Hospital-acquired infections and chronic respiratory distress with oxygen dependency among premature infants can be reduced by improving the quality of care with the help of a new method.
Published in Canadian Medical Association Journal (CMAJ), a research article based on the study describes the Evidence-based Practice for Improving Quality method, which has been applied to 12 Canadian Neonatal Network hospitals over a 3-year period.
Working in multidisciplinary groups, each hospital developed a list of hospital-specific practice changes and priorities to implement in the neonatal ICU.
The study had 6519 infants divided into three groups - infection, pulmonary and a control group.
After adopting practice-change strategies, the incidence of hospital-acquired (nosocomial) infection decreased 32 per cent and 45 per cent in the first two groups.
Respiratory distress (bronchopulmonary dysplasia) in the pulmonary group decreased 15 per cent, and there was a 12 per cent decrease in death from this condition.
Using pooled hospital data, the authors previously showed that 40 per cent of infections in neonatal ICUs were associated with central lines and central catheters inserted into organs.
When they looked at individual hospital data, different patterns of infection associated with catheter insertions were found.
"Our method enables hospitals to select practice changes pertinent to them for targeted intervention. This is potentially more efficient and cost-effective," writes principal investigator Dr. Shoo Lee of Mount Sinai Hospital and the University of Toronto and co-authors.
The authors wrote: "We found that interventions aimed at one outcome may affect other outcomes. We speculate that the decrease in the incidence of nosocomial infections in the pulmonary group was related to improved lung status and a reduced need for assisted respiration, invasive interventions, improved feeding and growth, and better overall health."
They believe that the method used in the study may be applicable in other areas of health care. They also say that it may increase efficiency and reduce the costs.