Small baby guidelines can improve patient outcomes and decrease the length of hospitalization

Nationwide Children's HospitalDec 2 2009

Implementing small baby guidelines can decrease the length of hospitalization

A substantial number of premature infants born before 27 weeks gestational age encounter complicated medical problems. Although the survival rate of these infants has increased over the last two decades, the survival data for these patients is highly variable.

A recent study conducted by neonatologists and nurses at Nationwide Children's Hospital found that a unified approach to the care of extremely premature infants in the first week of life resulted in improved patient outcomes and a decrease in the length of stay at the hospital.

According to the study, published in the online issue of Acta Paediatrica, infants who were treated using small baby guidelines were discharged an average 13 days earlier than infants who were not treated using a unified approach.

"There is a wide variety of attitudes and feelings about the care of these premature babies," said study author Leif Nelin, MD, neonatologist at Nationwide Children's Hospital. "Getting everyone on the same page was the most important aspect of this approach."

To develop a unified approach, a multidisciplinary group consisting of doctors, nurses, therapists, nutritionists, pharmacists and social workers came together to create small baby guidelines for 11 different focus areas. Infants who were treated using these guidelines also showed a higher survival rate without bronchopulmonary dysplasia (24 percent) and without severe intraventricular hemorrhage (65 percent), both of which are common complications that premature babies suffer.

"By adopting a unified approach, we were able to significantly improve the outcome of these babies," continued Dr. Nelin. "The key point is that the staff is educated and does things in the same way in the caregiving of these premature infants".

This is the first published study that examined this particular patient population while covering all aspects of their care. Data from this study was collected from infants less than 27 weeks gestational age and less than seven days of age on admission. Thirty-seven patients were cared for using the small baby guidelines and 40 patients were in the comparison group.