Target Oxygen Saturation Among Preterm Neonates on Supplemental Oxygen Therapy: A Quality Improvement Study

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Excessive oxygen use or hyperoxia among preterm neonates is associated with morbidities like retinopathy of prematurity (ROP) and chronic lung disease (CLD). Delivering optimal oxygen involves maintaining the oxygen saturation (SpO2) within a narrow range by adjusting the inspired oxygen concentration. In our neonatal intensive care unit (NICU), we observed that nurses faced difficulty in maintaining SpO2 of neonates within the unit’s target range, often resulting in fluctuating SpO2 values. We planned this quality improvement (QI) study to evaluate the existing compliance with oxygen saturation targeting in our NICU, and whether implementation of a unit policy on oxygen administration would improve the compliance.

This special issue of Indian Pediatrics (September 2018; Volume 55: Number 9) highlights mechanisms that can support health care providers in using various quality improvement (QI) approaches and showcases some of the improvement projects undertaken in India by different teams.

The USAID ASSIST Project started working in India in September 2013; initially working directly with districts and facilities to help them learn how to use QI approaches to save lives. This work went well and the staff in these facilities were able to reduce perinatal mortality by 15% over 18 months. During this time, we met great partners from important organizations and institutions across India.

These institutions are now leading a growing movement to help more people apply QI methods to deliver care that prevents harm, improves outcomes, and meets the needs of the people receiving it through their own networks using domestic funding; continuing these lifesaving efforts after ASSIST technical support has ended.

The supplement shows important results of the ongoing QI work in these networks and shows how domestic QI networks, earlier supported by ASSIST, are now independently supporting and spreading the use of QI methods to provide better care.

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