University Hospital Bristol NHS Foundation Trust

Scaling up a quality improvement package to reduce brain injury in premature babies by improving uptake of magnesium sulphate

Premature birth is the leading cause of brain injury and cerebral palsy in babies.

Evidence shows that you can protect babies from brain injury by giving women who are at risk of having a premature delivery magnesium sulphate. This protects babies’ brains and reduces the risk of cerebral palsy in a third of cases. But, two thirds of premature babies in the UK do not receive this highly cost-effective treatment, which costs approximately £1 per dose.

To increase the uptake of the treatment, a quality improvement package, PReCePT1, has been successfully implemented in five maternity units in West England by University Hospitals Bristol NHS Foundation Trust.

The package was co-designed by clinical teams and mothers who had experienced premature deliveries. The proportion of women at these units receiving magnesium sulphate increased from 35 per cent before the intervention, to around 60 per cent during and after the intervention.

RUBIS.Qi is working with The Health Foundation and University Hospitals Bristol Foundation Trust and their partners to scale up this project to another 10 maternity units across the UK. All women who are admitted to the participating maternity units with an imminent very premature delivery (less than 30 weeks gestational age) will benefit from this intervention, which if it were scaled up to a national level would mean around 11,000 babies per year benefiting.

PReCePT2 is designed to increase awareness and knowledge about use of magnesium sulphate as a treatment during premature delivery. The project will provide practical tools and training to staff in acute clinical settings so they consider the treatment in women who are at risk of having a premature delivery.

The project is led by University Hospitals Bristol NHS Foundation Trust, in partnership with the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West, People in Health West of England (PHWE), West of England Academic Health Science Network (WEAHSN), and the Innovation Agency (Academic Health Science Network for the North West Coast).

Project manager: Liz Hill

Project lead: Dr Karen Luyt, consultant in neonatal medicines and consultant senior lecturer in neonatal neuroscience at University Hospitals Bristol NHS Trust     

RUBIS.Qi improvement coach: Anna Burhouse

Find out more about the project