Am J Perinatol
DOI: 10.1055/a-1677-9872
Original Article

Improving consistency and accuracy of neonatal amplitude-integrated electroencephalography

Improving use of neonatal aEEG
Kathleen Tsoi
1  Department of Paediatrics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong (Ringgold ID: RIN71024)
,
Karen Kwan Ming Yam
1  Department of Paediatrics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong (Ringgold ID: RIN71024)
,
Hon Ming Cheung
1  Department of Paediatrics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong (Ringgold ID: RIN71024)
,
Terence Ping Yuen Ma
1  Department of Paediatrics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong (Ringgold ID: RIN71024)
,
King Woon So
1  Department of Paediatrics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong (Ringgold ID: RIN71024)
,
Eva Lai Wah Fung
1  Department of Paediatrics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong (Ringgold ID: RIN71024)
,
2  Department of Paediatrics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong (Ringgold ID: RIN71024)
› Author Affiliations
Supported by: SK Yee Medical Foundation 216223

Objective: To improve the utilization of amplitude-integrated electroencephalography (aEEG) in a neonatal unit by improving aEEG documentation, aEEG knowledge and pattern recognition ability of neonatal staff. Methods: A quality improvement (QI) program comprising two plan-do-study-act (PDSA) cycles was conducted in a level 3 neonatal intensive care unit. The first cycle was focused on improving aEEG documentation with the primary outcome indicator being compliance with aEEG documentation. The second cycle was focused on aEEG interpretation in a healthcare professional education program with the outcome indicators being accuracy of seizure identification on aEEG and change in conventional EEGs (EEG) performed. Other outcome indicators included accuracy in identification of background pattern, sleep-wake cycles and artefacts. Process indicators included improvement in aEEG-related knowledge. Interventions: First PDSA cycle – lectures on aEEG interpretation, a bedside key and documentation form. Second PDSA cycle – online aEEG education pack, detailed aEEG guideline. Results: There was a significant improvement in aEEG documentation after the implementation of both PDSA cycles. 7 of the 46 patients (15.2%) had isolated electrographic seizures which would not have been identified in the pre-aEEG monitoring era. There was an increase in the number of patients with EEGs done, but a steady decrease in number of EEGs per patient. Conclusions: With the successful application of standardized QI methods, improvements in outcome indicators such as correct aEEG pattern recognition and improved coverage of at risk infants with EEGs were observed. Our QI measures were associated with improvement in aEEG pattern recognition.



Publication History

Received: 01 July 2021

Accepted after revision: 19 October 2021

Publication Date:
25 October 2021 (online)

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