Nosocomial Infections
Conditions
Keywords
Intensive Care, Neonatal, Nosocomial Infections, Quality Improvement
Brief summary
This 4-year cluster randomized controlled trial aims to determine whether implementation of Evidence-based Practice for Improving Quality (EPIQ) method can reduce hospital-acquired infection in Chinese Neonatal Intensive Care Units (NICUs).
Detailed description
Following randomization into two groups, the intervention NICUs (n = 12) will receive training in the EPIQ method and then develop, implement, and document evidence-based practice changes to reduce hospital-acquired infection. Compliance with practice changes and neonatal outcomes will be monitored. NICUs will receive quarterly feedback on their progress, as well as access to implementation support. Control NICUs (n = 12) will collect neonatal data and continue to provide standard care. Study subjects will be all preterm infants born at \<34 weeks' gestation and admitted to participating NICUs during the trial (estimated n = 5,200 per year). Data analysis will be conducted to compare neonatal outcomes and health-care resources used between the intervention and control groups.
Interventions
BEHAVIORALEvidence-based Practice for Improving Quality (EPIQ) method
The intervention NICUs (n = 12) will receive training in the Evidence-based Practice for Improving Quality (EPIQ) method and then develop, implement, and document evidence-based practice changes to reduce hospital-acquired infection. Compliance with practice changes and neonatal outcomes will be monitored. NICUs will receive quarterly feedback on their progress, as well as access to implementation support.
Sponsors
China Medical Board
Children's Hospital of Fudan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 120 Days
Healthy volunteers
No
Inclusion criteria
* Infants born at \<34 weeks' gestation * Admitted to the participating NICUs within 7 days after birth * Admitted to the participating NICUs between May 1, 2015 and April 30, 2018
Exclusion criteria
* Infants with major congenital anomalies * Infants who are moribund on admission (a decision is made to provide only palliative care)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of hospital-acquired infection | Three years | Combined cases of following types of hospital-acquired infection: ventilation associated pneumonia, central line-associated blood stream infection (CLABSI), blood stream infections excluding CLABSI, urinary tract infections, meningitis, clinical sepsis |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of central line-associated blood stream infection | Three years |
| Incidence of blood stream infection excluding CLABSI | Three years |
| Incidence of meningitis | Three years |
| Incidence of clinical sepsis | Three years |
| Incidence of urinary tract infections | Three years |
| Incidence of stage ≥2 necrotizing enterocolitis | Three years |
| Incidence of ventilation associated pneumonia | Three years |
| Days on total parenteral nutrition | Three years |
| Days on antibiotics | Three years |
| Days on inotropes | Three years |
| All cause mortality | Three years |
| Infection-related mortality | Three years |
| Days on ventilation support | Three years |
Countries
China
Outcome results
None listed