A multifaceted collaborative quality improvement intervention significantly improves delivery of surfactant therapy for preterm infants

Abstract

QuestionDoes a multifaceted collaborative quality improvement intervention increase surfactant use and improve outcomes for preterm infants in neonatal intensive care units?Study designRandomised controlled trial.Main resultsHospitals enrolled in the multifaceted quality improvement intervention had significantly higher rates of surfactant use compared with control hospitals (see results table). Infants born in intervention hospitals received the first dose of surfactant sooner than infants born in control hospitals (median time to first dose: 18 minutes in intervention hospitals v 75 minutes in control hospitals). Although there were no significant differences in rates of death or pneumothorax, there was a trend towards a decrease in the incidence of pneumothorax in preterm infants transferred to hospitals participating in the intervention (OR 0.6, 95%CI 0.3 to 1.0).Authors’ conclusionsA multifaceted intervention designed to promote change, evidence-based practice, systems thinking and collaborative learning significantly improved surfactant use for preterm infants in neonatal intensive care units. Improved surfactant use did not significantly reduce the rates of death and pneumothorax in this study.