Objective: To utilize a probiotic protocol to achieve a 50% reduction in rates of necrotizing enterocolitis (NEC) ≥ Bell Stage 2 within 2 years of protocol implementation.

Study Design: Literature review guided probiotic selection and protocol design. A driver diagram identified key drivers to achieve our aim. A U chart followed monthly NEC ≥ Bell Stage 2 per 100 patient days and per monthly admissions. The process measure was protocol compliance and the balancing measure was probiotic sepsis.

Results: NEC ≥ Bell Stage 2 decreased from 0.14 to 0.04 per 100 patient days in infants < 33 weeks gestation or <1500 g, or a yearly rate of 7-2%. Protocol compliance was 98% and there were no cases of probiotic sepsis.

Conclusion: Implementation of a probiotic protocol was associated with a decrease in rates of NEC.

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http://dx.doi.org/10.1038/s41372-019-0443-5DOI Listing

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