Optimizing therapeutic hypothermia for neonatal encephalopathy

Steven L. Olsen, Mitchell DeJonge, Alex Kline, Ellina Liptsen, Dongli Song, Betsi Anderson, Amit Mathur

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

OBJECTIVE: Therapeutic hypothermia (TH) for neonatal encephalopathy is becoming widely available in clinical practice. The goal of this collaborative was to create and implement an evidence-based standard-of-care approach to neonatal encephalopathy, deliver consistent care, and optimize outcomes. METHODS: The quality improvement process identified and used the Model for Improvement as a framework for improvement efforts. This was a Vermont Oxford Network Collaborative focused on optimizing TH in the treatment of neonatal encephalopathy. By using an evidencebased approach, Potentially Better Practices were developed by the topic expert, modified by the collaborative, and implemented at each hospital. These included the following: timely identification of at-risk infants, coordination with referring hospitals to ensure TH was available within 6 hours after birth, staff education for both local and referring hospitals, nonsedated MRI, incorporating amplitude-integrated EEG into a TH protocol, and ensuring standard neurodevelopmental follow-up of infants. Each center used these practices to develop a matrix for implementation. RESULTS: Local self-assessments directed the implementation and adaptation of the Potentially Better Practices at each center. Resources, based on common identified barriers, were developed and shared among the group. CONCLUSIONS: The implementation of a TH program to improve the consistency of care for patients in NICUs is feasible using standardquality improvement methodology. The successful introduction of new interventions such as TH to the NICU culture requires a collaborative multidisciplinary team, use of a systematic quality improvement process, and perseverance.

Original languageEnglish
Pages (from-to)e591-e603
JournalPediatrics
Volume131
Issue number2
DOIs
StatePublished - Feb 1 2013

Keywords

  • Encephalopathy
  • Hypothermia
  • Neonate
  • Quality improvement

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