Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Wong SY (1), Cheng ML (1), Chiu NY (1), Lee M (1), Ip MY (1), Cheng SM (1)
Affiliation :
(1) Department of Pediatrics, Prince of Wales Hospital
Introduction :
Intraventricular hemorrhage (IVH) is a major cause of brain injury and a contributor for morbidity and mortality among the preterm neonates. Neonates with severe IVH may develop significant and long-term neurodevelopmental disabilities. An effective IVH care bundle reduces the incidence and severity of IVH. However, there is a lack of standardized nursing care for IVH bundle care in PWH NICU.
Objectives :
The program provides IVH care bundles to preterm neonates born before 32-week-gestation. The program’s aim is to examine the effectiveness of designated IVH care bundles. The main outcome of the program was the reduction in the incidence and severity of IVH among the preterm neonates.
Methodology :
Pre-intervention data was collected prior to the implementation of the IVH bundle care. A literature search was conducted to develop an evidence based IVH care bundle. Briefing sessions were organized for nurses to introduce the IVH care bundle. The program was carried out and promoted. Post-intervention data collection was conducted after the implementation to evaluate the effectiveness of IVH bundle care.
Result & Outcome :
Two data collection periods were included and analyzed. Retrospective baseline data were collected from the electronic medical record for all inborn infants born at <32 weeks of gestation and admitted to PWH NICU from Oct 2021 to Oct 2022. Post- intervention data were collected from Dec 2022 to Dec 2023. A total of 119 preterm neonates (64 in the pre-intervention group) and (55 in the post-intervention group) at <32 weeks of gestational age were recruited. The new care bundles in preventing intraventricular hemorrhage were introduced for all infants with gestational age under 32 weeks starting from Nov 2022. Of the 64 infants in the control group, 9 (14.1%) compared with 2 (3.6%) of 55 infants in the post-intervention group had developed severe intraventricular hemorrhage (IVH). The incidence of severe IVH decreased from 14.1% to 3.6%. The incidence of severe IVH reduced remarkably. Apart from the incidence rate, the nursing knowledge of IVH care is relatively low (51%) in the pre intervention period. After the briefing session and bundle implementation, the nursing knowledge significantly improved with an average post-education test score of 97%. The compliance rate of program reached 100%. The IVH care bundle was effectively implemented, resulting in a remarkable reduction in the incidence of IVH and severe IVH cases in PWH NICU. Nursing staff welcomed the IVH care bundle with a positive attitude and provided valuable feedback.
