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Objective <p>Reduce the proportion of eligible infants who leave the NICU with a decline in weight-for-age z-score &gt;1.0 SD by 20%.</p> Study design <p>Designed to engage NICUs with an average daily census ≤10.9, the California Perinatal Quality Care Collaborative conducted a quality improvement collaborative titled Growth Advancement in the NICU (GAIN) Ten Point Nine (10.9) among seven NICUs between 05/2021 and 07/2023. Inborn infants with a birthweight between 1500 and 2500 g and a minimum NICU stay of seven days were included. NICU teams took part in virtual monthly meetings and three half-day Learning Sessions.</p> Results <p>GAIN 10.9 achieved a 41.6% relative reduction in infants with z-score declines &gt; 1.0 SD. All seven NICUs adopted weight-based feeding guidelines and implemented weekly nutrition rounds.</p> Conclusions <p>A quality improvement initiative among low volume NICUs successfully reduced growth restriction in moderate or late preterm infants.</p>

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A quality improvement approach to growth in moderate and late preterm infants in small NICUs

  • 期刊论文

  • 发表日期：

    2026年5月18日

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  • Mindy Morris,
  • Jessica Liu,
  • Maria C. Hetherton,
  • Courtney C. Breault,
  • Anjali C. Dibner,
  • Jochen Profit,
  • Guadalupe Padilla

摘要

Objective

Reduce the proportion of eligible infants who leave the NICU with a decline in weight-for-age z-score >1.0 SD by 20%.

Study design

Designed to engage NICUs with an average daily census ≤10.9, the California Perinatal Quality Care Collaborative conducted a quality improvement collaborative titled Growth Advancement in the NICU (GAIN) Ten Point Nine (10.9) among seven NICUs between 05/2021 and 07/2023. Inborn infants with a birthweight between 1500 and 2500 g and a minimum NICU stay of seven days were included. NICU teams took part in virtual monthly meetings and three half-day Learning Sessions.

Results

GAIN 10.9 achieved a 41.6% relative reduction in infants with z-score declines > 1.0 SD. All seven NICUs adopted weight-based feeding guidelines and implemented weekly nutrition rounds.

Conclusions

A quality improvement initiative among low volume NICUs successfully reduced growth restriction in moderate or late preterm infants.