Quality Improvement
-
QI Toolkits
- Hospital Acquired Infection Prevention (rev. MARCH 2008)
- Improving Initial Lung Function: Surfactant and Other Means (2005)
- Antenatal Corticosteroid Therapy (rev. OCTOBER 2009)
- Postnatal Steroid Administration (rev. 2003)
- Nutritional Support of the VLBW Infant - (rev. DECEMBER 2008)
- Care and Management of the Late Preterm Infant Toolkit (rev. APRIL 2007)
- Delivery Room Management of the Very Low Birth Weight (VLBW) Infant Toolkit (rev. OCTOBER 2006)
- Severe Hyperbilirubinemia Prevention (rev. OCTOBER 2005)
- Prevention of Perinatal Group B Streptococcus Disease Toolkit (rev. AUGUST 2008)
- Prevention of Perinatal HIV Toolkit (rev. SEPTEMBER 2008)
- CPQCC/CCS Healthcare Associated Infection (HAI) Collaborative
- Webcast Recordings
- PQIP Members
- CCS/CPQCC High Risk Infant Follow-up Quality of Care Initiative (HRIF QCI)
- Collaborative #2: CPQCC/CCS Breastmilk Nutrition QI Collaborative
- California Association of Neonatologists (CAN) 16th Annual Conference March 5-7, 2010
Toolkit Revision Summary
NUTRITIONAL SUPPORT OF THE VLBW INFANT
Revised December 2008
SUMMARY OF CHANGES from Nutrition Toolkit 1 (2004) and Nutrition Toolkit 2 (2005)
Acknowledgements: Toolkits 1 & 2:
Nancy Wight MD, IBCLC, FABM, FAAP, Sharp Mary Birch Hospital for Women
Jane Morton MD, FABM, FAAP, Stanford University Medical Center
William Rhine MD, FAAP, Stanford University Medical Center
David Durand MD, FAAP, Children’s Hospital Oakland
David Wirtschafter MD, FAAP, Kaiser Permanente
Courtney Nisbet, RN, MS, CPQCC
Acknowledgements: 2008 Revised Toolkit:
Nancy Wight MD, IBCLC, FABM, FAAP, Sharp Mary Birch Hospital for Women
William Rhine MD, FAAP, Stanford University Medical Center
David Durand MD, FAAP, Children’s Hospital Oakland
David Wirtschafter MD, FAAP, Kaiser Permanente
Jae Kim MD, PhD, FRCPC, FAAP, University of California San Diego
Courtney Nisbet, RN, MS, CPQCC
Toolkits 1 and 2 Combined & Reorganized. As human milk was felt to be a major factor in improving nutrition and long-term outcome for VLBW infants, Toolkit 1 provided a detailed list (divided into small steps) of best practices for establishing a source and continued access to a mother’s milk for her NICU infant. Toolkit 2 covered the other essential best practices, including parenteral nutrition, early enteral feeding, transition to oral feedings, discharge nutrition and continued breastfeeding. Understandably, there was some duplication.
The 2008 revised Nutrition Toolkit combines all of the best practices from the original 2 Toolkits, reorganized for easier access to specific issues, into 7 sections:
- General principles/CQI
- Parenteral nutrition
- Establishing enteral nutrition
- Human Milk/Breastfeeding
- Transition to oral feedings
- Discharge planning/post-discharge nutrition
- Special/Controversial issues
New research has reinforced the prior best practices - they have not changed. The appendices have also been reorganized by section, with additional examples and tools added.
References - Over 100 additional references have been added, including new 2005-2008 papers, books and other sources.
General Principles/CQI - This section has been greatly expanded with several new suggested measurement tools and grids complete with justification, forms and additional references. Everyone should be able to find something to measure in his or her nutritional quality improvement efforts.
Section 7: Special/Controversial Issues A new section on probiotics and prebiotics has been added, and all best practices updated with new information and references. The CMV section has been completely revised with newer references.
NUTRITIONAL SUPPORT OF THE VLBW INFANT , REVISED 12/08 - Newsletter Article
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