Vermont Oxford Network Vermont Oxford Network Data BaseData Base

Joyce ZwaneJoyce Zwane

IntroductionIntroduction• This is a non-profit voluntary collaboration of This is a non-profit voluntary collaboration of

healthcare professionals, that was started in 1987 in healthcare professionals, that was started in 1987 in Vermont.Vermont.

• The purpose is to improve the quality and safety of The purpose is to improve the quality and safety of medical care for the neonates and their families.medical care for the neonates and their families.

• Mission: Mission: The network has two database’sThe network has two database’s• That contain information about the care and outcomes That contain information about the care and outcomes

of high-risk newborns. We supply data of all our of high-risk newborns. We supply data of all our VLBW infants and all infants admitted into our ICU.VLBW infants and all infants admitted into our ICU.

..

Purpose of DataPurpose of Data

• Provides reliable and confidential data to the Provides reliable and confidential data to the units for quality management, audits and units for quality management, audits and improvements.improvements.

• Provides data for research and epidemiological Provides data for research and epidemiological studies studies

• Creates platform for education for health Creates platform for education for health professionals and families.professionals and families.

I was one of the lucky five to spread my wings

over the Atlantic Ocean to attend the eighth VON congress in Washington

D.C

Advantages of VONAdvantages of VON• Provides global uniformity in terms of Neonatal CareProvides global uniformity in terms of Neonatal Care

• Ensures correct capturing of data, thus improving Ensures correct capturing of data, thus improving correct documentationcorrect documentation

• Gives time-frame for administration of Survanta or Gives time-frame for administration of Survanta or CurosurfCurosurf

• Reduces the indiscriminate use of oxygenReduces the indiscriminate use of oxygen

• Encourages the use of Neopuffs instead of ambubagsEncourages the use of Neopuffs instead of ambubags

• Suggests that oxygen to be increased by three Suggests that oxygen to be increased by three gradings at a timegradings at a time

• Emphasizes the importance of blending Emphasizes the importance of blending oxygenoxygen

• Standardizes alarm settings for oxygen Standardizes alarm settings for oxygen saturation of between 85-95%saturation of between 85-95%

• Encourages the use of CPAP more than Encourages the use of CPAP more than conventional ventilation thus reducing the no. conventional ventilation thus reducing the no. of ventilation days and therefore complications of ventilation days and therefore complications such BPDsuch BPD

InfantInfant NutritionNutrition

• Promotes the use of early Breastmilk feeding Promotes the use of early Breastmilk feeding where possible, Or Total Parenteral Nutrition where possible, Or Total Parenteral Nutrition as early 6 hours post delivery if infant is stable as early 6 hours post delivery if infant is stable and blood sugar monitoring daily or prnand blood sugar monitoring daily or prn

• Adding FM85 if infant tolerates Adding FM85 if infant tolerates 100ml/kg/24hrs100ml/kg/24hrs

GeneralGeneral

• Focus on admission temperatureFocus on admission temperature• Use of Caffeine instead AminophyllinUse of Caffeine instead Aminophyllin• Use of sucrose for pain during proceduresUse of sucrose for pain during procedures• Eye-testing Criteria :Infant s < 35 weeks & Eye-testing Criteria :Infant s < 35 weeks &

< 1.5kg for R.O.P< 1.5kg for R.O.P• Cranial Ultrasound as aboveCranial Ultrasound as above• Reduction of noise levels in the N.I.C.U.Reduction of noise levels in the N.I.C.U.• More focus on infection prevention and More focus on infection prevention and

control i.e. Basic hand washing, use of control i.e. Basic hand washing, use of non-touch dispensers- sprays.non-touch dispensers- sprays.

Proper use of equipmentProper use of equipmentand Cleaning techniquesand Cleaning techniques• Focus on specific area’s:Focus on specific area’s:• Humidification systemsHumidification systems• Trolleys, outside equipment brought into the unit (X-Trolleys, outside equipment brought into the unit (X-

ray machines)ray machines)• Stethoscopes, thermometersStethoscopes, thermometers• Calculators, patient files Calculators, patient files • TelephonesTelephones• Temperature control and cleaning of fridgesTemperature control and cleaning of fridges• Control of VisitorsControl of Visitors• Weekly incubators and Ventilator changesWeekly incubators and Ventilator changes• Long nails, nail polish, wrist watches and religious Long nails, nail polish, wrist watches and religious

stringsstrings

The End