ArticleJournal of perinatology : official journal of the California Perinatal Association2014
Reducing necrotizing enterocolitis in very low birth weight infants using quality-improvement methods.
Article in Journal of perinatology : official journal of the California Perinatal Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Investigating the implementation of infection prevention and control practices in neonatal care across country income levels: a systematic review.Antimicrobial resistance and infection control · 2025Pooled it
- Quality improvement interventions to prevent neonatal necrotizing enterocolitis: a systematic review.Frontiers in pediatrics · 2025Pooled it
- Pooled it
- Standardized feeding regimen for reducing necrotizing enterocolitis in preterm infants: an updated systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2017Pooled it
- Neonatal Intensive Care Admissions and Outcomes in Malta from 2019 to 2022-A Retrospective Observational Study.Children (Basel, Switzerland) · 2026Article
- A Multi-Center Survey of Necrotizing Enterocolitis Prevention Strategies in Very Low Birth Weight Infants.Pediatric health, medicine and therapeutics · 2025Article
- Used Nasogastric Feeding Tubes from Neonates Contain Infant-Specific Bacterial Profiles.Microorganisms · 2023Article
- Standardizing the Evaluation and Management of Necrotizing Enterocolitis in a Level IV NICU.Pediatrics · 2022Article
- Advancements in neonatology through quality improvement.Journal of perinatology : official journal of the California Perinatal Association · 2022Review
- Racial/ethnic disparities and human milk use in necrotizing enterocolitis.Pediatric research · 2020Article
- Grading the evidence to identify strategies to modify risk for necrotizing enterocolitis.Pediatric research · 2020Review
- Relationship of Necrotizing Enterocolitis Rates to Adoption of Prevention Practices in US Neonatal Intensive Care Units.Advances in neonatal care : official journal of the National Association of Neonatal Nurses · 2019Article
- Risk of Necrotizing Enterocolitis Following Packed Red Blood Cell Transfusion in Very Low Birth Weight Infants.Indian journal of pediatrics · 2019Article
- Bacterial colonization and antimicrobial resistance genes in neonatal enteral feeding tubes.FEMS microbiology ecology · 2019Article
- Reducing time to initiation and advancement of enteral feeding in an all-referral neonatal intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2018Article
- Influence of own mother's milk on bronchopulmonary dysplasia and costs.Archives of disease in childhood. Fetal and neonatal edition · 2017Article
- Elevated fecal calprotectin levels during necrotizing enterocolitis are associated with activated neutrophils extruding neutrophil extracellular traps.Journal of perinatology : official journal of the California Perinatal Association · 2016Article
- Nasogastric feeding tubes from a neonatal department yield high concentrations of potentially pathogenic bacteria- even 1 d after insertion.Pediatric research · 2016Observational
- Optimizing the Use of Antibacterial Agents in the Neonatal Period.Paediatric drugs · 2016Article
- Cost savings of human milk as a strategy to reduce the incidence of necrotizing enterocolitis in very low birth weight infants.Neonatology · 2015Observational
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectiveOwing to a rise in necrotizing enterocolitis (NEC, stage ⩾ 2) among very low birth weight (VLBW, birth weight <1500 g) infants from 4% in 2005 to 2006 to 10% in 2007 to 2008, we developed and implemented quality improvement (QI) initiatives. The objective was to evaluate the impact of QI initiatives on NEC incidence in VLBW infants. STUDY
designIn September 2009, we developed an NEC QI multidisciplinary team that conducted literature reviews and reviewed practices from other institutions to develop a feeding protocol, which was implemented in December 2009. The team tracked intervention compliance and occurrence of NEC stage ⩾ 2. In May 2010, we reviewed our nasogastric tube practice and relevant literature to develop a second intervention that reduced nasogastric tube indwelling time. The infants were divided into three groups: baseline (January 2008 to Novovember 2009, n219), QI phase 1 (December 2009 to May 2010, n62) and QI phase 2 (June 2010 to November 2011, n170).
resultThe NEC incidence did not decrease after implementation of the feeding protocol in QI phase 1 (19.4%) but did decline significantly after changing nasogastric tube management in QI phase 2 (2.9%). Multivariable logistic regression analysis demonstrated a significant relationship between QI phase and the incidence of NEC.
conclusionQI initiatives were effective in decreasing NEC incidence in our high human milk-feeding NICU. Nasogastric tube bacterial contamination may have contributed to our peak in NEC incidence.
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