Reducing severe intraventricular haemorrhage rates in <26‐week preterm infants with bedside assessment and care bundle implementation

Abstract Aim To assess staff adherence to a ‘Preterm Brain Injury Prevention Bundle’, and its effectiveness in reducing severe intraventricular haemorrhage (IVH) rates and risk factors in extremely preterm infants born at <26 weeks' gestation. Methods Adherence to the bundle was assessed using a novel bedside assessment tool, with immediate feedback to bedside staff post‐assessment. Data on IVH rates and associated risk factors were stratified by IVH severity, and compared between pre‐ and post‐bundle implementation. Results Of 203 bedside assessments, good adherence was observed in 12/28 items (43%), while the remaining items required improvement. Rates of grade 3/4 IVH reduced (39.2% pre‐bundle vs. 19.0% post‐bundle, p = 0.13). Thermoregulation and base excess improved ( p = 0.02 and p = 0.04 respectively) after bundle implementation. Conclusion Reduced severe IVH rates post‐bundle implementation may be attributed to staff education and improved clinical parameters. Adherence to the bundle interventions varied which highlighted target areas for future education.