Benchmarking care for very low birthweight infants in Ireland and Northern Ireland.

Hdl Handle:
http://hdl.handle.net/10147/206224
Title:
Benchmarking care for very low birthweight infants in Ireland and Northern Ireland.
Authors:
Murphy, B P; Armstrong, K; Ryan, C A; Jenkins, J G
Affiliation:
Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork,, Ireland. brendanpaul.murphy@hse.ie
Citation:
Arch Dis Child Fetal Neonatal Ed. 2010 Jan;95(1):F30-5. Epub 2009 Aug 31.
Journal:
Archives of disease in childhood. Fetal and neonatal edition
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206224
DOI:
10.1136/adc.2009.160002
PubMed ID:
19723619
Abstract:
BACKGROUND: Benchmarking is that process through which best practice is identified and continuous quality improvement pursued through comparison and sharing. The Vermont Oxford Neonatal Network (VON) is the largest international external reference centre for very low birth weight (VLBW) infants. This report from 2004-7 compares survival and morbidity throughout Ireland and benchmarks these results against VON. METHODS: A standardised VON database for VLBW infants was created in 14 participating centres across Ireland and Northern Ireland. RESULTS: Data on 716 babies were submitted in 2004, increasing to 796 babies in 2007, with centres caring for from 10 to 120 VLBW infants per year. In 2007, mortality rates in VLBW infants varied from 4% to 19%. Standardised mortality ratios indicate that the number of deaths observed was not significantly different from the number expected, based on the characteristics of infants treated. There was no difference in the incidence of severe intraventricular haemorrhage between all-Ireland and VON groups (5% vs 6%, respectively). All-Ireland rates for chronic lung disease (CLD; 15-21%) remained lower than rates seen in the VON group (24-28%). The rates of late onset nosocomial infection in the all-Ireland group (25-26%) remained double those in the VON group (12-13%). DISCUSSION: This is the first all-Ireland international benchmarking report in any medical specialty. Survival, severe intraventricular haemorrhage and CLD compare favourably with international standards, but rates of nosocomial infection in neonatal units are concerning. Benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning neonatal intensive care service provision.
Language:
eng
MeSH:
*Benchmarking; Cerebral Hemorrhage/epidemiology; Chronic Disease; Cross Infection/epidemiology; Data Collection/methods; Databases, Factual; Female; Gestational Age; Hospitalization/statistics & numerical data; Humans; *Infant Mortality; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases/*epidemiology/therapy; *Infant, Very Low Birth Weight; Intensive Care, Neonatal/*standards; Ireland; Lung Diseases/epidemiology/therapy; Male; Morbidity; Northern Ireland; Outcome Assessment (Health Care); Staphylococcal Infections/epidemiology
ISSN:
1468-2052 (Electronic); 1359-2998 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMurphy, B Pen_GB
dc.contributor.authorArmstrong, Ken_GB
dc.contributor.authorRyan, C Aen_GB
dc.contributor.authorJenkins, J Gen_GB
dc.date.accessioned2012-01-31T16:42:14Z-
dc.date.available2012-01-31T16:42:14Z-
dc.date.issued2012-01-31T16:42:14Z-
dc.identifier.citationArch Dis Child Fetal Neonatal Ed. 2010 Jan;95(1):F30-5. Epub 2009 Aug 31.en_GB
dc.identifier.issn1468-2052 (Electronic)en_GB
dc.identifier.issn1359-2998 (Linking)en_GB
dc.identifier.pmid19723619en_GB
dc.identifier.doi10.1136/adc.2009.160002en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206224-
dc.description.abstractBACKGROUND: Benchmarking is that process through which best practice is identified and continuous quality improvement pursued through comparison and sharing. The Vermont Oxford Neonatal Network (VON) is the largest international external reference centre for very low birth weight (VLBW) infants. This report from 2004-7 compares survival and morbidity throughout Ireland and benchmarks these results against VON. METHODS: A standardised VON database for VLBW infants was created in 14 participating centres across Ireland and Northern Ireland. RESULTS: Data on 716 babies were submitted in 2004, increasing to 796 babies in 2007, with centres caring for from 10 to 120 VLBW infants per year. In 2007, mortality rates in VLBW infants varied from 4% to 19%. Standardised mortality ratios indicate that the number of deaths observed was not significantly different from the number expected, based on the characteristics of infants treated. There was no difference in the incidence of severe intraventricular haemorrhage between all-Ireland and VON groups (5% vs 6%, respectively). All-Ireland rates for chronic lung disease (CLD; 15-21%) remained lower than rates seen in the VON group (24-28%). The rates of late onset nosocomial infection in the all-Ireland group (25-26%) remained double those in the VON group (12-13%). DISCUSSION: This is the first all-Ireland international benchmarking report in any medical specialty. Survival, severe intraventricular haemorrhage and CLD compare favourably with international standards, but rates of nosocomial infection in neonatal units are concerning. Benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning neonatal intensive care service provision.en_GB
dc.language.isoengen_GB
dc.subject.mesh*Benchmarkingen_GB
dc.subject.meshCerebral Hemorrhage/epidemiologyen_GB
dc.subject.meshChronic Diseaseen_GB
dc.subject.meshCross Infection/epidemiologyen_GB
dc.subject.meshData Collection/methodsen_GB
dc.subject.meshDatabases, Factualen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGestational Ageen_GB
dc.subject.meshHospitalization/statistics & numerical dataen_GB
dc.subject.meshHumansen_GB
dc.subject.mesh*Infant Mortalityen_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshInfant, Prematureen_GB
dc.subject.meshInfant, Premature, Diseases/*epidemiology/therapyen_GB
dc.subject.mesh*Infant, Very Low Birth Weighten_GB
dc.subject.meshIntensive Care, Neonatal/*standardsen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshLung Diseases/epidemiology/therapyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMorbidityen_GB
dc.subject.meshNorthern Irelanden_GB
dc.subject.meshOutcome Assessment (Health Care)en_GB
dc.subject.meshStaphylococcal Infections/epidemiologyen_GB
dc.titleBenchmarking care for very low birthweight infants in Ireland and Northern Ireland.en_GB
dc.contributor.departmentDepartment of Neonatology, Cork University Maternity Hospital, Wilton, Cork,, Ireland. brendanpaul.murphy@hse.ieen_GB
dc.identifier.journalArchives of disease in childhood. Fetal and neonatal editionen_GB
dc.description.provinceMunster-

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