NICU Collaborations
The NICU at ACH-PR is actively involved with the Vermont Oxford Network (VON) and Illinois Perinatal Quality Collaborative (ILPQC) Quality Collaboratives. We are also a Magnet Center for Nursing Excellence and are currently in the process of re-designation as part of Advocate Children’s Hospital.
VON
VON is “health care professionals and families at more than 1300 member centers collaborating to improve neonatal care around the world with data-driven quality improvement and research”. Our NICU has participated in VON collaboratives for over 20 years with expanded focus and improvement in the following areas:
- Choosing anitbiotics Wisely – decreasing unnecessary exposure to antibiotics through the implementation of the sepsis risk calculator and antibiotic time out.
- Micro-preemie care, including development of the Henry Mangurten Small Baby Unit (SBU):
- Our team aims to increase survival without major morbidity in infants born at less than 30 weeks gestational age (SBU population) by 10% year over year.
- In 2016, a complete SBU program was developed including including team member education, specific SBU workflows, protocols, and unit space.
- Working through the VON Micropreemie Toolkit, we have worked on numerous potentially better practices. Currently, our specific project aim is to improve admission temperature, time to glucose infusion, time to antibiotic administration, and early pumping of mother’s milk in the SBU population.
- The Ins and Outs of Neonatal Care Improving Critical Transitions for Every Newborn:
- Any change in an infant’s site of care, significant change of status or plan of care, or a change in the infant’s care team is a Critical Transition.
- These transitions occur for all newborns at all levels of care and there are great variations in how transitions occur.
- Using the Institute of Medicine’s STEEEPS criteria, we aim to make all transitions Safe Timely Effective Efficient Equitable Parent and Family Centered and Socially Responsible.
- Our current focus is on the "Ins" of Neonatal Care with the following Key Driver Diagram.
- Measurement plan includes: Family communication before delivery, First touch in DR, Family present during resuscitation, and Family present during admission. Next steps look at standard communication handouts to families throughout NICU stay. VON teams are multidisciplinary and include NICU parents.
Criteria | Measure(s) | Type of Measure | Primary Driver(s) | Frequency |
|---|---|---|---|---|
Safe | NICU – OB Team Pre-briefs completed | Process, Value, Family | Communication, Teamwork, Standardized Processes | Monthly |
Timely | Time to provide first section of NICU Journey Book | Process, Family | Communication, Teamwork, Family Integration, Standardized Processes | Monthly |
Efficient | Family debrief after NICU admission | Process, Family | Communication, Teamwork | Monthly |
Effective | Time to first skin to skin hold Unplanned extubation | Process, Family Balancing | Communication, Teamwork, Family Integration, Standardized Processes | Monthly |
Equitable | Family Satisfaction Rates | Outcome, Family | Family Integration | Monthly |
Patient and Family Centered | Sim lab education of staff on skin to skin of ventilated infant | Process | Communication, Teamwork, Standardized Processes | Monthly |
Socially Responsible | Length of Stay Precentable NICU Admission | Outcome, Family Value | Communication, Teamwork, Standardized Processes | Monthly |
ILPQC (Illinois Perinatal Quality Collaborative)
“ILPQC is a nationally recognized statewide network of hospital teams, perinatal clinicians, patients, public health leaders, and policymakers committed to improving health care and outcomes for mothers and babies across Illinois.” The ACH-PR NICU has been involved in the ILPQC Golden Hour, Mothers and Newborns affected by Opioids (MNO), and now BASIC (Babies Antibiotic Stewardship Improvement Collaborative).
1. MNO Project prompted us to look at our Non-pharmacologic and Pharmacologic management of opioid exposed newborns (OENs). This included the adaptation of the Eat, Sleep, Console (ESC) approach as well as finding opportunities for couplet care of these mother-infant dyads. Metrics include length of stay, use of pharmacologic treatment, breastfeeding at discharge, and safe discharge planning.
Magnet Recognition for Nursing Excellence
“The Magnet Recognition Program designates organizations worldwide where nursing leaders successfully align their nursing strategic goals to improve the organization’s patient outcomes. The Magnet Recognition Program provides a roadmap to nursing excellence, which benefits the whole of an organization. To nurses, Magnet Recognition means education and development through every career stage, which leads to greater autonomy at the bedside. To patients, it means the very best care, delivered by nurses who are supported to be the very best that they can be.” Advocate Children’s Hospital (ACH) has previously enjoyed Magnet recognitions as part of their adult hospital campuses (Lutheran General and Christ Medical Center). In 2019, ACH applied as its own entity for Magnet recognition. The site visit for this application is in July 2020. ACH-PR has been highlighted for its exemplary professional nursing practice and innovation including: Swaddled bathing, Clean Slate® phone disinfection system, use of oxygen saturation histogram in the care of micro-premature infants, refining lab label process to decrease mislabeled specimens, decreasing blood transfusions in ECMO patients, decreasing MRSA infection rates, and human milk bar code scanning. Additionally, the ACH-PR NICU was recognized for its high percentage of certifications related to the specialty of neonatal nursing, percentage of nurses with a Bachelor of Science degree or higher in the field of nursing, and employee satisfaction rates. While Magnet recognition focuses on nursing, the achievement of its components and standards relies on true interdisciplinary collaboration and teamwork which is a hallmark of our practice in the ACH-PR NICU.
