Inside Pediatrics Spring 2018

Under the Global Network, UAB/ Children’s researchers have led

seminal investigations of resuscitation and essential newborn care in 100 communities in six countries, which included almost 200,000 infants. These trials established the effectiveness of these interventions in reducing stillbirths and neonatal mortality, and led to worldwide implementation of training, including the globally implemented Helping Babies Breathe Program and the Essential Care for Every Baby Program launched in 2014. The programs have been introduced in more than 75 countries to save babies’ lives at birth, with the potential to reduce infant deaths soon after birth by 1 million. “It should save a million lives every single year at almost no cost,” Carlo said of the programs. “It will save the most lives in the world.” Quality Improvement Advances Patients in the Children’s NICU represent a complex patient mix. Children’s NICU is Alabama’s only extracorporeal membrane oxygenation (ECMO) provider and a designated Platinum Level Center of Excellence by the Extracorporeal Life Support Organization (ELSO). Children’s NICU is also the primary provider in the state for dialysis, tracheostomy, neurosurgical support, craniofacial surgery and jaw distractions, and a major contributor to the Home Ventilator Program. Coghill said the unit participates in multiple research and quality improvement projects through the Children’s Hospital National Consortium (CHNC) and Solutions for Patient Safety (SPS). In 2017, the unit experienced a 40 percent reduction in central line associated blood stream infections (CLABSIs) using care bundles. Allison Black, M.D., UAB assistant professor of pediatrics and associate medical director of Children’s NICU, leads

Namasivayam Ambalavanan, M.D., left, and Wally Carlo, M.D., Edwin M. Dixon Endowed Chair in Neonatology are co-directors of the UAB Division of Neonatology at Children’s of Alabama.

100 percent, and the number of infants returning from the operating room with temperature instability has decreased from 28 percent to 4 percent. “The focus of neonatal care at Children’s becomes more complex every year as smaller and smaller infants survive and care advances for more and more formally fatal illnesses,” Coghill said. “Optimization of care will require more involvement of families, and the NICU has followed the hospital’s lead in moving to family-centered rounds to get input from those who spend the

another major project through the CHNC — the Safe Transitions and Euthermia in the Perioperative Period in Infants and Neonates, or STEPP-IN. “This project promotes smooth transitions and improved communication by utilizing a specific work flow for surgical patients that includes face-to-face handoff between the surgical, anesthesia and NICU team members both pre-and post-surgery. Through this project we have improved stability and care during the critical perioperative period in some of our sickest patients,” Black said. Since Children’s initiated STEPP-IN in the summer of 2017, the percentage of patients having formal face-to- face communication between care providers has increased from 60 to

most time with the patient.” For more information, visit childrensal.org/neonatology .

The Regional Neonatal Intensive Care Unit at UAB Women & Infants Center, together with Children’s of Alabama, offers the only Level IV NICU in Alabama — which, according to American Academy of Pediatrics guidelines, provides the highest andmost comprehensive level of care available. Combined Level IV NICU beds at UAB and Children’s total as many as 175.

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