Effect of Implementing Neuroprotective Care Bundle on Nurses, Performance and the Incidence of Intraventricular Hemorrhage in Premature Infants

Background: Intraventricular hemorrhage remains a serious and a potentially life-threatening complication in preterm or very low birth weight infants. Applying neonatal nursing care bundles can help mitigate the incidence and severity of Intraventricular hemorrhage. Aim: To examine the effect of implementing neuroprotective care bundle on nurses’ performance and the incidence of intraventricular hemorrhage in premature infants. Design: A quasi-experimental study was utilized, including preterm infants and neonatal nurses. Setting: Neonatal Intensive Care Units of Birket El Sabah Central Hospital and Menoufia University Hospital, Menoufia Governorate, Egypt. Results: implementation of the nursing care bundle significantly reduction of intraventricular hemorrhage incidence from 15% to 7%, (adjusted odds ratio of 0.42 p-value < 0.001). There was also a significant decrease in composite outcome including severe IVH, cystic periventricular leukomalacia and mortality (OR 0.54, p < 0.001). There were highly significant improvements in nurse's knowledge and practice, post intervention Conclusions: The application of Neuroprotective Care Bundle within the first 72 hours after birth is associated with lower risk of intraventricular hemorrhage, cystic periventricular leukomalacia, and mortality in very premature infants. Recommendation: Integrating the Neuroprotective Care Bundle into the routine Neonatal Intensive Care Unit is strongly recommended to improve neonatal outcomes and standardization of best practices across care settings.