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QI Toolkit

Neonatal Opioid Withdrawal Syndrome (NOWS) Toolkit

The rate of Neonatal Opioid Withdrawal Syndrome (NOWS), also known as Neonatal Abstinence Syndrome (NAS), has been increasing over the past decade nationally. The aim of this toolkit is to provide healthcare staff with a straightforward manual of care that they can use as a reference to manage infants with NOWS. This may be particularly useful when infants with NOWS are not commonly managed at their institution. Our hope is that by providing easy to use evidence-based guidelines, the quality and equity of care for infants with NOWS will improve.

Preventing HAI in the NICU

Over the past 20 years, through efforts of single and multi-center NICU quality improvement (QI) projects and collectively through state collaboratives, the rates of central line-associated blood stream infections (CLABSIs) and, subsequently, hospital-acquired infections (HAI), in the NICU have been reduced. Despite these improvements, HAI remains a persistent challenge in the NICU, resulting in increased length of stay, morbidity and mortality, and increased hospital costs. Very low birthweight (VLBW) infants hospitalized in the NICU are at an increased risk for HAI. 

Neonatal Disaster Preparedness

Neonatal patients have unique needs that distinguish them from most other hospitalized patients. Infants in the NICU are highly dependent on hospital staff for all aspects of their care. Many are critically ill and are heavily dependent on advanced technology for their survival. Any number of disasters has the potential to impact a NICU’s ability to care for their patients.

Early Screening and Identification of Candidates for Neonatal Therapeutic Hypothermia Toolkit

Therapeutic hypothermia, when initiated within six hours of birth, has been shown to significantly improve survival and neurodevelopmental outcomes in neonates with moderate to serve hypoxic-ischemic encephalopathy (HIE). However, not every baby who might benefit from cooling therapy is identified or referred to a regional cooling center in a timely fashion. Early identification of the risk factors for perinatally-acquired asphyxia and recognition of the signs and symptoms of neonatal encephalopathy are challenging even for the most experienced neonatologists. 

Perinatal HIV

The Perinatal HIV toolkit summarizes the current recommendations of the U.S. Department of Health and Human Services (HHS) Panel on Treatment of HIV-infected Pregnant Women and Prevention of Perinatal Transmission (a working group of the Office of AIDS Research Advisory Council). The toolkit is designed to assist healthcare providers in providing HIV information and prenatal testing and care to pregnant women. 

Care and Management of the Late Preterm Infant

Late preterm infants (LPI) (those born 34 to 36 6/7 weeks gestation) comprise a unique population requiring enhanced awareness and sensitivity to issues of delivery, transition, infection, nutrition, discharge readiness, and parent education that need to be addressed shortly after birth. The Care and Management of the Late Preterm Infant Toolkit is designed to assist every perinatal unit, regardless of level of care, in implementing an organized plan to address the unique physiologic needs and challenges of the late preterm infant.


Improving Initial Lung Function

Premature infants with respiratory distress syndrome (RDS) require stabilization of their lung function, starting with resuscitation. While surfactant remains an important part of the treatment for RDS, increased experience with other methods of respiratory care has led CPQCC to revise its previous recommendations regarding prophylactic surfactant use.


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