Standardizing the diagnosis of necrotizing enterocolitis in infants with congenital heart disease

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发表日期：

2024年9月12日

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Margot Hillyer,
Michael Fundora,
Feifei Williams,
Michelle Gleason,
Mary Lukacs,
Shannon Hamrick,
Jonathan Meisel,
Shanelle Clarke,
Natalie Korcinsky-Tillman,
Nikhil Chanani

摘要

Objective

This quality improvement initiative aimed to standardize the diagnosis of necrotizing enterocolitis (NEC) in infants with congenital heart disease (CHD).

Study design

A multidisciplinary team developed clinical practice guidelines for the diagnosis and treatment of NEC within the Cardiac Intensive Care Unit (CICU). The diagnosis rate of NEC per 100 at-risk admissions was the primary outcome measure. NEC order set usage was employed as a process measure, and the balancing measures monitored were CICU length of stay (LOS) and mortality.

Result

After guideline development and implementation, the diagnosis rate of NEC decreased from 3% to 1%, sustained over three years. The EMR order set enabled guideline integration into daily workflow. No change was noted in CICU LOS or mortality.

Conclusion

Guideline implementation standardized the diagnosis of NEC in infants with CHD. Establishing a standardized definition and subsequent treatment regimen has enabled us to provide more consistent and appropriate care.