Objective To investigate the effect of the quality improvement program on high-risk infants follow up (HRIF) clinic, in order to provide reference for improving the multidisciplinary follow-up system for high-risk preterm infants. Methods A total of 268 infants with gestational age<32 weeks or birth weight<1 500 g discharged from Tongji Hospital were recruited in a high-risk infant follow-up program from July 1st 2017 to July 31st 2018.Infants discharged in early period were defined as control group (n=185) and those discharged later were selected as intervention group (n=83).The control group was given conventional discharge guidance, while the intervention group received multidisciplinary HRIF.The follow-up rates of two groups at the corrected age of 1, 3, 6 months and Gesell score at the age of 6 months were compared. Results The follow-up rate of the intervention group and control group was not significantly different at the corrected age of 1 month(P>0.05), but the difference was significant at the age of 3 months and 6 months(χ2=5.307, 7.965, P<0.05).Infants in the intervention group had higher scores of cognitive and social functions assessed by Gesell scale at the corrected aged of six months (t=2.719, 3.661, P<0.05).Infants, who took regular follow-up at the corrected age of 1, 3, 6 months, had higher score in gross motor development and cognitive function than those without regular follow-up (F=8.486, 7.056, P<0.05). Conclusion The follow-up quality improvement program for high-risk infants increases the follow-up rate and indirectly facilitate the neurodevelopment of premature infants.
Key words
high-risk premature infants /
premature infants /
newborn /
follow up /
quality improvement
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References
[1] Fanaroff AA, Hack M, Walsh MC.The NICHD neonatal research network:changes in practice and outcomes during the first 15 years[J].Semin Perinatol, 2003, 27(4):281-287.
[2] You D, Hug L, Ejdemyr S, et al.Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030:a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation[J].Lancet, 2015, 386(10010):2275-2286.
[3] Marmot M, Friel S, Bell R, et al.Closing the gap in a generation:health equity through action on the social determinants of health[J].Lancet, 2008, 372(9650):1661-1669.
[4] Cavalier S, Escobar GJ, Fernbach SA, et al.Postdischarge Utilization of Medical Services by High-risk Infants:Experience in a Large Managed Care Organization[J].Pediatrics, 1996, 97(5):693-699.
[5] Poon WB, Ho SK, Yeo CL.Short- and long term outcomes at 2, 5 and 8 years old for neonates at borderline viability-an 11-year exeprience[J].Ann Acad Med Singapore, 2013, 42(1):7-17.
[6] Betty Vohr, Linda LW, Maureen H, et al.Follow-up care of high-risk infants[J].Pediatrics, 2004, 114(Suppl 5):1377-1397.
[7] 中国医师协会儿童健康专业委员会第一届儿童早期健康发展专业委员会, 西安医学会新生儿学分会.早产儿出院后随访及管理建议[J].中国妇幼健康研究, 2019, 30(9):1048-1052.
[8] Committee on fetus and newborn.hospital discharge of the high-risk neonate[J].Pediatrics, 2008, 122(5):1119-1126.
[9] Wang CJ, McGlynn EA, Brook RH, et al.Quality-of-care indicators for the neurodevelopmental follow-up of very low birth weight children:results of an expert panel process[J].Pediatrics, 2006, 117(6):2080-2092
[10] Doyle LW, Anderson PJ, Battin M, et al.Long term follow up of high risk children:who, why and how?[J].BMC Pediatr, 2014, 14:279.
[11] Kuppala VS, Tabangin M, Haberman B, et al.Curren state of high-risk infant folloew-up care in the United Sates:results of a national survey of academic follow-up program[J].J Perinatol, 2012, 32(4):293-298.
[12] Robert MK Joseph SG.Nelson textbook of pediatrics[M].21st Edition.Elsevier Health Sciences, 2020.
[13] 邓红岩, 邹秋艳, 陈玲, 等.张家港市高危儿随访现况分析[J].现代预防医学, 2018, 45(6):1016-1018.
[14] Mirnia K, Akrami F, Jodeiry B, et al.Clinical outcomes of high-risk infant follow-up program in a tertiary care Centre[J].Iran J Nurs Midwifery Res, 2017, 22(6):476-480.
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