Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Survey of preterm neuro-centric care practices in California neonatal intensive care units

Journal of Perinatology volume 39, pages 256–262 (2019)Cite this article

Subjects

Abstract

Objective

Examine the adoption and presence of preterm, neuro-centric care practices across neonatal intensive care units (NICUs).

Study design

Statewide, cross-sectional survey of California NICUs. Data were collected surrounding the timing of adoption and presence of delivery room practices, nursing protocols, provider management practices and quality improvement initiatives.

Result

Among the 95 NICUs completing the survey (65%), adoption of all surveyed practices increased between 2005 and 2016, though rates of uptake changed over time and varied by practice. Adoption of indomethacin prophylaxis increased 1.8-fold, whereas delayed cord clamping increased 78-fold. Adoption of premedication for intubation and a patent ductus arteriosus management algorithm differed by unit level. Additionally, two underlying practice domains were identified; adoption of delivery room practices and adoption of any preterm practice.

Conclusion

Adoption of preterm, neuro-centric care practices across California NICUs has increased, though uptake patterns vary by practice and level.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others

References

  1. Bonifacio SL, Glass HC, Peloquin S, Ferriero DM. A new neurological focus in neonatal intensive care. Nat Rev Neurol. 2011;7:485–94.

    Article  Google Scholar 

  2. Romantsik O, Calevo MG, Bruschettini M. Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular hemorrhage in preterm infants. Cochrane Database Syst Rev. 2017;7:Cd012362.

    PubMed  Google Scholar 

  3. Rabe H, Diaz-Rossello JL, Duley L, Dowswell T. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev. 2012;8:Cd003248.

  4. Symington A, Pinelli J. Developmental care for promoting development and preventing morbidity in preterm infants. Cochrane Database Syst Rev. 2006;2:Cd001814.

  5. Liu WF, Laudert S, Perkins B, Macmillan-York E, Martin S, Graven S. The development of potentially better practices to support the neurodevelopment of infants in the NICU. J Perinatol. 2007;27(Suppl 2):S48–74.

    Article  Google Scholar 

  6. Laudert S, Liu WF, Blackington S, Perkins B, Martin S, Macmillan-York E, et al. Implementing potentially better practices to support the neurodevelopment of infants in the NICU. J Perinatol. 2007;27(Suppl 2):S75–93.

    Article  Google Scholar 

  7. California Perinatal Quality Care Collaborative. Regional Perinatal Programs of California [Internet]. [Cited 27 March 2018] Available from: https://www.cpqcc.org/perinatal-programs/regional-perinatal-programs-california.

  8. Sabri K, Woodward MA, Easterbrook B, Shivananda S. Retinopathy of prematurity practices: a national survey of Canadian neonatal intensive care units. J Perinatol. 2018;38:381–5.

    Article  Google Scholar 

  9. Mukerji A, Shah PS, Shivananda S, Yee W, Read B, Minski J, et al. Survey of noninvasive respiratory support practices in Canadian neonatal intensive care units. Acta Paediatr. 2017;106:387–93.

    Article  Google Scholar 

  10. Shah NA, Van Meurs KP, Davis AS. Amplitude-integrated electroencephalography: a survey of practices in the United States. Am J Perinatol. 2015;32:755–60.

    PubMed  Google Scholar 

  11. Rabe H, Reynolds G, Diaz-Rossello J. Early versus delayed umbilical cord clamping in preterm infants. Cochrane Database Syst Rev. 2004;4:Cd003248.

  12. Perlman JM, Wyllie J, Kattwinkel J, Atkins DL, Chameides L, Goldsmith JP, et al. Part 11: Neonatal resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010;122(16Suppl 2):S516–38.

    Article  Google Scholar 

  13. American Academy of Pediatrics and American Heart Association. Textbook of neonatal resuscitation. 7th ed. Elk Grove Village, Illinois, USA: American Academy of Pediatrics; 2016.

