After finding that more than a quarter of premature babies delivered in the regional neonatal intensive-care unit at Sparrow Health System in 2013 developed some degree of intraventricular hemorrhage—which can lead to cognitive impairment and developmental disabilities—the nurses and neonatologists set out to eliminate IVH entirely.
Today, they've dramatically reduced the chances of brain injury in small infants by designing and initiating the “Small Baby Protocol” based on evidence-based best practices. Just 9.6% of babies delivered at Sparrow in 2016 suffered from IVH, which can lead to long-term medical problems and comorbidities. That's down from 27.4% in 2013.
“The goal was to not have them get the IVH, and then if they do, to minimize bleeding” said Sarah Collins, department manager of the NICU and special care nursery at Lansing, Mich.-based Sparrow.
Under the new care protocol implemented in July 2014, care team members delayed clamping the umbilical cord and minimized blood transfusions. Nurses were charged with keeping the infant's blood pressure steady, reducing stimulation and properly positioning the baby's head and bed, among other tasks.
Moreover, nurse “champions” were designated to teach the new guidelines to the staff. To do so, they photographed visual reminders of the protocol and put together an educational video.
“The more we have positive results, the more people are really invested in doing it,” Collins said.
Fighting to reduce brain injuries in premature babies
Regional Neonatal Intensive-Care Unit TeamSparrow Health System
PHOTO: The team: Back row (from left), Calli O'Keefe, BSN, RNC-NIC; Stephanie Boak, BSN, RN; Sarah Collins, MSN, RNC-NIC; Amanda D'Alessandro, BSN, RNC-NIC; Anne Devitto, MS, RD, CSP; Krista Wegenke , BA, RRT. Front row (from left), Tina Hummell, BSN, RNC-NIC; Zion Habtemariam, RRT; Kim Spencer, RN; Hollie Huhn, RN; Stephanie Short, BSN, RN; Jennifer Thompson-Wood, MSN, RN, C-EFM, ACNS-BC; Kathleen Marble, MSN, RNC-NIC. Not pictured: Dr. Padmani Karna and Dr. Robert Long.
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