Abstract
Purpose: The purpose of this project is to improve the outcomes of very preterm infants via development, implementation, and evaluation of a “Golden Hour” protocol to standardize delivery room practices in a level III NICU.|Background: Preterm infants are at risk for increased morbidity and mortality due to physical and developmental immaturity. Standardized delivery room practices can mitigate these adverse outcomes.|Methods: A “Golden Hour” protocol was developed with input from key stakeholders in the NICU. NICU staff were educated via printed materials and simulation activities prior to implementation. Data were collected before and after the implementation of the “Golden Hour” protocol.|Sample/Setting: This quality improvement project was conducted in a 16-bed, level III NICU in a community hospital. Ten infants with a mean gestational age of 32 weeks were reviewed prior to implementation of the protocol. Eight infants with a mean gestational age of 29 weeks were reviewed after implementation of the protocol.|Results: There were improvements in all “Golden Hour” time measurements, including time to initiation of intravenous fluids, time to administration of antibiotics, and time to isolette closure. Temperatures were stable in both groups, but no increased incidence of hyperthermia was noted in the post-implementation group. Incidence of intraventricular hemorrhage (IVH) was increased in the post-implementation group; data collection regarding bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) is ongoing.|Conclusion: The implementation of a “Golden Hour” protocol improved delivery room admission and stabilization processes for very preterm infants. These improvements were noted even with an increased acuity of the infants in the post-implementation period. IVH incidence did increase in the post-implementation group most likely due to lower gestational age. Further staff education will lead to continued improvements in delivery room practices and outcomes for these infants.