Collaboration to Improve Neuroprotection and Neuropromotion in the NICU: A Quality Improvement Initiative.

Implementation of neuroprotective and neuropromotive (NP2 ) strategies is essential to optimize outcomes for premature infants. Developmental care, once an addition to medical care, is now recognized by the NICU team as foundational to support long-term neurodevelopment of micropremature infants. A group approach to education and sharing implementation processes can result in collaborative and individual center improvements. This article includes examples of quality improvement (QI) education and tools inspired by implementation of NP2 strategies in a consortium of 11 NICUs in the United States and Canada. Process change guided by potentially better practices are key; however, consistency of application must be included to ensure success. Assessment of NP2 practices via use of surveys and practice audits are described. Increases occurred in family NP2 education and provision of support during painful experiences. There were also increases in skin-to-skin holding, 2-person caregiving, and focus on reducing unnecessary painful procedures.