"Golden Hour" quality improvement intervention and short-term outcome among preterm infants

J Perinatol. 2019 Mar;39(3):387-392. doi: 10.1038/s41372-018-0254-0. Epub 2018 Oct 19.

Abstract

Objective: To evaluate the impact of a quality improvement intervention during the first hour of life ("Golden Hour") on short-term preterm neonatal outcome.

Study design: A comprehensive protocol designed for initial stabilization and treatment of preterm infants that included cord blood sampling, use of a dedicated resuscitation room and improved team communication using Crew Resource Management tools. The infants admitted before and after implementation of the protocol were retrospectively compared in a matched case-control design.

Results: There were 194 infants in the intervention group and 194 controls. Admission temperatures improved significantly from a mean of 35.26 °C to 36.26 °C (P < 0.001), and late-onset sepsis and bronchopulmonary dysplasia rates lowered significantly (P = 0.035 and P = 0.028, respectively) in the intervention group. There was trend towards reduction in early blood transfusion and ventilation duration.

Conclusions: A "Golden Hour" quality improvement intervention was of significant benefit for preterm neonates. Further follow-up to assess long-term effects is warranted.

MeSH terms

  • Blood Transfusion
  • Body Temperature*
  • Bronchopulmonary Dysplasia / prevention & control*
  • Case-Control Studies
  • Clinical Protocols
  • Female
  • Gestational Age
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Infant, Premature*
  • Israel
  • Male
  • Neonatal Sepsis / prevention & control*
  • Neonatology / methods*
  • Positive-Pressure Respiration
  • Quality Improvement*
  • Tertiary Care Centers
  • Time-to-Treatment