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dc.contributor.authorGephart, Sheila M
dc.contributor.authorQuinn, Megan C
dc.date.accessioned2019-08-30T23:19:44Z
dc.date.available2019-08-30T23:19:44Z
dc.date.issued2019-08
dc.identifier.citationGephart, S. M., & Quinn, M. C. (2019). Relationship of Necrotizing Enterocolitis Rates to Adoption of Prevention Practices in US Neonatal Intensive Care Units. Advances in Neonatal Care, 19(4), 321-332.en_US
dc.identifier.issn1536-0903
dc.identifier.pmid30893097
dc.identifier.doi10.1097/ANC.0000000000000592
dc.identifier.urihttp://hdl.handle.net/10150/634043
dc.description.abstractBackground: Applying quality improvement methods has reduced necrotizing enterocolitis (NEC) in some neonatal intensive care units (NICUs) by 40% to 90%. Purpose: This study was conducted to (1) examine relationships between adoption of prevention practices using the NEC-Zero adherence score and NEC rates, and (2) describe implementation strategies NICUs use to prevent NEC. Methods: A descriptive cross-sectional correlational study was completed among US quality improvement-focused NICUs. Relationships of the NEC-Zero adherence score to NEC rates were examined. Subgroup analyses explored relationships of a human milk adherence subscore and differences between high NEC rate (>= 8%) and low NEC rate (<= 2%) NICUs. Results: NICUs (N = 76) ranged in size from 18 to 114 beds. The mean adherence score was 7.3 (standard deviation = 1.7; range, 3-10). The 10-point adherence score was not related to the NEC rate. The human milk subscore related to lower NEC rates (Rho = -0.26, P = .049), as was colostrum for oral care (Rho = -0.27, P = .032). The units that used a feeding protocol showed higher NEC rates (Rho = 0.27, P = .03), although very few addressed the use of effective implementation strategies to track adherence or to ensure consistency among clinicians. The units that used colostrum for oral care were more likely to adopt strategies to limit inappropriate antibiotic exposure (Rho = 0.34, P = .003). Implications for Practice: Broader use of evidence-based implementation strategies could bolster delivery of NEC prevention practices. Maternal lactation support is paramount. Implications for Research: Future studies are needed to identify how individual clinicians deliver prevention practices, to find the extent to which this relates to overall delivery of prevention, and to study effects of bundles on NEC outcomes.en_US
dc.description.sponsorshipRobert Wood Johnson Foundation Nurse Faculty Scholars Program [72114]; Agency for Healthcare Research and Quality [K08HS022908]; Pacific Southwest Region of the National Network of Libraries of Medicineen_US
dc.language.isoenen_US
dc.publisherLIPPINCOTT WILLIAMS & WILKINSen_US
dc.rights© 2019 by The National Association of Neonatal Nurses.en_US
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/
dc.subjectadherence scoreen_US
dc.subjectbreastfeedingen_US
dc.subjecthuman milken_US
dc.subjecthuman milk expressionen_US
dc.subjectimplementation strategyen_US
dc.subjectnecrotizing enterocolitisen_US
dc.subjectNEC-Zeroen_US
dc.subjectquality improvementen_US
dc.subjectvariationsen_US
dc.subjectvery low birth-weight infanten_US
dc.titleRelationship of Necrotizing Enterocolitis Rates to Adoption of Prevention Practices in US Neonatal Intensive Care Unitsen_US
dc.typeArticleen_US
dc.contributor.departmentUniv Arizona, Coll Nursing, Community & Hlth Syst Sci Diven_US
dc.identifier.journalADVANCES IN NEONATAL CAREen_US
dc.description.note12 month embargo; published online: 31 August 2019en_US
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en_US
dc.eprint.versionFinal accepted manuscripten_US
dc.source.journaltitleAdvances in neonatal care : official journal of the National Association of Neonatal Nurses


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