Women’s Hospital implements life-saving “Golden Hour” initiative for high-risk newborns
Women’s Hospital (WH) has successfully implemented a lifesaving quality improvement project for babies born prematurely.
The project entitled “The Golden Hour Delivery Room Management” adopts international evidenced-based practice to provide the best possible care to extreme preterm babies to ensure their optimal outcome (to improve the survival rate, quality of life and to reduce morbidity). These include infants with a gestational age of less than 29 weeks or a birth weight of less than 1000 grams.
“The Golden Hour is considered to be the first 60 minutes of a very premature baby’s life where a highly-specialized multidisciplinary team carries out team-oriented and task-driven protocols. These may include resuscitation, followed by gentle ventilation, thermo-regulation, early intravenous parenteral nutrition and early administration of antibiotics to treat potential infections, a known trigger in preterm birth,” said Dr. Hilal Al Rifai, Women’s Hospital Medical Director and Director of its Neonatal/Perinatal Services and the Qatar Newborn Screening Program.
“To a premature baby, the first 60 minutes of life are a golden opportunity that gives the medical team a chance to keep the baby in a stable condition. This enhances the baby’s chance of survival and short and long term health outcomes,” Dr. Al Rifai added.
According to the American Academy of Pediatrics, infants that are born too early tend to have immature body systems, which may not function properly. This can cause a number of problems that need prompt medical care such as difficulty in breathing and staying warm, circulation problems, eye problems, and infections.
Under this initiative, WH has incorporated the use of safer alternatives in the management of premature infants such as the introduction of non-invasive ventilation using Continuous Positive Airway Pressure (CPAP). This treatment involves positioning a mask by the nostril/nose while air is blown at a constant pressure to keep the baby’s airways open. This is followed by the selective use of surfactant, a fatty substance that is deficient in the air sacs of the lungs of premature babies, which will help to prevent the lungs from collapsing and also minimize the work of breathing by the infant. These methods have replaced the conventional invasive management techniques.
After the initial stabilization in the delivery room, babies are transferred with extreme care by highly-skilled and experienced staff to the newly-built Tiny Baby Unit (TBU), a section designed specifically for the care of high-risk babies.