1. Vermont Oxford Network Data Base Joyce Zwane

2. Introduction This is a non-profit voluntary collaboration of healthcare professionals, that was started in 1987 in Vermont. This is a non-profit voluntary collaboration of healthcare professionals, that was started in 1987 in Vermont. The purpose is to improve the quality and safety of medical care for the neonates and their families. The purpose is to improve the quality and safety of medical care for the neonates and their families. Mission: The network has two database’s Mission: The network has two database’s That contain information about the care and outcomes of high-risk newborns. We supply data of all our VLBW infants and all infants admitted into our ICU. That contain information about the care and outcomes of high-risk newborns. We supply data of all our VLBW infants and all infants admitted into our ICU..

3. Purpose of Data Provides reliable and confidential data to the units for quality management, audits and improvements. Provides reliable and confidential data to the units for quality management, audits and improvements. Provides data for research and epidemiological studies Provides data for research and epidemiological studies Creates platform for education for health professionals and families. Creates platform for education for health professionals and families.

4. 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

5. Advantages of VON Provides global uniformity in terms of Neonatal Care Provides global uniformity in terms of Neonatal Care Ensures correct capturing of data, thus improving correct documentation Ensures correct capturing of data, thus improving correct documentation Gives time-frame for administration of Survanta or Curosurf Gives time-frame for administration of Survanta or Curosurf Reduces the indiscriminate use of oxygen Reduces the indiscriminate use of oxygen Encourages the use of Neopuffs instead of ambubags Encourages the use of Neopuffs instead of ambubags Suggests that oxygen to be increased by three gradings at a time Suggests that oxygen to be increased by three gradings at a time

6. Emphasizes the importance of blending oxygen Emphasizes the importance of blending oxygen Standardizes alarm settings for oxygen saturation of between 85-95% Standardizes alarm settings for oxygen saturation of between 85-95% Encourages the use of CPAP more than conventional ventilation thus reducing the no. of ventilation days and therefore complications such BPD Encourages the use of CPAP more than conventional ventilation thus reducing the no. of ventilation days and therefore complications such BPD

7. Infant Nutrition Promotes the use of early Breastmilk feeding where possible, Or Total Parenteral Nutrition as early 6 hours post delivery if infant is stable and blood sugar monitoring daily or prn Promotes the use of early Breastmilk feeding where possible, Or Total Parenteral Nutrition as early 6 hours post delivery if infant is stable and blood sugar monitoring daily or prn Adding FM85 if infant tolerates 100ml/kg/24hrs Adding FM85 if infant tolerates 100ml/kg/24hrs

8. General Focus on admission temperature Focus on admission temperature Use of Caffeine instead Aminophyllin Use of Caffeine instead Aminophyllin Use of sucrose for pain during procedures Use of sucrose for pain during procedures Eye-testing Criteria :Infant s < 35 weeks & < 1.5kg for R.O.P Eye-testing Criteria :Infant s < 35 weeks & < 1.5kg for R.O.P Cranial Ultrasound as above Cranial 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 control i.e. Basic hand washing, use of non-touch dispensers- sprays. More focus on infection prevention and control i.e. Basic hand washing, use of non-touch dispensers- sprays.

9. Proper use of equipment and Cleaning techniques Focus on specific area’s: Focus on specific area’s: Humidification systems Humidification systems Trolleys, outside equipment brought into the unit (X- ray machines) Trolleys, outside equipment brought into the unit (X- ray machines) Stethoscopes, thermometers Stethoscopes, thermometers Calculators, patient files Calculators, patient files Telephones Telephones Temperature control and cleaning of fridges Temperature control and cleaning of fridges Control of Visitors Control of Visitors Weekly incubators and Ventilator changes Weekly incubators and Ventilator changes Long nails, nail polish, wrist watches and religious strings Long nails, nail polish, wrist watches and religious strings

10. The End