Improving preoperative identification of infants at risk for severe retinopathy of prematurity

Abstract

Objective: To increase preoperative identification of at-risk infants for severe Retinopathy of prematurity (ROP) to >95% by August 2016, with a secondary aim of reducing the number of infants with 100% intraoperative peripheral oxygen saturation (SpO₂) during the same time.

Study design: Prospective quality improvement project centered on preterm surgical infants admitted to Primary Children's Hospital (n = 41). Preoperative ROP risk identification rates were analyzed using an annotated run chart, intraoperative SpO₂ and laser intervention were compared using un-paired t test.

Results: Preoperative identification of ROP risk increased from 60 to 100% and no infant was exposed to 100% SpO₂ intraoperatively during the study period. The incidence of laser intervention in this population decreased by 45% from 22 to 12% (p = 0.21).

Conclusion: Simplifying our preoperative handoff increased our rates of correct identification and communication ROP risk in preterm infants while decreasing exposure to 100% SpO₂.