Interdisciplinary Teamwork Saves Lives of Premature Babies

Problem

Necrotizing enterocolitis (NEC) is an acquired gastrointestinal disease associated with significant morbidity and mortality in premature infants, especially those with a birth weight of less than 1500 grams. The national incidence of NEC in babies who weigh less than 1500 grams at birth is reported to be approximately 12 percent. Despite the adoption of nationally recognized evidence-based practices, the NEC rate in Dell Children’s NICU still remained relatively high at 22 percent.

The goal of this project was to decrease the rate of NEC in babies born at a birth weight of less than 1500 grams or at less than 32 weeks gestation to below the national benchmark of 12 percent.

Intervention

Pictured from left to right: Aimee Deriggi, BSN, RN, Sheila Stephens, BSN, RN, Marcie Moynihan, MSN, RN, CNS, Taimur Zeb, MD, Neonatologist, Becky Roberson, RN, NICU case manager Kenna Hamm, LMSW, perinatal social worker and Jennifer Robles, BSN, RN.

Pictured from left to right: Aimee Deriggi, BSN, RN, Sheila Stephens, BSN, RN, Marcie Moynihan, MSN, RN, CNS, Taimur Zeb, MD, Neonatologist, Becky Roberson, RN, NICU case manager Kenna Hamm, LMSW, perinatal social worker and Jennifer Robles, BSN, RN.

Dell Children’s Neonatal Nutrition Committee (NNC), a multidisciplinary team of internal neonatal experts, including neonatologists, a neonatal nurse practitioner, a neonatal intensive care unit (NICU) pharmacist, NICU nutritionists and a NICU clinical nurse specialist, reviewed literature that included compelling evidence that using probiotics with premature babies in the NICU resulted in significant drops in NEC rates.

The NNC recommended that DCMC’s NICU adopt the routine use of probiotics for eligible premature babies and garnered support from medical providers. In response, the NICU developed a protocol for the safe and effective use of the selected probiotic product, including a comprehensive rollout and education plan for physicians, nurses and dietitians.

The NNC obtained approval for probiotic use by the Pediatric Pharmaceuticals and Therapeutics Committee and Infection Control Committee and initiated the practice.

Results

Since the intervention was adopted, NEC rates at Dell Children’s NICU have dramatically decreased by 100 percent. In fact, the NEC rate has dropped to zero.