841 Routine supplementation of probiotics for prevention of necrotizing enterocolitis in premature infants—a qi project

Necrotizing enterocolitis (NEC) carries high rates of mortality and morbidity in perterm infants. Our NEC rates over 6 years, were in higher quartiles of the Vermont-Oxford Network and prompted an improvement project. To reduce NEC rates by 30% from 4.5% to 3% by 3/2016 in <33 weeks infants admitted in Sunnybrook NICU. Multi-professional team used fishbone analyses, process maps, literature review and compliance with hospital Infection Prevention unit. A product was selected (BioGaia, Lactobacillus reuteri; Ferring, Sweden). A policy written and approved. As a forcing mechanism, order for probiotics added to admission orders set. We gave education to staff, parents. We started after a cluster of cases (‘burning platform’). PDSA#1 on the first baby was in 2/2015. After first month, issues were addressed, then spot audits assured continuing compliance. Measures: Outcome measures: NEC in infants<33 wk GA, (>=stage 2), Sepsis, Mortality. Secondary outcomes: Sepsis evaluations, Feeding intolerance, Days NPO, Growth rate/week, Antibiotics days, TPN days, Formula days. Process …