Impact of a family-centered clinical care program on short term outcomes of very low birth weight infants.

Abstract

We evaluated the effects of a family-centered clinical care pathway and case management program on short term clinical outcome in a cohort of very low birth weight (VLBW) infants. The program, named NeoPAss, was developed at the Department of Neonatology Children´s hospital Passau in 2013. Short term outcomes of infants were compared to matched controls from the Bavarian neonatology surveillance database before (n=111; 2008-2012) and after implementation (n=170; 2014-2017). After implementation the rate of late-onset sepsis was significantly lower (2.5% vs. 10.7%, p=0.005) and the length of stay was significantly shorter (VLBW 28 to 31 weeks' gestational age (GA) 47.5 vs 53.1 days, p=0.047; <28 weeks' GA 79.4 vs. 91.9 days, p=0.007) in the intervention group compared to controls. Infants were discharged with significantly lower weight (mean 2,351g vs 2,539g, p=0.013). There was no statistical significant difference in the rate of intraventricular hemorrhage (3.7% vs. 8.2%), necrotizing enterocolitis (0.6% vs. 1.9%) and bronchopulmonary dysplasia (0% vs. 6.9%). Our data confirms that of other studies, demonstrating a beneficial effect of family-centered care programs and provides evidence that structured parental involvement is not associated with increased risk of infection in a VLBW cohort.