Alarm safety and oxygen saturation targets in the Vermont Oxford Network iNICQ 2015 collaborative

Hagadorn, James I.; Sink, David W.; Buus‐Frank, Madge E.; Edwards, Erika M.; Morrow, Kate A.; Horbar, Jeffrey D.; Ferrelli, Karla; Soll, Roger F.

doi:10.1038/jp.2016.219

Cited by 25 publications

(26 citation statements)

References 33 publications

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“…To understand practices related to transitions and to measure improvement over the course of the collaborative, a series of point-prevalence quality audits were planned, the first of which occurred in February 2019 (baseline audit). Analogous to prior VON collaboratives focused on neonatal abstinence syndrome (NAS) [25], alarm safety [26], and antibiotic stewardship [27], this audit included both unit-level and patient-level measures and occurred on a single day, selected by the local site, during a 2-week period. Auditors received a manual of operations with standardized definitions (Supplementary 2).…”

Section: Methodsmentioning

confidence: 99%

Variability in the systems of care supporting critical neonatal intensive care unit transitions

et al. 2020

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Objective Assess practices supporting care transitions for infants and families in the neonatal intensive care unit (NICU) using a model of four key drivers: communication, teamwork, family integration, and standardization. Study design Single-day audit among NICUs in the Vermont Oxford Network Critical Transitions collaborative addressing policies and practices supporting the four key drivers during admission, discharge, shift-to-shift handoffs, within hospital transfers, and select changes in clinical status. Results Among 95 NICUs, the median hospital rate of audited policies in place addressing the four key drivers were 47% (inter-quartile range (IQR) 35-65%) for communication, 67% (IQR 33-83%) for teamwork, 50% (IQR 33-61%) for family integration, and 70% (IQR 56-85%) for standardization. Of the 2462 infants included, 1066 (43%) experienced ≥1 specified transition during the week prior to the audit. Conclusions We identified opportunities for improving NICU transitions in areas of communication, teamwork, family integration, and standardization.

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Section: Methodsmentioning

confidence: 99%

Variability in the systems of care supporting critical neonatal intensive care unit transitions

et al. 2020

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“…Teams in the iNICQ collaborative focus on a single improvement topic over a 1 to 3-year timeframe. Recent improvement topics have included neonatal abstinence syndrome (42), alarm safety (43), and antibiotic stewardship (44). The current iNICQ collaborative, Critical Transitions: The Ins and Outs of Newborn Care involves over 120 neonatal teams from five countries focused on improving the quality and safety of the multiple transitions experienced by newborn infants and their families before during and after their initial hospitalization (45).…”

Section: Internet Newborn Improvement Collaborative For Quality (Inicq)mentioning

confidence: 99%

“…In a 2-year period of the neonatal abstinence syndrome iNICQ program, the mean number of NAS-focused policies increased while the median length of pharmacological treatment and length of stay decreased, as did the proportion of infants discharged on medication for NAS (42). Teams participating in a one-year iNICQ program on alarm safety showed significant progress toward implementation of Joint Commission Alarm Safety goals for oximeter monitoring (43). VON Day Audits were also used to measure delivery room management (46) stewardship (44).…”

Section: Von Day Auditsmentioning

confidence: 99%

Vermont Oxford Network: a worldwide learning community

et al. 2019

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Data to facilitate learning Currently, over 1,100 hospitals submit standardized, structured data to VON (Figure 1). The data have pragmatic definitions designed to help hospitals improve the quality of care for newborns and their families. In 2018, 532 hospitals finalized data on very low birth weight or very preterm infants, defined as infants 401 to 1,500 grams or 22 to 29 weeks at birth, and 491 hospitals finalized data on all infants admitted to neonatal intensive care units (NICU), including the very low birth weight and very preterm population (5). Reports based on these data give hospitals information for quality improvement in their local context. Process and outcome measures, collected over time and compared to peers, help hospitals identify potential areas for

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“…False alarms are common and known to create significant alarm fatigue [4]. It is well documented that this leads to risks of frequent disregard for alarm policy and SpO2 targeting guidelines [5].…”

Section: Introductionmentioning

confidence: 99%

Frequency and Duration of Oximeter Drop-Outs in the Nicu: An Observational Study

Bachman

Roubík²

2020

Clin Tech

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Oximeters used for continuous monitoring experience periods with no signal. This SpO2drop-out is widely acknowledged and its causes generally understood. This is a prospectively designed analysis of an existing database with the aim of characterizing drop-outs as experienced in the neonatal ICU. The data reflects 116 days of monitoring in seven tertiary care neonatal ICUs in 6 countries. From the evaluation of 1,396 drop-outs we found that typically the time was minimal with missing SpO2 data, and the episodes were short (median 2.79 minutes per day IQR 0.17-76, median 22 seconds IQR: 15-37, respectively). During during about half of the days there were no prolonged dropouts (1 minute or longer), even so half of the total time spent with no SpO2data were in prolonged episodes (median length 110 seconds IQR 85-150). The predominate factor associated with excessive drop-out time was the number of prolonged episodes rather than their duration. We concluded that the impact of drop-outs during manual control of inspired oxygen primarily impact alarm fatigue, but that during automatic FiO2control they could have an important impact. The relative effectiveness of the fall-back strategies of these automatic control systems ought to be evaluated.

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Alarm safety and oxygen saturation targets in the Vermont Oxford Network iNICQ 2015 collaborative

Cited by 25 publications

References 33 publications

Variability in the systems of care supporting critical neonatal intensive care unit transitions

Variability in the systems of care supporting critical neonatal intensive care unit transitions

Vermont Oxford Network: a worldwide learning community

Frequency and Duration of Oximeter Drop-Outs in the Nicu: An Observational Study

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