Background: 

Extreme preterm infants face lengthy hospitalizations and are often subjected to painful stimuli. These stimuli may be related to routine caregiving that may negatively impact long-term developmental outcomes. Frequently obtained cuff blood pressure (BP) measurements are an example of a potentially noxious stimulus to preterm infants that may have a cumulating impact on development.

Purpose: 

The primary aim was to explore the frequency of cuff BP measurements obtained in hemodynamically stable extreme preterm infants in the neonatal intensive care unit (NICU). Our secondary aim was to reduce the number of cuff BP measurements obtained in hemodynamically stable extreme preterm infants in the NICU.

Methods: 

Quality improvement methodologies per the Institute for Healthcare Improvement were used combined with a multidisciplinary approach. Participants were infants born less than 27 weeks of gestation and discharged home. The baseline period was 2015 through Q2-2018 and the intervention period was Q3-2018 through Q1-2020. The electronic medical record was used to collect data and Minitab Statistical Software was used for data analysis.

Findings/Results: 

A baseline of 5.0% of eligible patients received the desired number of cuff BP measurements and increased to 63.2% after the intervention period.

Implications for Practice: 

Findings demonstrate that using quality improvement methodology can improve clinical care. Findings suggest the feasibility and safety of reducing the number of cuff BP measurements obtained on hemodynamically stable infants in the NICU.

Implications for Research: 

Future endeavors should aim to reduce the quantity of painful stimuli in the NICU. Long-term developmental outcomes should be correlated in these patients.

中文翻译：

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NICU 质量改进计划，旨在改进袖带血压测量的实践

 背景：

极端早产儿面临长期住院治疗，并且经常受到痛苦的刺激。这些刺激可能与日常护理有关，可能会对长期发育结果产生负面影响。经常获得的袖带血压（BP）测量是对早产儿潜在有害刺激的一个例子，可能会对发育产生累积影响。

 目的：

主要目的是探讨新生儿重症监护病房 (NICU) 血流动力学稳定的极端早产儿的袖带血压测量频率。我们的次要目标是减少新生儿重症监护室血流动力学稳定的极端早产儿的袖带血压测量数量。

 方法：

医疗保健改进研究所的质量改进方法与多学科方法相结合。参与者是妊娠不足 27 周并出院回家的婴儿。基线期为 2015 年至 2018 年第二季度，干预期为 2018 年第三季度至 2020 年第一季度。采用电子病历收集数据，采用Minitab统计软件进行数据分析。

 调查结果/结果：

基线时，5.0% 的合格患者接受了所需次数的袖带血压测量，干预期后这一比例增加至 63.2%。

对实践的启示：

研究结果表明，使用质量改进方法可以改善临床护理。研究结果表明，减少新生儿重症监护室血流动力学稳定婴儿的袖带血压测量次数是可行且安全的。

对研究的影响：

未来的努力应该旨在减少新生儿重症监护病房中疼痛刺激的数量。这些患者的长期发育结果应该是相关的。