Implementation of a probiotic protocol to reduce rates of necrotizing enterocolitis

Abstract

Objective: To utilize a probiotic protocol to achieve a 50% reduction in rates of necrotizing enterocolitis (NEC) ≥ Bell Stage 2 within 2 years of protocol implementation. Study design: Literature review guided probiotic selection and protocol design. A driver diagram identified key drivers to achieve our aim. A U chart followed monthly NEC ≥ Bell Stage 2 per 100 patient days and per monthly admissions. The process measure was protocol compliance and the balancing measure was probiotic sepsis. Results: NEC ≥ Bell Stage 2 decreased from 0.14 to 0.04 per 100 patient days in infants < 33 weeks gestation or <1500 g, or a yearly rate of 7–2%. Protocol compliance was 98% and there were no cases of probiotic sepsis. Conclusion: Implementation of a probiotic protocol was associated with a decrease in rates of NEC.