Survey of Preterm Neuro-Centric Care Practices in California Neonatal Intensive Care Units

OBJECTIVE: Examine the adoption and presence of preterm, neuro-centric care practices across Neonatal Intensive Care Units (NICUs). STUDY DESIGN: Statewide, cross-sectional survey of California NICUs. Data were collected surrounding the timing of adoption and presence of delivery room practices, nursing protocols, provider management practices and quality improvement initiatives. RESULT: Among the 95 NICUs completing the survey (65%), adoption of all surveyed practices increased between 2005 and 2016, though rates of uptake changed over time and varied by practice. Adoption of indomethacin prophylaxis increased 1.8-fold whereas delayed cord clamping increased 78-fold. Adoption of premedication for intubation and a patent ductus arteriosus management algorithm differed by unit level. Additionally, two underlying practice domains were identified; adoption of delivery room practices and adoption of any preterm practice. CONCLUSION: Adoption of preterm, neuro-centric care practices across California NICUs has increased, though uptake patterns vary by practice and level.