Antibiotic Stewardship, Neonatal Sepsis, Late-Onset, Vancomycin
Conditions
Keywords
implementation study
Brief summary
This multi-center, cluster randomized study aimed at improving implementation of vancomycin reducing practices (VRP) in neonatal intensive care units (NICUs). Sites will be recruited and randomized to receive either external facilitation or no external facilitation to assess the effect on center-level fidelity to the core components of VRP implementation. Interventions available to both study arms are directed at hospital staff and includes identification of local champions, educational outreach, unit-level audit & feedback, and use of a clinical decision support tool.
Interventions
BEHAVIORALExternal Facilitation
Designated external facilitators will conduct monthly meetings with local champions at each site. Designated facilitators will follow the developed facilitation guide, that includes content area to cover in each meeting, case scenarios as examples, and tips on how to communicate and support the internal facilitators. The goal is to enable problem-solving and support the local champion in implementing VRP with fidelity
Sponsors
Agency for Healthcare Research and Quality (AHRQ)
Children's Hospital of Philadelphia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
Cluster randomized study of external facilitation as an implementation strategy
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Level III NICU * Affiliated with Kaiser Permanente Northern California (KPNC) or Children's Hospital of Philadelphia Newborn Care Network (CNBCN) * Recruited by study team
Exclusion criteria
* Site not recruited for the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fidelity of VRP use | 2.5 years - From beginning of implementation phase to the end of the sustainment phase | Proportion of late onset sepsis (LOS) evaluations performed with high fidelity. High fidelity is defined when the evaluation follows all three core components of VRP use. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Appropriateness/acceptability | 2.5 years - From beginning of implementation phase to the end of the sustainment phase | Response to questions about whether vancomycin reducing practices (VRP) was agreeable and/or a good fit for the unit measured using validated instruments comprising of 5-point Likert scales (Weiner et al). Participants are offered options ranging from completely disagree (1) to completely agree (5), with higher scores indicating a higher degree of acceptability or feasibility. |
Countries
United States
Contacts
Primary ContactKayla Gilpin
Backup ContactMorgan Gabbert
Outcome results
None listed