Women’s Hospital (WH) of Hamad Medical Corporation has successfully implemented a lifesaving quality improvement project for babies born prematurely.
The project entitled “The Golden Hour Delivery Room Management” adopts international evidence-based practice to provide the best possible care to extreme preterm babies to ensure their optimal outcome to improve the survival rate, quality of life and to reduce morbidity. These include infants with a gestational age of less than 29 weeks or a birth weight of less than 1,000 grams.
“The Golden Hour is considered to be the first 60 minutes of a very premature baby’s life where a highly-specialised multidisciplinary team carries out team-oriented and task-driven protocols. These may include resuscitation, followed by gentle ventilation, thermo-regulation, early intravenous parenteral nutrition and early administration of antibiotics to treat potential infections, a known trigger in preterm birth,” said Dr Hilal al-Rifai, medical director, Women’s Hospital.  
“To a premature baby, the first 60 minutes of life are a golden opportunity that gives the medical team a chance to keep the baby in a stable condition. This enhances the baby’s chance of survival and short and long term health outcomes,” Dr al-Rifai added.
“The Golden Hour approach incorporates an organised process that promotes teamwork to produce the best possible outcomes for the newborns at risk,” Dr al-Rifai said.
He further explained that the goal of this project was to implement international best practice for highly-specialised care to the tiniest babies.
Under this initiative, WH has incorporated the use of safer alternatives in the management of premature infants such as the introduction of non-invasive ventilation using Continuous Positive Airway Pressure. This treatment involves positioning a mask by the nostril/nose while air is blown at a constant pressure to keep the baby’s airways open.
This is followed by the selective use of surfactant, a fatty substance that is deficient in the air sacs of the lungs of premature babies, which will help to prevent the lungs from collapsing and also minimise the work of breathing by the infant.  
The ‘Golden Hour’ protocol has improved quality of life for several high-risk newborns including baby Robin who was recently treated for Tracheoesophageal fistula. The condition was diagnosed within the first hour of life – the golden hour for the baby.
The prompt diagnosis gave way to early surgical intervention for the baby who was at 28 weeks of gestation and weighing less than 1kg. After a six-hour surgery, the WH NICU team worked together to provide extraordinary care, using the highest risk management standards, in the days that followed.  
“The baby is recovering now and is under the care of highly-skilled staff at the NICU. The baby’s mother has also been among the first ones to use the newly-created mother and baby rooms at the expanded NICU where she is supported by staff and is building her confidence to care for her baby.” said Dr Amani Saeed Ibrahim, specialist at the Neonatal Intensive Care Unit, WH.