Cody Arnold1,2, Dharshi Sivakumar1,2, Malathi Balasundaram3,4, Rachel Land1,2, Stephanie Miller1,2, Jochen Profit1,5, Melinda Porter2. 1. Division of Neonatal & Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. 2. Neonatal Intensive Care Unit, El Camino Health, Mountain View, CA, USA. 3. Division of Neonatal & Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. malathib@stanford.edu. 4. Neonatal Intensive Care Unit, El Camino Health, Mountain View, CA, USA. malathib@stanford.edu. 5. California Perinatal Quality Care Collaborative, Palo Alto, CA, USA.
Abstract
OBJECTIVE: Increase the proportion of ≤33 weeks newborns exposed to mother's own milk (MOM) oral care by 12 h of age by 20% over 2 years to support a healthier microbiome. STUDY DESIGN: We implemented interventions to support early expression of colostrum and reliable delivery of resultant MOM to premature newborns. Statistical process control charts were used to track progress and provide feedback to staff. Proportions of newborns exposed to MOM by 12 h were compared relative to baseline. RESULTS: There were 46, 66, and 46 newborns in the baseline, implementation, and sustainability periods, respectively. The primary outcome improved from 48% to 61% in the implementation period (relative change 1.27, 95% CI 0.89, 1.81, p = 0.2), to 69% in sustainability period (relative to baseline 1.45, 95% CI 1.02, 2.08, p = 0.03). CONCLUSION: An interdisciplinary team-based, multicycle, quality improvement intervention resulted in increased rates of early exposure to MOM.
OBJECTIVE: Increase the proportion of ≤33 weeks newborns exposed to mother's own milk (MOM) oral care by 12 h of age by 20% over 2 years to support a healthier microbiome. STUDY DESIGN: We implemented interventions to support early expression of colostrum and reliable delivery of resultant MOM to premature newborns. Statistical process control charts were used to track progress and provide feedback to staff. Proportions of newborns exposed to MOM by 12 h were compared relative to baseline. RESULTS: There were 46, 66, and 46 newborns in the baseline, implementation, and sustainability periods, respectively. The primary outcome improved from 48% to 61% in the implementation period (relative change 1.27, 95% CI 0.89, 1.81, p = 0.2), to 69% in sustainability period (relative to baseline 1.45, 95% CI 1.02, 2.08, p = 0.03). CONCLUSION: An interdisciplinary team-based, multicycle, quality improvement intervention resulted in increased rates of early exposure to MOM.
Authors: Elizabeth A Cristofalo; Richard J Schanler; Cynthia L Blanco; Sandra Sullivan; Rudolf Trawoeger; Ursula Kiechl-Kohlendorfer; Golde Dudell; David J Rechtman; Martin L Lee; Alan Lucas; Steven Abrams Journal: J Pediatr Date: 2013-08-20 Impact factor: 4.406
Authors: Isabel María Fernández Medina; Cayetano Fernández-Sola; María Mar López-Rodríguez; José Manuel Hernández-Padilla; María Del Mar Jiménez Lasserrotte; José Granero-Molina Journal: Adv Neonatal Care Date: 2019-10 Impact factor: 1.968
Authors: Sandra Sullivan; Richard J Schanler; Jae H Kim; Aloka L Patel; Rudolf Trawöger; Ursula Kiechl-Kohlendorfer; Gary M Chan; Cynthia L Blanco; Steven Abrams; C Michael Cotten; Nirupama Laroia; Richard A Ehrenkranz; Golde Dudell; Elizabeth A Cristofalo; Paula Meier; Martin L Lee; David J Rechtman; Alan Lucas Journal: J Pediatr Date: 2009-12-29 Impact factor: 4.406
Authors: Nhan T Ho; Fan Li; Kathleen A Lee-Sarwar; Hein M Tun; Bryan P Brown; Pia S Pannaraj; Jeffrey M Bender; Meghan B Azad; Amanda L Thompson; Scott T Weiss; M Andrea Azcarate-Peril; Augusto A Litonjua; Anita L Kozyrskyj; Heather B Jaspan; Grace M Aldrovandi; Louise Kuhn Journal: Nat Commun Date: 2018-10-09 Impact factor: 14.919