Development of the NEC-Zero Toolkit: Supporting Reliable Implementation of Necrotizing Enterocolitis Prevention and Recognition

• Published in: Neonatal network Vol. 39; no. 1; p. 6
• Main Authors: Gephart, Sheila M, Newnam, Katherine, Wyles, Christina, Bethel, Claire, Porter, Caroline, Quinn, Megan Christine, Canvasser, Jennifer, Umberger, Erin, Titler, Marita
• Format: Journal Article
• Language: English
• Published: United States 01.01.2020
• Subjects: necrotizing enterocolitis; family engagement; neonatal intensive care; quality improvement toolkit
• ISSN: 1539-2880
• DOI: 10.1891/0730-0832.39.1.6

The goal of the NEC-Zero project is to reduce the burden of necrotizing enterocolitis (NEC) by increasing access to evidence-based tools to help clinicians and parents integrate evidence into daily care. It involves (a) human milk feeding with prioritized mother's own milk; (b) use of a unit-adopted standardized feeding protocol; (c) a unit-adopted strategy for timely recognition that integrates risk awareness and a structured communication tool when symptoms develop; and (d) stewardship of empiric antibiotics and avoidance of antacids. A toolkit for caregivers and parents was developed to make implementation consistent. For clinicians the toolkit includes: the GutCheck risk score, a structured communication tool, the "Avoiding NEC" checklist, and the NEC-Zero website. For parents, NEC-Zero tools include the website, three educational brochures in English and Spanish, and a collaborative care video produced with the NEC Society. This article describes the toolkit and how it has been accessed and used.