Multidisciplinary evidence-based tools for improving consistency of care and neonatal nutrition.

Background: Extrauterine growth restriction from inadequate nutrition remains a significant morbidity in very low birth weight infants. Participants in the California Perinatal Quality Care Collaborative Quality Improvement Collaborative, Grow, Babies, Grow! developed or refined tools to improve nutrition and reduce practice variation.

Method: Five Neonatal Intensive Care Units describe the development and implementation of nutrition tools.

Epidemiology and genomics of a slow outbreak of methicillin-resistant (MRSA) in a neonatal intensive care unit: Successful chronic decolonization of MRSA-positive healthcare personnel.

Objective: To describe the genomic analysis and epidemiologic response related to a slow and prolonged methicillin-resistant (MRSA) outbreak.

Design: Prospective observational study.

Setting: Neonatal intensive care unit (NICU).

Capillary blood draws in the NICU: the use of the Innovac quick-draw whole blood collection system versus traditional capillary blood draws.

Purpose: (1) To determine the rate of damaged and discarded capillary blood draws in the NICU; (2) to compare the rate of damaged and discarded samples between traditional capillary blood draws and the Innovac Quick-Draw device; (3) to determine whether in-service training for nurses on capillary blood draws decreased the rate of damaged and discarded blood samples.

Design: During Phase I of the study, the rate of capillary blood draws by the traditional method was determined. At the completion of Phase I, the manufacturer provided in-service training to senior nurses in the NICU with the use of the Innovac Quick-Draw device.

Vacuum-assisted closure for complicated neonatal abdominal wounds.

Background: Neonatal experience in vacuum-assisted closure (VAC) for complex abdominal wounds remains scant.

Methods: A neonatal VAC protocol was instituted in 2004. The medical records of patients treated with this protocol for the ensuing 3 years were retrospectively reviewed.

Percutaneously inserted central catheter for total parenteral nutrition in neonates: complications rates related to upper versus lower extremity insertion.

Objective: The objective of this study was to compare the complication rates of upper versus lower extremity percutaneously inserted central catheters used for total parenteral nutrition in neonates.

Methods: During a 48-month study period, 396 neonates were identified as having had percutaneously inserted central venous catheters. A total of 370 catheters were inserted from the upper and 107 from the lower extremity.