Abstract
Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects about 40% of infants born at less than 32 weeks and is diagnosed if an infant still requires oxygen therapy at 36 weeks corrected gestational age or at discharge home. BPD increases the healthcare costs and the rates of asthma, sudden infant death syndrome, and mortality for very premature infants. The purpose of this project was to improve rates of BPD in very premature infants without increasing length of hospitalization through the implementation and evaluation of a multidisciplinary care bundle involving respiratory support and medication use guidelines. A noninvasive ventilation algorithm for the delivery room was also created and implemented. This bundle was utilized for very premature infants born in one South Dakota hospital and admitted to the level III neonatal intensive care unit (NICU) during the project period and compared to very premature infants born in this hospital in 2017. Implementation of this BPD prevention care bundle contributed to a decrease in the use of oxygen at discharge home for very premature infants without increasing the length of hospitalization. Use of invasive mechanical ventilation and the severity of BPD also decreased after implementation of the bundle, indicating that a bundle approach can be successful in decreasing the rates of BPD for very premature infants.