G119(P) The preterm quality of care (PQOC) group: using qi initiatives to improve patient care

Aim To continuously improve outcomes for preterm babies using the QI approach. Method The PQoC group is a team of neonatal doctors, ANNPs and nurses who audit the care of inborn babies less than 30 weeks gestation. The audit assesses multiple aspects of care, including: Frequency and indication for intubations Frequency and length of time for delayed cord clamping. Time for umbilical line placement, colostrum administration, and parent updates. The team presents the results through multiple forums including biannual ‘Awareness days’ which are a fun way to update and educate staff using presentations, competitions, simulations and bite-sized teaching. They are a platform for launching new initiatives and equipment and are accompanied by social media updates and emails for staff unable to attend. In December 2018 the PQoC group produced a lanyard card to help staff deliver more consistent care pre, during and post delivery. In October 2019, we have launched a re-useable ‘Checklist’ to be used at delivery with the aim to improve documentation and adherence to the guideline. If the guideline was not adhered to or documentation is incomplete, the care will be discussed with the team involved. Results The lanyard card was received very positively. 69% of colleagues reported that the lanyard card had changed the care they had provided to a preterm admission. In particular, the medical staff commented on how useful it is to have a prompt card to brief the team pre delivery and use for teaching. The nursing team reported feeling more confident at setting up the bedspace and getting umbilical lines ready. There was an improvement seen in the percentage of babies who received delayed cord clamping from 38% to 55% and the average time from 45 to 53 seconds. However, there were not significant improvements in other audited areas. We are awaiting results from the introduction of the ‘Checklist’. Conclusion The PQoC group are very passionate about providing preterm babies with optimal care from birth. We continuously strive to improve care through creating and evaluating different initiatives.