernia. The Infant Mortality and Morbidity Group, Department of Health Sciences, University of Leicester, LeicesterGoogle Scholar
  29. Garg P, Abdel-Latif ME, Bolisetty S et al (2010) Perinatal characteristics and outcome of preterm singleton, twin and triplet infants in NSW and the ACT, Australia (1994–2005). Arch Dis Child Fetal Neonatal Ed 95(1):F20–F24CrossRefGoogle Scholar
  30. Genzel-Boroviczeny O, Macwilliams S, Von Poblotzki M et al (2006) Mortality and major morbidity in premature infants less than 31 weeks gestational age in the decade after introduction of surfactant. Acta Obstet Gynecol Scand 85:68–73CrossRefGoogle Scholar
  31. Hack M, Fanaroff AA (2005) Outcomes of children of extremely low birthweight and gestational age in the 1990s. Semin Neonatol 5:89–106CrossRefGoogle Scholar
  32. Hakansson S, Farooqi A, Holmgren PA et al (2004) Proactive management promotes outcome in extremely preterm infants: a population based comparison of two perinatal management strategies. Pediatrics 114:58–64CrossRefGoogle Scholar
  33. Hintz SR, Slovis T, Bulas D et al (2007) Interobserver reliability and accuracy of cranial ultrasound scanning interpretation in premature infants. J Pediatr 150:592–596CrossRefGoogle Scholar
  34. Horbar JD (1995) The Vermont-Oxford Neonatal Network: integrating research and clinical practice to improve the quality of medical care. Semin Perinatol 19:124–131CrossRefGoogle Scholar
  35. Horbar JD (1999) The Vermont Oxford Network: evidence-based quality improvement for neonatology. Pediatrics 103:350–359PubMedGoogle Scholar
  36. Horbar JD, Badger GJ, Carpenter JH (2002) Trends in mortality and morbidity for very low birth weight infants, 1991–1999. Pediatrics 110:143–150CrossRefGoogle Scholar
  37. Horbar JD, Carpenter JH, Buzas J et al (2004) Collaborative quality improvement to promote evidence based-surfactant for preterm infants: a cluster randomised trial. BMJ 329:1004CrossRefGoogle Scholar
  38. Hoyert DL, Freedman MA, Strobino DM et al (2001) Annual summary of vital statistics: 2000. Pediatrics 108:1241–1255CrossRefGoogle Scholar
  39. Institute of Medicine (2001) Crossing the quality chasm: a new health system for the 21st century. National Academy Press, Washington DCGoogle Scholar
  40. Institute of Medicine (IOM) (2001) Crossing the quality chasm: a new health system for the 21st century. National Academy Press, Washington, DCGoogle Scholar
  41. Jarjour IT (2015) Neurodevelopmental outcome after extreme prematurity: a review of the literature. Pediatr Neurol 52(2):143–152CrossRefGoogle Scholar
  42. Jobe AH (2011) The new bronchopulmonary dysplasia. Curr Opin Pediatr 23(2):167–172CrossRefGoogle Scholar
  43. Jobe AH, Bancalari E (2001) Bronchopulmonary dysplasia. Am J Respir Crit Care Med 163:1723–1729CrossRefGoogle Scholar
  44. Johnson S, Marlow N (2011) Preterm birth and childhood psychiatric disorders. Pediatr Res 69:11R–18RCrossRefGoogle Scholar
  45. Johnson S, Hennessy E, Smith R et al (2009) Academic attainment and special educational needs in extremely preterm children at 11 years of age: the EPICure study. Arch Dis Child Fetal Neonatal Ed 94(4):F283–F289CrossRefGoogle Scholar
  46. Kribs A, Roll C, Göpel W (2015) Nonintubated surfactant application vs conventional therapy in extremely preterm infants: a randomized clinical trial. JAMA Pediatr 169(8):723–730CrossRefGoogle Scholar
  47. Linder N, Haskin O, Levit O et al (2003) Risk factors for intraventricular haemorrhage in very low birth weight premature infants: a retrospective case control study. Pediatrics 111:e590–e595CrossRefGoogle Scholar
  48. Mainz J (2003) Developing evidence-based clinical indicators: a state of the art methods primer. Int J Qual Health Care 15(1):i5–i11CrossRefGoogle Scholar
  49. Markestad T, Kaaresen PI, Ronnestad A et al (2005) Early death, morbidity and need of treatment among extremely premature infants. Pediatrics 115:1289–1298CrossRefGoogle Scholar
  50. Marlow N, Gill AB (2007) Establishing neonatal networks: the reality. Arch Dis Child Fetal Neonatal Ed 92:F137–F142CrossRefGoogle Scholar
  51. McIntosh N, Youle L (2008) National Neonatal Audit Project annual report. Royal College of Paediatrics and Child HealthGoogle Scholar
  52. Moore T, Hennessy EM, Myles J (2012) Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies. BMJ 345, e7961CrossRefGoogle Scholar
  53. Morley CJ, Davis PG, Doyle L et al (2008) Nasal CPAP or intubation at birth for very preterm infants. NEJM 358:700–708CrossRefGoogle Scholar
