Reduction of Infection in Neonatal Intensive Care Units Using the Evidence-based Practice for Improving Quality

NCT ID: NCT02600195

Last Updated: 2018-08-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

15600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-31

Study Completion Date

2018-04-30

Brief Summary

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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

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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.

Conditions

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Nosocomial Infections

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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EPIQ sites

Use Evidence-based Practice for Improving Quality (EPIQ) method to develop and implement evidence-based practice changes to reduce hospital-acquired infection

Group Type EXPERIMENTAL

Evidence-based Practice for Improving Quality (EPIQ) method

Intervention Type BEHAVIORAL

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.

Control sites

Continue current practices

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Evidence-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.

Intervention Type BEHAVIORAL

Eligibility Criteria

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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)
Maximum Eligible Age

120 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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China Medical Board

OTHER

Sponsor Role collaborator

Children's Hospital of Fudan University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Yun Cao, MD, PHD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital of Fudan University

Vibhuti Shah, MD, Msc

Role: PRINCIPAL_INVESTIGATOR

University of Toronto

Shoo K Lee, MD, PHD

Role: PRINCIPAL_INVESTIGATOR

University of Toronto

Weiping Wang, MD, PHD

Role: PRINCIPAL_INVESTIGATOR

Fudan University

Locations

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The First Affiliated Hospital of Anhui Medical University

Hefei, Anhui, China

Site Status

Beijing Children's Hospital

Beijing, Beijing Municipality, China

Site Status

Fujian Maternity and Child Health Care Hospital

Fuzhou, Fujian, China

Site Status

Gansu Maternity and Child Health Care Hospital

Lanzhou, Gansu, China

Site Status

Shenzhen Maternity and Child Health Care Hospital

Shenzhen, Guangdong, China

Site Status

Guangxi Maternity and Child Health Care Hospital

Nanning, Guangxi, China

Site Status

Guiyang Children's Hospital

Guiyang, Guizhou, China

Site Status

Children's Hospital of Hebei Province

Shijiazhuang, Hebei, China

Site Status

Zhengzhou Children's Hospital

Zhengzhou, Henan, China

Site Status

Hubei Maternity and Child Health Care Hospital

Wuhan, Hubei, China

Site Status

Tongji Hospital Affiliated to Tongji Medical College

Wuhan, Hubei, China

Site Status

The Third Xiangya Hospital of Central South University

Changsha, Hunan, China

Site Status

Nanjing Children's Hospital

Nanjing, Jiangsu, China

Site Status

Nanjing Maternity and Child Health Care Hospital

Nanjing, Jiangsu, China

Site Status

Suzhou Municipal Hospital

Suzhou, Jiangsu, China

Site Status

Wuxi Maternity and Child Health Care Hospital

Wuxi, Jiangsu, China

Site Status

Jiangxi Children's Hospital

Nanchang, Jiangxi, China

Site Status

Jinan Children's Hospital

Jinan, Shandong, China

Site Status

Qingdao Maternity and Child Health Care Hospital

Qingdao, Shandong, China

Site Status

Shanxi Maternity and Child Health Care Hospital

Taiyuan, Shanxi, China

Site Status

Shanxi Maternity and Child Health Care Hospital

Xian, Shanxi, China

Site Status

The First Affiliated Hospital of Xinjiang Medical University

Ürümqi, Xinjiang, China

Site Status

The Second Affiliated Hospital of Wenzhou Medical College

Wenzhou, Zhejiang, China

Site Status

Shanghai First Maternity and Child Health Care Hospital

Shanghai, , China

Site Status

Countries

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China

References

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Lee SK, Aziz K, Singhal N, Cronin CM, James A, Lee DS, Matthew D, Ohlsson A, Sankaran K, Seshia M, Synnes A, Walker R, Whyte R, Langley J, MacNab YC, Stevens B, von Dadelszen P. Improving the quality of care for infants: a cluster randomized controlled trial. CMAJ. 2009 Oct 13;181(8):469-76. doi: 10.1503/cmaj.081727. Epub 2009 Aug 10.

Reference Type BACKGROUND
PMID: 19667033 (View on PubMed)

Zhou Q, Lee SK, Jiang SY, Chen C, Kamaluddeen M, Hu XJ, Wang CQ, Cao Y. Efficacy of an infection control program in reducing ventilator-associated pneumonia in a Chinese neonatal intensive care unit. Am J Infect Control. 2013 Nov;41(11):1059-64. doi: 10.1016/j.ajic.2013.06.007. Epub 2013 Sep 14.

Reference Type BACKGROUND
PMID: 24041863 (View on PubMed)

Polin RA, Denson S, Brady MT; Committee on Fetus and Newborn; Committee on Infectious Diseases. Strategies for prevention of health care-associated infections in the NICU. Pediatrics. 2012 Apr;129(4):e1085-93. doi: 10.1542/peds.2012-0145. Epub 2012 Mar 26.

Reference Type BACKGROUND
PMID: 22451712 (View on PubMed)

Fanaroff AA, Hack M, Walsh MC. The NICHD neonatal research network: changes in practice and outcomes during the first 15 years. Semin Perinatol. 2003 Aug;27(4):281-7. doi: 10.1016/s0146-0005(03)00055-7.

Reference Type BACKGROUND
PMID: 14510318 (View on PubMed)

Horbar JD, Soll RF, Edwards WH. The Vermont Oxford Network: a community of practice. Clin Perinatol. 2010 Mar;37(1):29-47. doi: 10.1016/j.clp.2010.01.003.

Reference Type BACKGROUND
PMID: 20363446 (View on PubMed)

Peng W, Han J, Li S, Zhang L, Yang C, Guo J, Cao Y. The Association of Human Milk Feeding With Short-Term Health Outcomes Among Chinese Very/Extremely Low Birth Weight Infants. J Hum Lact. 2022 Nov;38(4):670-677. doi: 10.1177/08903344221078237. Epub 2022 Mar 2.

Reference Type DERIVED
PMID: 35236170 (View on PubMed)

Luo N, Jiang S, McNamara PJ, Li X, Guo Y, Wang Y, Han J, Deng Y, Yang Y, Lee SK, Cao Y. Cardiovascular Pharmacological Support Among Preterm Infants in Chinese Referral Center Neonatal Intensive Care Units. Front Pediatr. 2021 Apr 22;9:638540. doi: 10.3389/fped.2021.638540. eCollection 2021.

Reference Type DERIVED
PMID: 33968845 (View on PubMed)

Peng W, Jiang S, Li S, Xia S, Chen S, Yang Y, Lee SK, Cao Y. Human Milk Feeding Status of Preterm Infants in Neonatal Intensive Care Units in China. J Hum Lact. 2020 May;36(2):283-290. doi: 10.1177/0890334419901265. Epub 2020 Feb 20.

Reference Type DERIVED
PMID: 32078781 (View on PubMed)

Other Identifiers

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14-194

Identifier Type: -

Identifier Source: org_study_id

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