Implementation of the Golden Hour for Preterm Infants : a Quality Improvement Study

Study Overview
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Brief Summary
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Effective initial stabilization of preterm neonates in the initial 60 minutes of life (golden hour) was shown to improve outcomes. Keys components include anticipative and collaborative approach, respiratory support, thermal regulation and early initiation of parenteral nutrition. The objective is to complete the admission within 60 minutes of delivery.

Official Title
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Implementation of the Golden Hour, an Initial Standardized Stabilization of Preterm Less Than 31 Weeks and/or 1300 g : a Quality Improvement Study

Conditions
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Premature Birth

Intervention / Treatment
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* Other: golden hour : an initial standardized stabilization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Premature infants (< 31 weeks' gestation) Infants with expected weight less than 1300 g Inborn babies Exclusion Criteria: Infants outborn Infants with major congenital anomalies (laparoschisis, omphalocèle, diaphragmatic hernia, …) Parental refusal

Ages Eligible for Study
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Maximum Age: 1 Hour

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| premature infants<br>premature infants less than 31 weeks of gestation or weighting less than 1300 g | Other: golden hour : an initial standardized stabilization<br>* This is a quality improvement project to evaluate the implementation of Golden hour, a standardized stabilization during the first hour of life in inborn preterm infants younger than 31 weeks of gestational age or weighting less than 1300 g in the NICU of the University of Liege. There is no comparative arm.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Completion of the procedure : closing time of the incubator | Number of minutes of life at incubator closure | 1 hour | 
| Glycemia at admission and within 24 hours | blood glucose measurement on admission and then every 3 hours for the first 24 hours of life | 24 hours | 
| Thermal stability : temperature at admission and at the end of the procedure |  | 1 hour | 
| Mortality rate |  | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Process of the procedure: | Number of minutes of life at initiation of parenteral nutrition, caffeine and antibiotics administration. | 1 hour | 
| Incidence of hypotension and bradycardia |  | 1 hour | 
| Intubation rate and duration of mechanical ventilation | Number of hours of mechanical ventilation | 3 months | 
| Need for surfactant administration and time of administration | Number of hours of life at surfactant administration | 3 days | 
| Comorbidities of prematurity: NEC, BPD, ROP, sepsis, PDA, cPVL, IVH |  | 3 months | 
| Duration of hospital stay (only if no transfer) |  | 3 months | 
| Caregiver's perception of the procedure: stress… | use of a questionnaire adapted from the Teamwork Perceptions Questionnaire (T-TPQ) | 24 hours | 
| Parental experience of the procedure |  | 24 hours | 
| Conditions of the procedure : realization during the night shift and team composition | collection of the time and date of performance and the number of nurses, doctors, fellows,... | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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premature birth, golden hour, 60 minutes