Implementation and Evaluation of “Golden Hour” Practices in Infants Younger Than 33 Weeks' Gestation

The Golden Hour: a quality improvement initiative for extremely premature infants in the neonatal intensive care unit

“…In a review of the literature, nine quality improvement (QI) studies were identified presenting outcomes following implementation of a GH protocol in the NICU [8,10,[12][13][14][15][16][17][18]. Admission temperature was reported as a short-term outcome measure and improvements in temperatures to goal range were described in eight of the studies [10,[12][13][14][15][16][17][18]. One study provided statistical analysis of improvement in admission serum glucose concentration to >50 mg/dL following protocol implementation [13].…”

“…Following birth, EP-ELBW infants are susceptible to rapid development of hypothermia, hypoglycemia, hypotension, and respiratory failure [1,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Resuscitation in the delivery room (DR) and stabilization during admission to the neonatal intensive care unit (NICU) involves a series of interdependent tasks and procedures.…”

“…Resuscitation in the delivery room (DR) and stabilization during admission to the neonatal intensive care unit (NICU) involves a series of interdependent tasks and procedures. These interventions must be performed quickly, proficiently, and systematically to minimize the short-term sequelae of prematurity, which contribute to the risk of long-term morbidity and mortality [1,[6][7][8][9][10][11][12][13][14][15][16][17][18].…”

“…The hour immediately following the birth of an EP-ELBW infant is referred to as the "Golden Hour" (GH) [6][7][8][10][11][12][13][14][15][16][17][18]. This term denotes the period of time in which medical care to prevent irreversible damage is most effective and represents the inverse relationship between elapsing minutes and likelihood of survival.…”

“…This term denotes the period of time in which medical care to prevent irreversible damage is most effective and represents the inverse relationship between elapsing minutes and likelihood of survival. Due to the complexity of the care required at birth, protocols that bundle evidence-based practices and standardize their application to the first few minutes after birth have been used to improve the quality and consistency of care for EP-ELBW infants during the GH [6][7][8][10][11][12][13][14][15][16][17][18].…”