Single Patient Room Versus Open Bay in NICU

NCT ID: NCT03867669

Last Updated: 2019-03-08

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-04-11

Study Completion Date

2023-03-31

Brief Summary

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The NICU at the IWK Health Center in Halifax, Nova Scotia is embarking on a redevelopment project that will see its current open bay design converted to a single room care environment. There will be a period during the redevelopment when new single room care unit will coexist with one open bay unit. This provides a unique opportunity to explore the effect of the two different environmental designs on both short and long-term outcomes. Preterm infants (under 31 weeks gestational age) and very low birth weight infants (under 1500 grams) will be randomized to either the open bay unit or the single patient room unit, at 36 months corrected age neurodevelopmental outcomes will be assessed.

Detailed Description

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Do very preterm infants (\< 31 weeks gestational age) and very low birth weight infants (\< 1500 grams) admitted to a single patient room in the NICU have improved long-term neurodevelopmental outcomes when compared to very preterm infants admitted to an open bay in the NICU?

Babies who will be admitted to NICU will be randomized to either the open-bay unit or single room care. The randomization will be achieved through the use of the WANNNT (Winnipeg Assessment of Neonatal Nurses Need Tool) and current patient census; this involves taking 1/3 of the fraction of the patient census on each team and adding it to 2/3 of the fraction of the WANNNT. This methodology was reviewed by several IWK Committees including Ethics, Family Leadership Council, Neonatal care Committee and the Family Centered Care Committee. This randomization is designed to ensure fairness and an equitable workload between the two units.

Eligible study infants are also enrolled in the Perinatal Follow-Up Program (PFU) as a standard of care at the IWK Health Center. The baby's legal guardian signs a consent to be enrolled in the PFU Program and to allow collection and use of data for their child as long as their child cannot be identified from the use of the data. All families of infants admitted to NICU, whether or not they have been enrolled in the PFU Program will receive an information package explaining the single patient room NICU compared with the open bay NICU.

At three years of corrected gestational age, all eligible infants will have the Bayley Scales of Infant and Toddler Development - version 3 assessment completed which evaluates cognitive, language and motor skills. These infants will also be examined for the presence or absence of cerebral palsy.

Conditions

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Neurodevelopmental Outcomes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Single Patient Room

Patients randomized to this arm will be admitted to a NICU single patient room.

Group Type EXPERIMENTAL

Single patient room

Intervention Type OTHER

The eligible infants will be randomized at birth/admission to either the single patient room (experimental) or the open bay unit (Comparator)

Open Bay

Patients randomized to this arm will be admitted to the open bay NICU Unit.

Group Type PLACEBO_COMPARATOR

Open Bay Unit

Intervention Type OTHER

The eligible infants will be randomized at birth/admission to either the single patient room (experimental) or the open bay unit (Comparator)

Interventions

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Open Bay Unit

The eligible infants will be randomized at birth/admission to either the single patient room (experimental) or the open bay unit (Comparator)

Intervention Type OTHER

Single patient room

The eligible infants will be randomized at birth/admission to either the single patient room (experimental) or the open bay unit (Comparator)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All very preterm infants born less than 31 weeks gestational age or birth weight less than or equal to 1500 grams
* age less than 14 days
* Multiples will be randomized to the same arm.

Exclusion Criteria

* Babies with major anomalies
* Babies admitted for palliative care only
Maximum Eligible Age

14 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dalhousie University

OTHER

Sponsor Role collaborator

IWK Health Centre

OTHER

Sponsor Role lead

Responsible Party

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Mike Vincer

Michael Vincer, Staff Neonatologist, Medical Director Perinatal Follow Up Program

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michael Vincer

Role: PRINCIPAL_INVESTIGATOR

Dalhousie University

Locations

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IWK Health Centre

Halifax, Nova Scotia, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Tara Hatfield

Role: CONTACT

902-470-6630

Wendy Mitchell

Role: CONTACT

902-470-6466

Facility Contacts

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Tara R Hatfield

Role: primary

902-470-6630

Hatfield

Role: backup

References

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Domanico R, Davis DK, Coleman F, Davis BO. Documenting the NICU design dilemma: comparative patient progress in open-ward and single family room units. J Perinatol. 2011 Apr;31(4):281-8. doi: 10.1038/jp.2010.120. Epub 2010 Nov 11.

