Which activity is part of a NICU quality improvement program?

• A. Ignoring near-miss reporting
• B. Implementing a root cause analysis after a sentinel event
• C. Skipping staff training sessions
• D. Limiting infection control audits

Answer: (B)

Root cause analysis after a sentinel event is a key activity in NICU quality improvement. A sentinel event is an unanticipated incident involving death or serious injury that triggers an immediate review. The RCA goes beyond the immediate cause to uncover underlying system factors—like communication gaps, workflow issues, staffing, or equipment problems—that allowed the event to occur. By tracing the sequence of events and using structured methods (for example, fishbone diagrams or 5 Whys), the team identifies root causes, implements corrective actions, and then monitors outcomes to prevent recurrence. This approach embodies the learning culture at the heart of NICU quality improvement. In contrast, ignoring near-miss reporting, skipping staff training, or limiting infection control audits undermines safety and misses opportunities to strengthen systems.