All Care is Brain Care: Neuro-Focused Quality Improvement in the Neonatal Intensive Care Unit

Melissa Liebowitz; Katelin P Kramer; Elizabeth E Rogers

doi:10.1016/j.clp.2023.01.004

All Care is Brain Care: Neuro-Focused Quality Improvement in the Neonatal Intensive Care Unit

Clin Perinatol. 2023 Jun;50(2):399-420. doi: 10.1016/j.clp.2023.01.004. Epub 2023 Mar 9.

Authors

Melissa Liebowitz¹, Katelin P Kramer², Elizabeth E Rogers³

Affiliations

¹ Envision Physician Services, St. Francis Hospital, 6001 East Woodmen Road, Colorado Springs, CO 80923, USA.
² Department of Pediatrics, University of California, 550 16th Avenue, 5th Floor, San Francisco, CA 94143, USA; University of California, Benioff Children's Hospital, 550 16th Avenue, 5th Floor, San Francisco, CA 94143, USA. Electronic address: katelin.kramer@ucsf.edu.
³ Department of Pediatrics, University of California, 550 16th Avenue, 5th Floor, San Francisco, CA 94143, USA; University of California, Benioff Children's Hospital, 550 16th Avenue, 5th Floor, San Francisco, CA 94143, USA. Electronic address: https://twitter.com/eerogersmd.

PMID: 37201988
DOI: 10.1016/j.clp.2023.01.004

Abstract

Neonates requiring intensive care are in a critical period of brain development that coincides with the neonatal intensive care unit (NICU) hospitalization, placing these infants at high risk of brain injury and long-term neurodevelopmental impairment. Care in the NICU has the potential to be both harmful and protective to the developing brain. Neuro-focused quality improvement efforts address 3 main pillars of neuroprotective care: prevention of acquired injury, protection of normal maturation, and promotion of a positive environment. Despite challenges in measurement, many centers have shown success with consistent implementation of best and potentially better practices that may improve markers of brain health and neurodevelopment.

Keywords: Neonatal brain care; Neonatology; Neurodevelopment; Neuroprotection; Quality improvement.

Publication types

Review

MeSH terms

Brain
Critical Care
Hospitalization
Humans
Infant
Infant, Newborn
Intensive Care Units, Neonatal*
Quality Improvement*