Neonatology presents care improvement strategies at Pediatric Academic Societies meeting

Neonatology presents care improvement strategies at Pediatric Academic Societies meeting

David Paul, M.D.
David Paul, M.D.

Christiana Care’s neonatology research team highlighted its leading-edge care and quality initiatives among 11 studies presented this spring at the Pediatric Academic Societies (PAS) Meeting.

“This is an outstanding accomplishment to have so many papers accepted at the largest, most prestigious pediatric meeting of the year,” says Christiana Care  Director of Neonatology, John Stefano, M.D. “Much of our research represents a shift in how we think about and provide care to mothers and babies.”

One example of that shift was the platform presentation by neonatologist Stephen Pearlman, M.D., director of the Neonatal Fellowship Program. His  multidisciplinary team successfully instituted a bundle of interventions that markedly reduced hypothermia among infants admitted to the NICU and lowered the potential for serious negative outcomes.

Director of Neonatal Research David Paul, M.D., also gave a platform presentation on a rapid cycle process improvement effort driven by bedside nurses to reduce serious IV infiltrates and associated tissue damage among infants in the NICU.

According to Dr. Paul, “Our research team is a national leader in using rigorous scientific methodology, and we are recognized for excellent neonatal outcomes.” Part of the reason, he says, is the culture of research and innovation in the NICU, where bedside nurses are key contributors.

Highlights of the presented posters

Antibiotic therapy for hospital-acquired pneumonia was the subject of a health care utilization study led by Dr. Paul along
with Neonatal Research Nurse Supervisor Kelly Gray, RN. This sub-project is part of a five-year, NIH-funded collaboration with Columbia University, Cornell University and The Children’s Hospital of Philadelphia that showed that despite similar diagnosis rates and choices of antibiotic coverage, duration of antibiotic therapy varied greatly, suggesting the need for a more standardized, evidence-based approach.

Motor delay (delay in physical actions including movement) in premature infants is the focus of an NIH-funded collaboration with the University of Delaware. Led by Dr. Paul and Neonatal Research Nurse Supervisor Amy Mackley, RN, MSN, RNC, a sub-analysis of MRI brain scans and follow-up motor assessments showed no association between early brain growth and later motor outcomes.

Wendy Sturtz, M.D., led a study of ventilated premature infants to identify a potentially valid hormone marker for gastric reflux, a danger for infants whose airway is not well protected.

Three studies by neonatology fellows Julie Ryan, M.D., and Beatriz De Jongh, M.D., focused on maternal body mass index (BMI) as a controllable factor affecting infant health, linking a high BMI to large gestational age at birth and increased likelihood of requiring costly NICU services. However, non-Hispanic African-American women may need a more comprehensive approach toward a healthy pregnancy beyond controlling weight.

Preliminary results from a first-of-its-kind study led by Dr. Jongh show that babies with breathing difficulties fared slightly better using nasal continuous positive airway pressure than a newer modality, high-flow nasal cannula.

Nurse Practitioner Karen McDonald, NNP, presented an intervention checklist developed for the NICU palliative care team to avoid disparities in end-of-life care, and investigator Ursula Guillen, M.D., presented a film decision aid developed during her fellowship as an innovative counseling tool for parents expecting a premature baby.