Standardizing the diagnosis of necrotizing enterocolitis in infants with congenital heart disease.

Autor: Hillyer M; Emory University School of Medicine, Department of Pediatrics, Division of Critical Care Medicine, Atlanta, GA, USA. margot.hillyer@emory.edu., Fundora M; Emory University School of Medicine, Department of Pediatrics, Division of Cardiology, Atlanta, GA, USA.; The Heart Center, Children's Healthcare of Atlanta, Atlanta, GA, USA., Williams F; Emory University School of Medicine, Department of Pediatrics, Division of Cardiology, Atlanta, GA, USA.; AdventHealth Medical Group, Division of Pediatric Critical Care Medicine, AdventHealth for Children, Orlando, FL, USA., Gleason M; The Heart Center, Children's Healthcare of Atlanta, Atlanta, GA, USA., Lukacs M; The Heart Center, Children's Healthcare of Atlanta, Atlanta, GA, USA., Hamrick S; Emory University School of Medicine, Department of Pediatrics, Division of Neonatology, Atlanta, GA, USA., Meisel J; Emory University School of Medicine, Department of Pediatrics, Division of General Surgery, Atlanta, GA, USA., Clarke S; Emory University School of Medicine, Department of Pediatrics, Division of Cardiology, Atlanta, GA, USA.; The Heart Center, Children's Healthcare of Atlanta, Atlanta, GA, USA., Korcinsky-Tillman N; The Heart Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.; Children's Healthcare of Atlanta Quality Department, Atlanta, GA, USA., Chanani N; Emory University School of Medicine, Department of Pediatrics, Division of Cardiology, Atlanta, GA, USA.; The Heart Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2024 Sep 12. Date of Electronic Publication: 2024 Sep 12.
DOI: 10.1038/s41372-024-02112-0
Abstrakt: Objective: This quality improvement initiative aimed to standardize the diagnosis of necrotizing enterocolitis (NEC) in infants with congenital heart disease (CHD).
Study Design: A multidisciplinary team developed clinical practice guidelines for the diagnosis and treatment of NEC within the Cardiac Intensive Care Unit (CICU). The diagnosis rate of NEC per 100 at-risk admissions was the primary outcome measure. NEC order set usage was employed as a process measure, and the balancing measures monitored were CICU length of stay (LOS) and mortality.
Result: After guideline development and implementation, the diagnosis rate of NEC decreased from 3% to 1%, sustained over three years. The EMR order set enabled guideline integration into daily workflow. No change was noted in CICU LOS or mortality.
Conclusion: Guideline implementation standardized the diagnosis of NEC in infants with CHD. Establishing a standardized definition and subsequent treatment regimen has enabled us to provide more consistent and appropriate care.
(© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Databáze: MEDLINE
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