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Presentation by Dr. Sheen on weaning isolette at 1600 vs 1800 grams

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Meeting Minutes 8/10/18
1. Introduction by Dr Hudak.
2. Identification of multiteam approach
3. Key Driver Diagram
4. Dr Day described Discharge Flow diagram
5. Planned interventions discussed
6. Identify more interventions
7. volunteer for working on one or many teams
8. Merging different related protocols in one finally after each component has been worked on.
9. new securing device for NGs- Sarah Gravelle
10: NICU nurses working on weaver patients vs floats
11: New list of added team members to each protocol - refer to meeting PDF slides.
12 Have monthly QA meetings discussing deviations from protocol after chart reviews
13: Patient Satisfaction - how to assess

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Meeting minutes 9/4/18
Attendees: Dr. Hudak, Dr. Garber, Dr. Makker, Dr. Cortez, Dr. Suchomski, Dr. Kirk, Dr. Day, Trace Getzlaff
Salient points from protocol discussion below (edited copies will be sent to group for review by respective authors)
1. Apnea/brady protocol:
- New definition of clinically significant cardiopulmonary event (CSCPE) = HR <60 without coincident VS changes OR HR <80 with pulse ox <80%, cyanosis, or stimulation requirement
- Decision for clinical practice standardization within group: caffeine loads of 20mg/kg and then start maintenance at 5mg/kg daily with possibility of increasing dose based on status
- Guidelines proposed for when to send home on monitor
2. Isolette protocol:
- Removed gestational age criteria for weaning
- Decision for clinical practice standardization within group: wait 48 hours after failed isolette wean before re-attempting
- Need for nursing protocol for weaning isolette to air mode
3. Discharge planning checklist:
- Will work to make one page and more visually effective
- Work with Sara G for final edits
- Add documentation and specifics re: timing of hepatitis B immunization recommendations based on age/weight
4. Oral feeding protocol: NOT discussed in detail but a few questions arose
- Who gives these scores with each feed? nurse? OT/ST?
- Lag time for this to be implemented into cerner?
- Any progress made on a simpler protocol for interventions leading up to oral feeds (when to consult OT/ST, oral stim activities, etc).

Overall plans/needs:
- Need standardized formatting for protocols
- Need to be developing KDD and at least one process, outcome, and balancing measure per protocol
- Need to prioritize interventions to plan roll outs
- Still aiming for initial roll out of 1-2 interventions on 10/1/2018

NEXT MEETING: Will discuss this LOS QI initiative at the division meeting on Sept 13, 2018 at 7AM

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Meeting Dates
7/27/18
8/3/18
8/10/18
9/4/18
next meeting : ***