We developed and tested a new method, called the Evidence-based Practice for Improving Quality method, for continuous quality improvement.
We used cluster randomization to assign 6 neonatal intensive care units (ICUs) to reduce nosocomial infection (infection group) and 6 ICUs to reduce bronchopulmonary dysplasia (pulmonary group). We included all infants born at 32 or fewer weeks gestation. We collected baseline data for 1 year. Practice change interventions were implemented using rapid-change cycles for 2 years.
The difference in incidence trends (slopes of trend lines) between the ICUs in the infection and pulmonary groups was - 0.0020 (95% confidence interval [CI] - 0.0007 to 0.0004) for nosocomial infection and - 0.0006 (95% CI - 0.0011 to - 0.0001) for bronchopulmonary dysplasia.
The results suggest that the Evidence-based Practice for Improving Quality method reduced bronchopulmonary dysplasia in the neonatal ICU and that it may reduce nosocomial infection.
Notes
Cites: Pediatrics. 2000 Nov;106(5):1070-911061777
Cites: JAMA. 2008 Mar 12;299(10):1182-418334694
Cites: Pediatrics. 2001 Jan;107(1):14-2211134428
Cites: J Pediatr. 2001 Jan;138(1):92-10011148519
Cites: J Pediatr. 2001 Apr;138(4):525-3111295716
Cites: CMAJ. 2002 Jan 22;166(2):173-811826939
Cites: J Perinatol. 2002 Jan;22(1):26-3011840239
Cites: Pediatr Infect Dis J. 2002 Jun;21(6):505-1112182373
Cites: BMJ. 2004 Oct 30;329(7473):100415514344
Cites: Ann Surg. 1978 Jan;187(1):1-7413500
Cites: Pediatrics. 1984 Jul;74(1):127-336547526
Cites: Am J Infect Control. 1988 Jun;16(3):128-402841893
Cites: Pediatrics. 1988 Oct;82(4):527-323174313
Cites: Lancet. 1993 Jul 24;342(8865):193-88100927
Cites: Qual Manag Health Care. 1992 Fall;1(1):65-7410131648
Cites: JAMA. 1996 Mar 20;275(11):841-68596221
Cites: Jt Comm J Qual Improv. 1998 Mar;24(3):119-299568552