Quality improvement initiative to decrease severe intraventricular hemorrhage rates in preterm infants by implementation of a care bundle

Abstract

Objective: To decrease the incidence of severe Intraventricular Hemorrhage (sIVH) rates in preterm infants in a Neonatal Intensive Care Unit (NICU) to 10% over eight months. Population: All infants born less than 30 gestational weeks. Methods: Targeted interventions focus on the first 72 h of life and include minimizing disturbance in cerebral blood flow and minimal stimulation. Data were collected from a review of electronic medical records from September 2023 – April 2024. Outcome measures: A decrease in sIVH (grade III-IV), an increase in head-of-bed elevation rate, and an evaluation of pedal/pelvic edema due to head-of-bed elevation. Results: The rate of sIVH decreased over the eight-month implementation period from 24.4% in the baseline period to 9.3% in the intervention period. Conclusion: Standardization of care using a sIVH prevention bundle was instrumental in the success of this project.