G121(P) Think magnesium: concerted multidisciplinary improvement initiative to increase antentanal magnesium uptake in < 30 week preterm births

• Published in: Archives of disease in childhood 2020-10, Vol.105 (Suppl 1), p.A40-A40
• Main Authors: Narayanan, CS, Katana, A, Abdulle, H, Coker, M, Mitra, D, Shetty, N
• Format: Article
• Language: English
• Subjects: Cerebral Palsy; Magnesium sulfate; Neonates; Neuroprotection; Offspring; Paralysis; Premature birth; Quality control; Risk reduction
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2020-rcpch.96

AimThere is compelling evidence that magnesium sulfate (MgSO4) given antenatally in threatened preterm labour is neuroprotective and reduces risk of cerebral palsy in offspring. National Neonatal Audit Programme (NNAP) in the UK monitors compliance to antenatal magnesium uptake in births < 30 weeks. Our centre was a negative outlier (16% vs 43% national average) for this audit measure in the 2016. Our aim was to improve MgSO4 compliance by at least 50% within the first year and then to sustain achieved improvement.MethodsA multidisciplinary improvement team comprising of neonatologists, obstetricians and midwives was formed. This team process mapped a preterm mother’s admission to understand enablers and barriers to timely MgSO4 administration. A driver diagram conceptualised overall aim, primary & secondary drivers to inform change ideas. Change ideas (MgSO4 awareness sessions, clear guideline, preterm labour proforma, Think Mg posters, ward level champions, daily safety huddles, monthly display of compliance figures) were tested in iterative PDSA cycles. Number of preterm births