Maj Cory J Darrow1,2, Hong Li3, Allison Prince3,4, Jacquelyn McClary3,4, Michele C Walsh5,6. 1. Department of Pediatrics, Uniformed Services University of Health Sciences, Bethesda, MD, USA. 2. 18th Medical Operations Squadron Kadena AB, Okinawa, Japan. 3. Case Western Reserve University, Cleveland, OH, USA. 4. University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA. 5. Case Western Reserve University, Cleveland, OH, USA. Michele.Walsh@UHHospitals.org. 6. University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA. Michele.Walsh@UHHospitals.org.
Abstract
OBJECTIVE: Poor extrauterine growth in very low birth weight (VLBW) neonates is common and associated with worsened long-term outcomes. We aimed to decrease growth restriction, measured by the change in weight z-score from birth to 36 weeks post menstrual age, from - 1.13 (baseline) to < -1 within 12 months. STUDY DESIGN: The Model for Improvement was used in the design and implementation of an optimized, standardized parenteral nutrition protocol. Three Plan-Do-Study-Act cycles were completed and a [Formula: see text] and S control chart was created for the primary outcome. RESULT: Mean weight z-score change from birth to 36 weeks post menstrual age improved by 23% to - 0.87. Improvements in early weight gain and linear growth were seen as well. CONCLUSION: Use of the Model for Improvement to implement an optimized, standardized parenteral nutrition protocol can help improve extrauterine growth among VLBW infants.
OBJECTIVE: Poor extrauterine growth in very low birth weight (VLBW) neonates is common and associated with worsened long-term outcomes. We aimed to decrease growth restriction, measured by the change in weight z-score from birth to 36 weeks post menstrual age, from - 1.13 (baseline) to < -1 within 12 months. STUDY DESIGN: The Model for Improvement was used in the design and implementation of an optimized, standardized parenteral nutrition protocol. Three Plan-Do-Study-Act cycles were completed and a [Formula: see text] and S control chart was created for the primary outcome. RESULT: Mean weight z-score change from birth to 36 weeks post menstrual age improved by 23% to - 0.87. Improvements in early weight gain and linear growth were seen as well. CONCLUSION: Use of the Model for Improvement to implement an optimized, standardized parenteral nutrition protocol can help improve extrauterine growth among VLBW infants.
Authors: Tanis R Fenton; Barbara Cormack; Dena Goldberg; Roseann Nasser; Belal Alshaikh; Misha Eliasziw; William W Hay; Angela Hoyos; Diane Anderson; Frank Bloomfield; Ian Griffin; Nicholas Embleton; Niels Rochow; Sarah Taylor; Thibault Senterre; Richard J Schanler; Seham Elmrayed; Sharon Groh-Wargo; David Adamkin; Prakesh S Shah Journal: J Perinatol Date: 2020-03-25 Impact factor: 2.521
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