Severe Hypertension in Pregnancy
This improvement initiative will kick off at the April 5th Summit. More information on the safety bundle.
Nebraska clinicians and payers have been working together to increase the use of hydroxyprogesterone caproate (17P, Makena) in order to reduce the risk of preterm birth.
FAQ’s Hydroxyprogesterone Caproate (17P, Makena)
Jaundice is a fairly common newborn condition that can result in devastating kernicterus. Evidence provides guidance in the identification of newborns at risk and their appropriate management.
Bhutani, V. K., Stark, A. R., Lazzeroni, L. C., Poland, R., Gourley, G. R., Kazmierczak, S., . . . Stevenson, D. K. (2013). Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy. The Journal of Pediatrics, 162(3), 477-482.e1. doi:10.1016/j.jpeds.2012.08.022
Keren, R., Tremont, K., Luan, X., & Cnaan, A. (2009). Visual assessment of jaundice in term and late preterm infants. Archives of Disease in Childhood. Fetal and Neonatal Edition, 94(5), F317-F322. doi:10.1136/adc.2008.150714
Maisels, J.M., Bhutani, V.K., Boge, D., Newman, T.B., Start, A.R., and Watchko, J.F. (2009). Hyperbilirubinemia in the newborn infant > or = to 35 weeks gestation: An update with clarifications. Pediatrics, 124
Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. (2004). Pediatrics, 114(1), 297-316.
Shahid, R., & Graba, S. (2012). Outcome and cost analysis of implementing selective coombs testing in the newborn nursery. Journal of Perinatology: Official Journal of the California Perinatal Association, 32(12), 966-969.
Breastfeeding Practices A quality improvement initiative is underway to increase exclusive breastfeeding rates at Nebraskahospitals. Currently, the in-hospital state-wide exclusive breastfeeding is at 67% and breastfeeding initiation is at 90%. The aim is to get all birthing hospitals exclusive breastfeeding rate to 68% within a year. Many hospitals are participating in this improvement initiative.
ACOG Committee Opinion No. 756 Summary "Optimizing Support for Breastfeeding as Part of Obstetric Practice"
Recommendations for Adopting the International Code of Marketing of Breast-milk Substitutes Into U.S. Policy.
Immediate and Sustained Skin-to-Skin Contact for the Healthy Term Newborn After Birth: AWHONN Practice Brief Number 5
Prevention of CMV
In Nebraska, there are approximately 156 CMV infected newborns born every year. Unsuspecting pregnant women may contract CMV and pass it on to their developing baby in-utero. Some of these newborns will have hearing loss as a result of the CMV infection. Public education programs have been effective in reducing the transmission of CMV to pregnant women. Social media is being utilized to education childbearing women in Nebraska about this disease and hygienic measures to prevent CMV transmission.
Prevention of the 1st Cesarean Delivery
The rising cesarean delivery rate in the United States has been in the news. In 2014, ACOG and SMFM published a consensus document on the Safe Prevention of the Primary Cesarean Delivery. The plan is to facilitate dissemination of this information throughout the state and to support the implementation of the recommendations. Baseline data on Nebraska cesarean rates have been collected.
American College of Obstetricians and Gynecologists (College); Society for Maternal-Fetal Medicine, Caughey AB, Cahill AG, Guise JM, Rouse DJ. Safe prevention of the primary cesarean delivery. Am J Obstet Gynecol. 2014 Mar;210(3):179-93
Spong CY, Berghella V, Wenstrom KD, Mercer BM, Saade GR. Preventing the first cesarean delivery: summary of a Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstet Gynecol. 2012 Nov;120(5):1181-93.
Nebraska Safe Babies
Nebraska Safe Babies is a campaign to promote safe sleep environment for infants and to educate caregivers about abusive head trauma.
Be recognized as a Safe Sleep Hospital. Get your brochures, videos, and learn about a great educational resource here.
Learn how to become a Nebraska Safe Sleep Champion.
The goal of the Abusive Head/Shaken Baby Syndrome Prevention Hospital Campaign is to provide evidence-based education to parents of newborns as well as birthing hospital staff. Learn more about how your birthing facility can become a Champion. Join the 20 who have already pledged.
Count the Kicks
Kick counts are a simple way for mothers to identify if their unborn baby is healthy. The Count the Kicks campaign, which originated in Iowa, strives to educate pregnant women and provides tools to assist them with kick counts. Kick counts are an easy way to prevent stillborn babies. Nebraska hospitals and providers may order free brochures to share the campaign with their patients. Order your brochures today. In addition, social media is being utilized to reach childbearing women in Nebraska.
Maternal Advisory Group
NPQIC Maternal Advisory Group is comprised of providers who deliver babies in the state. They advise the collaborative on maternal care needs in their regions and work to keep their colleagues informed on collaborative activities.
OB Advisory Group Regions
Matt Bruner, Scottsbluff, Matthew.Bruner@rwhs.org, 308-635-3033
Matt Felber, Pender, Felberm@mercyhealth.com, 402-385-3033
Ben Klug, North Platte, 308-534-4804
Brady Beechum, Lexington, 308-324-8308
Jesse Loefler, Kearney, 402-984-0591
Molly Johnson, Grand Island, 308-382-1100
Connie Novak, Seward, 402-643-4800
Ben Byers, Lincoln, Benjamin.Byers@bryanhealth.org, 402-483-8485
Dan Connealy, Omaha, 402-815-1970
Karen Carlson, Omaha, KSCarlson@unmc.edu
Lisa Strasheim, Omaha, Lisa.Straheim@alegent.org