Placental Lab Draws in the Newborn ICU: A Quality Improvement Project

Background: Obtaining an infant's labs from the placenta on admission is a relatively new practice in the Newborn Intensive Care Unit (NICU). This practice decreases phlebotomy losses, reduces blood transfusions, reduces iatrogenic blood loss, and decreases exposure to pain. There is a lack of standardized guidelines for obtaining placental labs upon admission to the NICU, and there is variability in practice when drawing placental labs in each NICU. This project aimed to create standardized guidelines and improve the process when obtaining placental labs in the NICU. Methods: This quality improvement project standardized the inclusion criteria for placental lab draws by creating a clinical practice guideline for infants admitted to the NICU. An education video was provided to the charge nurses who perform placental lab draws. The charge nurses were then surveyed on how the new education affected their practice. Demographic and descriptive statistic data were gathered in a post placental lab draw checklist/survey and analyzed. The usability and feasibility of implementing these new guidelines for infants receiving placental lab draws were evaluated. Results: Post-implementation of the new practice guideline, 97% of infants (n=36) had attempts to obtain placental labs. With the new guidelines, sixteen additional infants (gestational age >32 weeks) received placental draws. Of the charge nurses surveyed, 83.3% reported improved practice in drawing from the placenta after viewing the educational video provided. Conclusions: Creating a standardized guideline with increased inclusion criteria for placental lab draws is usable and feasible in this NICU. The educational video provided added value to improve practice when obtaining placental draws. The usability and feasibility of placenta labs for all infants admitted to the NICU is a consideration for future practice.