Infant Journal
for neonatal and paediatric healthcare professionals

Antenatal optimisation for preterm infants less than 34 weeks: a quality improvement toolkit

The British Association of Perinatal Medicine (BAPM) and the National Neonatal Audit Programme (NNAP) are collaborating on four quality improvement toolkits to support perinatal staff to implement the evidence around perinatal optimisation. This article presents the Antenatal Optimisation Toolkit. The evidence for key interventions is described alongside a quality improvement journey, which supports staff to choose improvement solutions most suitable for the local context.

Lauren Shaw
Neonatal Grid Trainee, East Deanery, Scotland

Julie-Clare Becher
Lead for Quality, BAPM and Consultant Neonatologist, Royal Infirmary of Edinburgh,

On behalf of the BAPM Antenatal Optimisation Toolkit Group

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EEG; sleep; sleep interruption
Key points
  1. Disturbances of nocturnal sleep in preterm infants were frequent in the NICU, predominantly for feeding.
  2. Infants who woke spontaneously, fed more efficiently within a shorter time-frame compared to infants who were disturbed from their sleep for feeding.
  3. Optimising sleep in the NICU will support the normal trajectory of development.

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The use of clinical audit in successfully implementing a change of clinical practice in developmental positioning
This article outlines a clinical audit process to determine whether standards of developmental positioning were being achieved in a neonatal unit. An initial audit of positioning identified a need for change in clinical practice and an evaluation of a new fluidised conformational positioning system was undertaken. Positioning was re-audited and the opinions of nursing staff gathered. The importance of education when implementing a change in clinical practice is considered alongside the results of the audit process.