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Decreasing radiographs in neonates through targeted quality improvement interventions.
Journal of Perinatology ( IF 2.4 ) Pub Date : 2019-12-16 , DOI: 10.1038/s41372-019-0565-9
Patrick Motz 1 , Julie Do 1 , Teresa Lam 1 , Robert M DiBlasi 2 , Tim Fang 2 , Karen Kelly 2 , Robert DiGeronimo 1 , Zeenia C Billimoria 1
Affiliation  

OBJECTIVE Our aim was to decrease radiograph use for monitoring placement of peripherally inserted central catheters (PICC) and endotracheal tubes (ETT) in neonates admitted to the neonatal intensive care unit (NICU) by 20% from November 2017 to November 2018. STUDY DESIGN We carried out three Plan-Do-Study-Act (PDSA) cycles: (1) implementation of a radiograph protocol emphasizing ideal patient positioning, standard radiograph views and frequency, (2) standardizing ETT depth using the NRP guidelines, and (3) implementation of an institution specific ETT depth guideline. RESULTS The pre-intervention radiographs per PICC day was 0.86 versus a post-intervention value of 0.46 (P = 0.004). The pre-intervention radiographs per ETT day was 1.45 versus a post-intervention value of 1.07 (P = 0.002). CONCLUSIONS Our multidisciplinary NICU team performed a QI project, which resulted in more than a 20% decrease in the number of radiographs used for monitoring placement of PICCs and ETTs.

中文翻译:

通过有针对性的质量改善干预措施来减少新生儿的X光片。

目的我们的目标是将自2017年11月至2018年11月入院的新生儿重症监护病房(NICU)的新生儿的X线照片使用量减少20%。进行了三个“计划-研究-行动”(PDSA)周期:(1)实施放射照相协议,强调理想的患者位置,标准的放射照相视图和频率;(2)使用NRP指南对ETT深度进行标准化;以及(3)实施特定于机构的ETT深度指南。结果:PICC每天的干预前X射线照片为0.86,而干预后为0.46(P = 0.004)。每ETT日的干预前X射线照片为1.45,而干预后为1.07(P = 0.002)。
更新日期:2019-12-17
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