Table 1.
Quality indicators definitions and targets
| Category | Indicator Definitions | Targets |
|---|---|---|
| Vital signs | Percent of patient records in which vital signs are documented on average every 3 h within the first 48 h of admission | 15 (every 3 h × 48 h with possibility of one less on day of admission) per patient and 80% overall. |
| Thermoregulation | Percent of neonates who have first temperature documented within 30 min of admission to neonatal unit | 80% |
| Percent of neonates with documented first temperature after admission < 36.0 °C having temperature improve to > 36.0 °C in ≤2 h | 80% | |
| Hypoglycemiaa | Percent of neonates with documented blood sugar < 40- < 45 mg/dL who had blood sugar level improve to > 40- > 45 mg/dL within 1 h | 80% |
| Infectious disease | Percent of neonates who received antibiotics (ampicillin and gentamicin) at correct dose and interval for first 24 h of therapy | 80% |
| Fluid electrolytes and nutrition | Percent of neonates admitted to neonatal unit within first 48 h of life and remain in unit until at least 2 weeks of age who regain their birth weight by < 2 weeks of age | 80% |
| Respiratory | Percent of neonates with BW < 1.5 kg or GA < 33 weeks for whom methylxanthine treatment (caffeine or aminophylline) is prescribed | 80% |
| Percent of preterm/LBW neonates eligible for CPAP who are started on CPAP within 2 h of life (eligibility criteria: BW < 2 kg or GA < 33 weeks and any degree of respiratory distress - O2 saturation ≤ 90% oxygen requirement and/or RR ≥50 and/or grunting/flaring/retractions) | 90% |
oC degrees centigrade, mg/dL milligrams per deciliter, BW birth weight, LBW low birth weight, kg kilogram, GA gestational age, O2 Oxygen, RR respiratory rate, CPAP continuous positive airway pressure
aCut-off point for hypoglycemia changed during the study period. Originally, low blood sugar was defined as less than 40 mg/dl. The definition was eventually changed to be less than 45 mg/dl. It took time for the new definition to be applied, so for the purposes of our analysis we used the range of less than 40 or less than 45 mg/dl to define low blood sugar