NICU Recognized for Outstanding Results in Reducing Necrotizing Enterocolitis
Necrotizing enterocolitis (NEC) is a serious threat to premature infants, affecting close to 10 percent of all babies born weighing less than 3 ½ pounds. In 2010, Greater Cincinnati’s regional rate of the disease significantly exceeded national benchmarks. Determined to change that, Amy Nathan, MD, medical director, Perinatal Institute, and members of the NEC task force standardized care and made improvements to reduce it by 83 percent over five years.
Necrotizing enterocolitis results when lack of blood flow or pathogenic bacteria and inflammation damage the lining of the intestines.
“It strikes suddenly and has no effective treatment strategies. Therefore, prevention of necrotizing enterocolitis is crucial,” said Jay Dritz, MD, assistant professor, Neonatology.
Standardizing feeding protocols for infants born at less than 1,500 grams and increasing the use of human milk critically aided the team in preventing an estimated 50 cases for a calculated cost savings of more than $5 million.
According to Pam Pockras, APRN, the team encouraged frequent and early skin-to-skin contact, which improved the success of mothers being able to provide their own milk; designated adequate space for mothers to pump in the NICU to maintain milk supplies; and supported a relaxing environment to aid with milk let down by supplying moms with ear buds to listen to music while pumping.
“Key take-home learnings included the utility of concurrent testing of multiple drivers in different units, the importance of a multi-disciplinary approach, and the benefits of standardization across multiple independent hospital systems,” said Nathan. "Testing interventions at multiple sites was key to accelerating learning and making adjustments along the way. Through this process, the improvement team was able to refine specific elements of the bundle while at the same time learning which elements, when combined, would have the greatest impact on reducing NEC."
Cincinnati Children’s neonatologists care for the majority of infants born in Greater Cincinnati, providing care at five Level 3 NICUs.
The Children's Hospital Association recognized the NEC taskforce at its Quality and Safety Conference with the Distinctive Achievement Award for Clinical Care.
