Care Bundle to Improve Oxygen Maintenance and Events.

Unlabelled: Prolonged periods spent outside the target range of oxygen saturation (SpO) in preterm infants, along with frequent desaturation events, predispose them to retinopathy of prematurity (ROP) and long-term neurodevelopmental impairment. The primary aim of this study was to increase the mean time spent within the target SpO range (WTR) by 10% and to reduce the frequency of desaturation events by 5 events per patient day, respectively, within 18 months of implementing a care bundle.

Methods: This study was completed in a 46-bed neonatal intensive care unit (NICU), involving 246 staff members and led by a quality improvement team.

Should less invasive surfactant administration (LISA) become routine practice in US neonatal units?

The harmful effects of mechanical ventilation (MV) on the preterm lung are well established. Avoiding MV at birth and stabilization on continuous positive airway pressure (CPAP) decreases the composite outcome of death or bronchopulmonary dysplasia. Although preterm infants are increasingly being admitted to the neonatal intensive care unit on CPAP, centers differ in the ability to manage infants primarily on CPAP.

Designing behavioral interventions using the capability-opportunity-motivation-behavior model and the theoretical domains framework to optimize oxygen saturation maintenance by NICU providers.

Objective: Despite evidence-based guidelines, SpO maintenance-related practices of care providers remain inconsistent. Our aim was to evaluate the impact of interprofessional learning workshops, bedside coaching, and neonatal intensive care unit (NICU) level enablers on targeted behavioral change of NICU staff, focusing on SpO maintenance.

Methods: NICU is a specialized area of the hospital with sophisticated monitors where multidisciplinary staff provide round-the-clock care for sick and preterm infants.

Frequency of diagnostic errors in the neonatal intensive care unit: a retrospective cohort study.

Objective: To determine the frequency and etiology of diagnostic errors during the first 7 days of admission for inborn neonatal intensive care unit (NICU) patients.

Study Design: We conducted a retrospective cohort study of 600 consecutive inborn admissions. A physician used the "Safer Dx NICU Instrument" to review the electronic health record for the first 7 days of admission, and categorized cases as "yes," "unclear," or "no" for diagnostic error.

Diagnostic Error: Why Now?

Diagnostic errors remain relatively understudied and underappreciated. They are particularly concerning in the intensive care unit, where they are more likely to result in harm to patients. There is a lack of consensus on the definition of diagnostic error, and current methods to quantify diagnostic error have numerous limitations as noted in the sentinel report by the National Academy of Medicine.

I can't breathe.

The phrase "I can't breathe" has become a national slogan in recent months for those who are protesting against racial discrimination across the world. For clinicians caring for neonates, this phrase should serve as a reminder about the stark disparities in health outcomes and health services for black infants and their families that have persisted for decades in spite of a voluminous amount of literature describing these disparities and the factors contributing to them. It should galvanize us into action within the neonatal intensive care unit and beyond to ensure equal treatment for all patients and their families, and to take measures to compensate for the disparities.