  54. Nguyen TP, Amon E, Al-Hosni M et al (2012) “Early” versus “late” 23-week infant outcomes. Am J Obstet Gynecol 207(3):226.e1–6CrossRefGoogle Scholar
  55. Peerzada JM, Schollin J, Hakansson S (2006) Delivery room decision making for extremely preterm infants in Sweden. Pediatrics 117:1988–1995CrossRefGoogle Scholar
  56. Petrou S, Johnson S, Wolke D et al (2013) The association between neurodevelopmental disability and economic outcomes during mid-childhood. Child Care Health Dev 39(3):345–347CrossRefGoogle Scholar
  57. Productive Time Delivery Board and NHS Benchmarking Club (2006) Delivering quality and value: focus on benchmarking. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4139062
  58. Provonost P, Needham D et al (2006) An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 355:2725–2732CrossRefGoogle Scholar
  59. Richardus JH, Graafmans WC, Verloove-Vanhorick SP, Mackenbach JP (2003) Differences in perinatal mortality and suboptimal care between 10 European regions: results of an international audit. BJOG 110:97–105CrossRefGoogle Scholar
  60. Roberts D, Dalziel SR (2006) Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 3, CD004454Google Scholar
  61. Rysavy MA, Li L, Bell EF et al (2015) Between-hospital variation in treatment and outcomes in extremely preterm infants. N Engl J Med 372(19):1801–1811CrossRefGoogle Scholar
  62. Schmidt B, Asztalos EV, Roberts RS et al (2003) Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months. JAMA 289:1124–1129CrossRefGoogle Scholar
  63. Slattery M, Morrison J (2002) Preterm delivery. Lancet 360:1489–1497CrossRefGoogle Scholar
  64. Smith LK, Draper ES, Manktelow BN et al (2007) Socioeconomic inequalities in very preterm birth rates. Arch Dis Child Fetal Neonatal Ed 92:F11–F14CrossRefGoogle Scholar
  65. Stevens TP, Harrington EW, Blennow M et al (2007) Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome. Cochrane Database Syst Rev 4, CD003063Google Scholar
  66. Stevens TP, Finer NN, Carlo WA et al (2014) Respiratory outcomes of the surfactant positive pressure and oximetry randomized trial (SUPPORT). J Pediatr 165(2):240–249CrossRefGoogle Scholar
  67. Stoelhurst GM, Rijken M, Martens SE et al (2005) Changes in neonatology: Comparison of two cohorts of very preterm infants (gestational age <32 weeks): the project on preterm and small for gestational age infants 1983 and the Leiden follow up project on prematurity 1996–1997. Pediatrics 115:396–404CrossRefGoogle Scholar
  68. Stoll BJ, Hansen NI, Bell EF et al (2010) Neonatal outcomes of extremely preterm infants from the NICHD neonatal research network. Pediatrics 126(3):443–456CrossRefGoogle Scholar
  69. Sweet DG, Carnielli V, Greisen G et al (2013) European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants – 2013 update. Neonatology 103:353–368CrossRefGoogle Scholar
  70. Taylor HG, Klein N, Minich NM et al (2000) Middle-school-age outcomes in children with very low birthweight. Child Dev 71:1495–1511CrossRefGoogle Scholar
  71. The Victorian Infant Collaborative Study Group (1997) Outcome at 2 years of children 23–27 weeks’ gestation born in Victoria in 1991–2. J Pediatr Child Health 33:161–165CrossRefGoogle Scholar
  72. Topp M, Huusom LD, Langhoff-Roos J et al (2004) Multiple birth and cerebral palsy in Europe: a multicenter study. Acta Obstet Gynecol Scand 83(6):548–553CrossRefGoogle Scholar
  73. Wolke D, Strauss VY, Johnson S et al (2015) Universal gestational age effects on cognitive and basic mathematic processing: 2 cohorts in 2 countries. Pediatrics 166(6):1410–1416CrossRefGoogle Scholar
  74. Wood NS, Costeloe K, Gibson AT et al (2005) The EPICure study: associations and antecedents of neurological and developmental disability at 30 months of age following extremely preterm birth. Arch Dis Child Fetal Neonatal Ed 90:F134–F140CrossRefGoogle Scholar
  75. Yeo KT, Lee QY, Quek WS et al (2015) Trends in morbidity and mortality of extremely preterm multiple gestation newborns. Pediatrics 136(2):263–271CrossRefGoogle Scholar
  76. Zeitlin J, Draper ES, Kollee L et al (2008) Differences in rates and short-term outcome of live births before 32 weeks of gestation in Europe in 2003: results from the MOSAIC cohort. Pediatrics 121:e936–e944CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre for Newborn CareLeeds Teaching Hospitals TrustLeedsUK

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