Awareness of Pediatricians About Neonatal Intensive Care Unit Quality Assurance and Unit Outcomes in Imamein Kadhymein Medical City, Baghdad

Abstract

Background: Neonatal care standards vary widely across countries due to differences in medical practices, healthcare accessibility, and equipment availability. Neonatal intensive care unit (NICU) outcomes offer critical insights into factors influencing neonatal mortality, enabling targeted interventions to improve neonatal survival. Ongoing quality improvement initiatives are essential to enhancing care quality and minimizing complications. Objectives: Assess pediatricians' awareness of NICU quality assurance practices, analyze the characteristics of neonates admitted to the NICU in 2013 and 2014 and determine admission outcomes and identify contributing factors. Methods: This study consisted of two components: Pediatricians' Knowledge: A cross-sectional survey conducted at Imamein Kadhymein Medical City from April 15 to June 1, 2015. Pediatricians answered true/false questions, with scores ranging from 0 to 10. Neonatal Outcomes: A record-based cross-sectional analysis of NICU admissions between January 2013 and December 2014. Data included mortality rates and case fatality rates (CFR). Chi-square tests evaluated relationships between variables, with statistical significance set at P ≤ 0.05. Results: Pediatricians' Awareness: The most frequent knowledge score among pediatricians was 7. Neonatal Outcomes: Of the admitted neonates (n = 1,694):  640 (37.8%) were discharged in good health. 624 (36.8%) were referred to pediatric or other hospital wards. 370 (21.8%) died. 19 (1.1%) were transferred to other hospitals. 41 (2.4%) were discharged on parental responsibility. Case Fatality Rates (CFR): The highest CFR occurred in cases of congenital anomalies (61.1%), while the lowest was among respiratory distress syndrome (RDS) cases (17%). Significant associations were observed between outcomes and gestational age, prematurity, and mode of delivery (P = 0.0001). Conclusions: Two-thirds of pediatricians demonstrated good knowledge of NICU quality assurance practices. Admission outcomes and contributing factors were identified, with significant associations between neonatal outcomes and gestational age, birth weight, and delivery type. This underscores the importance of targeted quality assurance measures in NICUs.