Abstract
Upon review of Vermont Oxford Network data, a Midwest Level III Neonatal Intensive Care Unit (NICU) noted increased levels of chronic lung disease (CLD) in infants born at less than 33 weeks gestation. Initial analysis of delivery room practices with these infants showed great variance based upon each provider's experience and knowledge. In an effort to standardize processes and to reduce the level of CLD within this subpopulation of infants, providers adopted "golden hour" practices focused on providing respiratory support (use of an inspiratory hold, early continuous positive airway pressure, and intubation criteria), oxygen targeting, thermal regulation, and teamwork. Compliance was tracked via delivery room documentation. Although this is an ongoing quality improvement project, examination at three and six months post-practice shows increasing compliance with the "golden hour" practices. Furthermore, after six months of utilizing "golden hour" practices, there is a decreased incidence of CLD.