    Google Scholar 

  14. California Perinatal Quality Care Collaborative. Delayed Cord Clamping Project (DCCP): Data and implementation. [Cited 9 April 2018]. Available from: https://www.cpqcc.org/DCCPP.

  15. Handley SC, Passarella M, Lee HC, Lorch SA. Incidence trends and risk factor variation in severe intraventricular hemorrhage across a population based cohort. J Pediatr. 2018;200:24–9.

    Article  Google Scholar 

  16. DeMauro SB, Douglas E, Karp K, Schmidt B, Patel J, Kronberger A, et al. Improving delivery room management for very preterm infants. Pediatrics. 2013;132:e1018–25.

    Article  Google Scholar 

  17. Lee HC, Powers RJ, Bennett MV, Finer NN, Halamek LP, Nisbet C, et al. Implementation methods for delivery room management: a quality improvement comparison study. Pediatrics. 2014;134:e1378–86.

    Article  Google Scholar 

  18. Kumar P, Denson SE, Mancuso TJ. Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics. 2010;125:608–15.

    Article  Google Scholar 

  19. Sauer CW, Kong JY, Vaucher YE, Finer N, Proudfoot JA, Boutin MA, et al. Intubation attempts increase the risk for severe intraventricular hemorrhage in preterm infants-A Retrospective Cohort Study. J Pediatr. 2016;177:108–13.

    Article  Google Scholar 

  20. Wallenstein MB, Birnie KL, Arain YH, Yang W, Yamada NK, Huffman LC, et al. Failed endotracheal intubation and adverse outcomes among extremely low birth weight infants. J Perinatol. 2016;36:112–5.

    Article  CAS  Google Scholar 

  21. Phibbs CS, Baker LC, Caughey AB, Danielsen B, Schmitt SK, Phibbs RH. Level and volume of neonatal intensive care and mortality in very-low-birth-weight infants. N Eng J Med. 2007;356:2165–75.

    Article  CAS  Google Scholar 

  22. Lorch SA, Baiocchi M, Ahlberg CE, Small DS. The differential impact of delivery hospital on the outcomes of premature infants. Pediatrics. 2012;130:270–8.

    Article  Google Scholar 

  23. Jensen EA, Lorch SA. Effects of a birth hospital’s neonatal intensive care unit level and annual volume of very low-birth-weight infant deliveries on morbidity and mortality. JAMA Pediatr. 2015;169:e151906.

    Article  Google Scholar 

  24. American Academy of Pediatrics Committee of Fetus and Newborn. Levels of neonatal care. Pediatrics. 2012;130:587–97.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to recognize all the NICUs across California who completed the survey. We would also acknowledge the National Institutes of Health (T32HD007440 [to SH]) and The Children’s Hospital of Philadelphia for supporting this research.

Funding

Supported by the National Institutes of Health (T32HD007440 [to SH]) and The Children’s Hospital of Philadelphia.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Sara C. Handley, Molly Passarella & Scott A. Lorch

  2. Leonard Davis Institute of Health Economics, The Wharton School, The University of Pennsylvania, Philadelphia, PA, USA

    Sara C. Handley & Scott A. Lorch

  3. Center for Perinatal and Pediatric Health Disparities Research, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Molly Passarella & Scott A. Lorch

  4. Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA

    Henry C. Lee

  5. California Perinatal Quality Care Collaborative (CPQCC), Stanford, CA, USA

    Henry C. Lee

Authors
  1. Sara C. Handley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Molly Passarella
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Scott A. Lorch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Henry C. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sara C. Handley.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Handley, S.C., Passarella, M., Lorch, S.A. et al. Survey of preterm neuro-centric care practices in California neonatal intensive care units. J Perinatol 39, 256–262 (2019). https://doi.org/10.1038/s41372-018-0283-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-018-0283-8

This article is cited by

Search

Advanced search

Quick links