{
  "abstract": "Objective The introduction of quality improvement projects has been reported to be associated with a reduced rate of intraventricular haemorrhage (IVH) rate in some neonatal intensive care units.Methods In this retrospective single-centre study of 1675 preterm infants <1500 g, we analysed the frequency of overall IVH and severe IVH before and after the introduction of a first (2010) and a second (2019) quality improvement bundle.Results After the introduction of a first bundle of interventions in 2010, we were able to show a significant reduction of the rate of IVH from 22.2% to 10.5% (p=0002), mainly related to a reduction of severe IVH in the subgroup of infants below 26 weeks of gestational age. By continuous monitoring and implementation of a second intervention bundle in 2019 according to new identified risk factors, we could maintain a low rate of IVH over a 14 year period. With the reduction of the IVH rate, we observed improved long-term neurodevelopmental outcome as indicated by a lower rate of cerebral palsy and improved psychomotor development scores.Conclusion Our data suggest that implementing an intervention bundle of measures targeted to avoid risk factors may be associated with a significant reduction in IVH rate. By constant monitoring of the effects of the intervention and individual measures and refining the care bundle based on new evidence becoming available, a reduced IVH rate may be maintained despite annual fluctuations in the incidence of IVH. These intensified efforts are justified as IVH is not an inevitable event.",
  "authors": [
    {
      "affiliations": [
        "Section of Neonatology and Pediatric intensive care, Ulm University, Ulm, Germany"
      ],
      "name": "Jochen Essers"
    },
    {
      "affiliations": [
        "Department of Neonatology, Kantonspital Baden, Basel, Switzerland"
      ],
      "name": "Manuel Boris Bryant"
    },
    {
      "affiliations": [
        "Institute for Epidemiology und Medical Biometry, Ulm University, Ulm, Germany"
      ],
      "name": "Cornelia Horsch"
    },
    {
      "affiliations": [
        "Division of Social Pediatrics and Child Neurology, Mannheim University, Mannheim, Germany"
      ],
      "name": "Benedikt Winter"
    },
    {
      "affiliations": [
        "Department of Gynecology and Obstetrics, Ulm University, Ulm, Germany"
      ],
      "name": "Frank Reister"
    },
    {
      "affiliations": [
        "Institute for Epidemiology und Medical Biometry, Ulm University, Ulm, Germany"
      ],
      "name": "Benjamin Mayer"
    },
    {
      "affiliations": [
        "Section of Neonatology and Pediatric intensive care, Ulm University, Ulm, Germany"
      ],
      "name": "Harald Ehrhardt"
    },
    {
      "affiliations": [
        "Section of Neonatology and Pediatric intensive care, Ulm University, Ulm, Germany",
        "Global Foundation for the Care of Newborn Infants (GFCNI), München, Germany"
      ],
      "name": "Helmut D Hummler"
    }
  ],
  "title": "Reduction of IVH in very preterm infants via a two-step quality improvement project: a retrospective study of 14 years’ experience",
  "uid": "8eec0007-ad33-5700-a266-71a0880c32e2"
}