Reference Type BACKGROUND
PMID: 21072040 (View on PubMed)

Erdeve O, Arsan S, Canpolat FE, Ertem IO, Karagol BS, Atasay B, Yurdakok M, Tekinalp G, Turmen T. Does individual room implemented family-centered care contribute to mother-infant interaction in preterm deliveries necessitating neonatal intensive care unit hospitalization? Am J Perinatol. 2009 Feb;26(2):159-64. doi: 10.1055/s-0028-1095186. Epub 2008 Nov 19.

Reference Type BACKGROUND
PMID: 19021100 (View on PubMed)

Lester BM, Hawes K, Abar B, Sullivan M, Miller R, Bigsby R, Laptook A, Salisbury A, Taub M, Lagasse LL, Padbury JF. Single-family room care and neurobehavioral and medical outcomes in preterm infants. Pediatrics. 2014 Oct;134(4):754-60. doi: 10.1542/peds.2013-4252. Epub 2014 Sep 22.

Reference Type BACKGROUND
PMID: 25246623 (View on PubMed)

Lester BM, Salisbury AL, Hawes K, Dansereau LM, Bigsby R, Laptook A, Taub M, Lagasse LL, Vohr BR, Padbury JF. 18-Month Follow-Up of Infants Cared for in a Single-Family Room Neonatal Intensive Care Unit. J Pediatr. 2016 Oct;177:84-89. doi: 10.1016/j.jpeds.2016.06.069. Epub 2016 Jul 26.

Reference Type BACKGROUND
PMID: 27470693 (View on PubMed)

Ortenstrand A, Westrup B, Brostrom EB, Sarman I, Akerstrom S, Brune T, Lindberg L, Waldenstrom U. The Stockholm Neonatal Family Centered Care Study: effects on length of stay and infant morbidity. Pediatrics. 2010 Feb;125(2):e278-85. doi: 10.1542/peds.2009-1511. Epub 2010 Jan 25.

Reference Type BACKGROUND
PMID: 20100748 (View on PubMed)

Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997 Apr;39(4):214-23. doi: 10.1111/j.1469-8749.1997.tb07414.x.

Reference Type BACKGROUND
PMID: 9183258 (View on PubMed)

Pineda RG, Neil J, Dierker D, Smyser CD, Wallendorf M, Kidokoro H, Reynolds LC, Walker S, Rogers C, Mathur AM, Van Essen DC, Inder T. Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. J Pediatr. 2014 Jan;164(1):52-60.e2. doi: 10.1016/j.jpeds.2013.08.047. Epub 2013 Oct 17.

Reference Type BACKGROUND
PMID: 24139564 (View on PubMed)

Wood-Kaczmar A, Deas E, Wood NW, Abramov AY. The role of the mitochondrial NCX in the mechanism of neurodegeneration in Parkinson's disease. Adv Exp Med Biol. 2013;961:241-9. doi: 10.1007/978-1-4614-4756-6_20.

Reference Type BACKGROUND
PMID: 23224884 (View on PubMed)

Vohr B, McGowan E, McKinley L, Tucker R, Keszler L, Alksninis B. Differential Effects of the Single-Family Room Neonatal Intensive Care Unit on 18- to 24-Month Bayley Scores of Preterm Infants. J Pediatr. 2017 Jun;185:42-48.e1. doi: 10.1016/j.jpeds.2017.01.056. Epub 2017 Feb 24.

Reference Type BACKGROUND
PMID: 28238479 (View on PubMed)

White RD, Smith JA, Shepley MM; Committee to Establish Recommended Standards for Newborn ICU Design. Recommended standards for newborn ICU design, eighth edition. J Perinatol. 2013 Apr;33 Suppl 1:S2-16. doi: 10.1038/jp.2013.10.

Reference Type BACKGROUND
PMID: 23536026 (View on PubMed)

Bayley, N. (2006). Bayley Scales of Infant and Toddler Development: Technical manual (3rd ed.). San Antonio, TX: Harcourt Assessment, Inc.

Reference Type BACKGROUND

Stevens, D. C., Munson, D. P., & Khan, M. A. (2016). The single-family room neonatal intensive care environment. NeoReviews, 17(12)(17(12)), e687-e696.

Reference Type BACKGROUND

Provided Documents

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Document Type: Informed Consent Form

View Document

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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http://cna-aiic.ca/~/media/cna/files/safe-staffing-toolkit/WANNNT-2013.pdf

Winnipeg Regional Health Authority. Winnipeg Assessment of Neonatal Nurses Need Tool (WANNNT). Retrieved 01/15, 2018

Other Identifiers

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Single room vs open bay

Identifier Type: -

Identifier Source: org_study_id

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