PQCNC HM NCCC Track Learning Session 3

8/3/2019 PQCNC HM NCCC Track Learning Session 3

1/32

Click to edit Master subtitle style

Review of EHM NICUOctober 2010-October 2011


2/32


3/32

EHM NICU

Expert Team Met June-September 2010 Identified patient population and scope of

project (VLBW Infants and < 28 Days) Claimed our Aim

A 50% increase in the use of ExclusiveHuman Milk in NICUs

Developed Action Plan S2S Discussing BM use with mother

Documenting milk production (500 cc/day at 2weeks)


4/32

EHM NICU

Action Plan Skin to Skin Documenting provider discussing BM use with

mother Documenting milk production (500 cc/day at 2

weeks) Frequency of mothers use of a breast pump Protein supplementation of breast milk Feeding at discharge


5/32

EHM NICU

1st Learning Session (Jan 2011) Action plan overview Team building Establishing milk supply Developing feeding protocols

2nd Learning Session (May 2011)

Kangaroo care Pumping and Nursing

Weekly email newsletters

Monthly webinar meetings


6/32


7/32

EHM NICU Discharges

0

2

4

6

8

10

12

Discharges


8/32

Pumping 500 cc/Day in Week 2


9/32

MD or NNP Discussed BreastMilk Use


10/32


11/32

Frequency of Skin to Skin


12/32


13/32

Early Use of Parenteral Protein


14/32

Mothers Milk Fortified Between8-13 DOL


15/32

Adding Enteral Protein by DOL 14


16/32


17/32

Exclusive Human Milk First 3DOL


18/32


19/32

Any Human Milk First 3 DOL


20/32


21/32

Only Human Milk for First 28DOL


22/32


23/32

Formula Feedings in First 28DOL


24/32

TEAMWORK


25/32

TEAMWORK

Alone we can do

so little, together wecan do so much.

Helen Keller


26/32

Think Big


27/32

Why Think Big?

The work you have done The work you will do What other people think about your work

AHA DMA DPH

State Legislature BCBS and the Office for Rural Health and

Community Care


28/32

Phase 2 EHM NICU

Based on evidence Based on accumulated experience Combine this initiative with ongoing

projects Develop a focused action plan

Getting to 500cc, human milk in the first 3

days, at least one skin to skin session, momhas a pump, type of feeding

Key focus period: 3D, 7D, 14D, 28D, DC??


29/32

Phase 2 EHM NICU

Develop a data set Every patient Manageable

Supports the workis not the work


30/32

Potential New Data Collection Tool

Was there a discussion held with the mother by the MD or NNP re: theimportance of human milk either preantally or within the first 24 hours afteradmission of the baby?

Y _____ N _____ Unk _____

First day of enteral feeding? Date (or day/hour of life)

Type of milk used for first feeding?

MM _____ DM _____ formula _____

Day 7, 14, 21 and 28:1. Volume of feeding for last 24 hours: MM _____ DM _____ Formula _____

2. How many sessions of STS occurred in the past week?

Then the discharge info as we have on our current data sheet


31/32

Inference Engine

ClinicalDataRepository(CDR)

User

Knowledge Base

Event Monitor

NotifierRecipient(s)

Clinical Decision Support


32/32

Think Big

Documents

PQCNC HM NCCC Track Learning Session 3