PReCePT2: Reducing brain injury through improving uptake of magnesium sulphate in preterm deliveries

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, and the West of England Academic Health Science Network (WEAHSN).
Aiming to increase uptake of magnesium sulphate to protect babies’ brains during premature births.
Scaling up a successful quality improvement package to maternity units across the UK.

Premature birth is the leading cause of brain injury and cerebral palsy in babies. Evidence shows that babies can be protected from brain injury by giving women who are at risk of having a premature delivery magnesium sulphate. This reduces the risk of cerebral palsy in a third of cases. Despite this, more than half of premature babies in the UK do not receive this highly cost-effective treatment (approximately £1 per dose).

To increase uptake, a quality improvement package, PReCePT1, has been successfully implemented in five maternity units in West England. The proportion of women at these units receiving magnesium sulphate increased from an average of 21% before the intervention to around 88% after the intervention.

This Scaling Up Improvement project, PReCePT2, will scale this quality improvement package to maternity units across England.

PReCePT2 is designed to increase awareness and knowledge about use of magnesium sulphate as a treatment during premature delivery. It provides practical tools and training to staff in acute clinical settings, and quality improvement training at learning events.

The project will evaluate the effectiveness of two different approaches: a fully supported model with dedicated quality improvement coaching, versus a self-engaged national-level implementation with less support.

PReCePT is also one of the seven programmes to have been selected for adoption and spread across the national AHSN Network during 2018-2020. This work will be led by the West of England AHSN and is funded by NHS England.

The programme will bring together the 15 AHSNs and the aligned drivers of the Maternal and Neonatal Health Safety Collaborative (MNHSC) and the national Patient Safety Collaboratives (PSCs) to support the aim of achieving 85% uptake of administration of magnesium sulphate to preterm babies in all maternity units in England, with a stretch target of 95%, by 2020.

If successfully scaled up to a national level, PReCePT would benefit around 11,000 infants per year.