目的 提高新生儿重症监护室（neonatal intensive care unit, NICU）极早产儿母乳喂养率。 方法 以2023年1—12月为基线期，此期沧州市人民医院NICU极早产儿母乳喂养率为75%作为基线值，以2024年1—12月为质量改进期，应用计划-执行-研究-行动（plan-do-study-act, PDSA）循环选出有效改进措施，质量改进目标是该院NICU极早产儿母乳喂养率提高10个百分点。分析无法母乳喂养的原因，构建关键驱动图，确定具体的改进措施；通过运行图动态监测每月母乳喂养率的变化，直至达到质量改进的目标。 结果 基线期纳入极早产儿70例，干预期纳入极早产儿72例。运行图动态显示，实施PDSA 选出改进措施后母乳喂养率上升至89%，较基线值提升了14个百分点，差异有统计学意义（P=0.039）。未发生袋鼠式护理严重不良事件及捐赠母乳相关感染。 结论 基于PDSA循环的多维度质量改进措施，可显著提高NICU极早产儿母乳喂养率。

Objective To increase the breastfeeding rate of very preterm infants in the neonatal intensive care unit (NICU). Methods The baseline period was January to December 2023, during which the breastfeeding rate for very preterm infants in the NICU of Cangzhou People's Hospital was 75%. The quality improvement period was January to December 2024, with a target to increase the rate by 10 percentage points. Effective improvement measures were identified using the plan-do-study-act (PDSA) cycle. Reasons for not receiving breast milk were analyzed, and a key driver diagram was constructed to guide targeted actions. A run chart was used to dynamically monitor monthly breastfeeding rates until the quality improvement goal was achieved. Results Seventy very preterm infants were included in the baseline group and 72 in the intervention group. The run chart showed that breastfeeding rate increased to 89% after implementation of the improvement measures, an increase of 14 percentage points from baseline, showing a statistically significant difference (P=0.039). No severe adverse events related to kangaroo care or donor milk-associated infections were reported. Conclusions Multidimensional quality improvement strategies based on the PDSA cycle significantly increase the breastfeeding rate of very preterm infants in the NICU.