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. 2025 Jul 1;23(3):282-290.
doi: 10.1097/XEB.0000000000000464.

Care bundle for preventing intraventricular hemorrhage in premature infants: a best practice implementation project

Álvaro Solaz García  1   2   3 , Rosario Ros Navarret  2 , Marta Aguar Carrascosa  1   2 , Nerea Valles Murcia  1 , Roberto Llorens  1   4 , Laura Torrejón Rodríguez  1   2 , Alejandro Pinilla González  1   2 , Laura Albornos-Muñoz  3   5 , Raquel Escrig Fernández  1   2
Affiliations

Care bundle for preventing intraventricular hemorrhage in premature infants: a best practice implementation project

Álvaro Solaz García et al. JBI Evid Implement. .

Abstract

Introduction: Intraventricular hemorrhages remain a major problem in neonatology, as their complications affect neonatal morbidity, mortality, and long-term neurodevelopmental outcomes.

Aim: The aim of this project was to prevent intraventricular hemorrhage in premature infants during their first days of life in a neonatal intensive care unit (NICU).

Methods: This pre- and post-implementation clinical audit project used the JBI Evidence Implementation Framework and was conducted in a tertiary-level Spanish NICU with a consecutive sample. A baseline audit was conducted using 13 audit criteria derived from JBI summaries of the best available evidence. This was followed by the implementation of an action plan, which included a care bundle and health care professionals' education. These improvement strategies were then evaluated using a follow-up audit.

Results: The baseline and follow-up audits evaluated 54 and 56 infants, respectively. The follow-up audit showed 100% improvement for Criteria 2, 3, 6, and 7, which covered sleep safety and noise. Criteria 12 and 13, which covered cord clamping and positioning the infant, improved by 25.99%. Criterion 9, on antenatal corticosteroids, showed a slight improvement of 5.56%.

Conclusions: This study increased compliance with an evidence-based, family-centered care approach to preventing intraventricular hemorrhage in premature infants. This was achieved by conducting a baseline and follow-up audit, implementing a training program, and keeping more comprehensive nursing records. Further studies could assess the long-term effectiveness of interventions and/or the incidence of intraventricular hemorrhage and neurodevelopmental disorders in premature infants.

Spanish abstract: http://links.lww.com/IJEBH/A262.

Keywords: best practice; cerebral hemorrhage; neonatal intensive care unit; neurodevelopment; premature infant.

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Conflict of interest statement

The authors declare no conflicts of interest.

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