{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:27:32Z","timestamp":1788305252076,"version":"build-2803163510"},"reference-count":23,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Quality improvement (QI) interventions may reduce the incidence and severity of Intraventricular Hemorrhage (IVH) in the population of inborn micropremature infants (born at \u226426 weeks\u2019 gestation) with the goal of improving outcomes in this high-risk population. Methods: A multidisciplinary team reviewed the current literature to develop a site-specific brain protective bundle. Baseline data were collected from June 2014 to February 2015, with interventions occurring from March 2015 to December 2015. The period of sustainability was assessed from January 2016 to December 2023. Control charts were used to analyze the effect of the interventions. Outcome measures included all grades of IVH, periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC), and spontaneous intestinal perforations (SIP). Results: Brain care initiatives decrease the rate of severe IVH in the inborn micropremature infant population from a baseline of 21% to 6.45% with a sustained rate of 4.5% with no change to balancing measures. Conclusions: Brain-protective initiatives such as midline head positioning and minimal handling are associated with a significant and sustained reduction in severe IVH among inborn micropremature infants.<\/jats:p>","DOI":"10.3390\/children12030264","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:12:11Z","timestamp":1740132731000},"page":"264","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sustained Reduction in Severe Intraventricular Hemorrhage in Micropremature Infants: A Quality Improvement Intervention"],"prefix":"10.3390","volume":"12","author":[{"given":"Sabrina E.","family":"Wong","sequence":"first","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Sampson","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3908-4147","authenticated-orcid":false,"given":"Michael","family":"Dunn","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3399-0130","authenticated-orcid":false,"given":"Asaph","family":"Rolnitsky","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4329-8401","authenticated-orcid":false,"given":"Eugene","family":"Ng","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1542\/peds.2015-0944","article-title":"Periventricular\/Intraventricular Hemorrhage and Neurodevelopmental Outcomes: A Meta-analysis","volume":"136","author":"Mukerji","year":"2015","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Persad, N., Kelly, E., Amaral, N., Neish, A., Cheng, C., Fan, C.S., Runeckles, K., and Shah, V. 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