Optimising Kangaroo Care to Reduce Neonatal Severe Infection/Sepsis and Resistant Bacterial Colonisation Among High-risk Infants in NICU.

NCT ID: NCT05993442

Last Updated: 2024-12-27

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

RECRUITING

Clinical Phase

NA

Total Enrollment

3080 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-28

Study Completion Date

2026-03-31

Brief Summary

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NeoDeco is a pragmatic, multicenter, parallel group, cluster randomised hybrid effectiveness-implementation study with baseline assessment, wash-in period and staggered randomisation. All sites will be offered the implementation support for optimised Kangaroo Care (KC) as part of the study; however, intervention sites will be randomised to immediate receipt of implementation support whereas standard care sites will be offered this after the study period.

Detailed Description

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The NeoDECO trial is a cluster-randomized trial involving up to 24 neonatal units across 5 European countries: Switzerland, Italy, Greece, Spain, and the United Kingdom.

Sites will be grouped into two staggered phases (with at least 10 sites in each). Within each stagger, sites will be randomized to either the intervention arm or the control arm (standard care). Randomisation will occur at the end of the baseline period, which will be identical for all sites. Intervention sites will then undergo a 2-month wash-in phase during which they will receive training and workshops on implementation strategies for optimized Kangaroo Care (KC). Each neonatal unit/site constitutes a cluster, and the intervention is applied at the unit level.

Following the wash-in phase, the intervention period for intervention sites will last 10 months. During this time, optimised KC-defined as early, repeated, and sustained skin-to-skin contact-will be continuously implemented.

All sites, regardless of their allocation (intervention or control arm), will conduct a baseline data collection phase involving clinical surveillance and colonisation assessments. This includes data and sample collection for all consented high-risk babies present in the unit on the day of assessment. Specifically, all sites will collect stool samples weekly during the baseline period and monthly during the wash-in and intervention periods from all high-risk babies present in the unit on the day of the assessment.

Additionally, one representative site per country from the intervention arm will be selected for further in-depth engagement and data collection by the implementation team. This will gather additional information on intervention fidelity and implementation strategies, including acceptability, appropriateness, feasibility, and sustainability.

At the end of the intervention period, all control sites will be supported and trained to implement the optimised KC using the selected implementation strategies.

Conditions

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Infection, Bacterial

Keywords

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Nosocomial Infection Prevention Bacterial Cluster Implementation science Surveillance Neonatal unit

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Optimised kangaroo care

The sites randomised in this group will adapt the study intervention consisting of:

Component 1: Skin-to-skin contact for optimised KC, describes the targeted level of early, repeated and sustained skin-to-skin contact (StSC) considered to represent optimised KC in a high-technology neonatal unit environment in which KC is already offered as part of routine care.

Component 2: Implementation Support aims to engage clinical staff in the neonatal unit who are involved in implementing StSC as part of optimised KC.

Group Type EXPERIMENTAL

Optimised kangaroo care

Intervention Type BEHAVIORAL

The intervention of optimised KC implementation consists of two components. Component 1 defines the targeted StSC for optimised KC, while component 2 is the implementation support to put in place a tailored implementation strategy.,

Standard of Care

The sites randomised in this group will follow the standard care, including KC and StSC sessions, treatment of severe infections/sepsis and infection prevention and control measures based on current routine local practice. Standard care in all participating NICUs already includes KC but without specific activities to ensure this is implemented according to international best practice recommendations.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Optimised kangaroo care

The intervention of optimised KC implementation consists of two components. Component 1 defines the targeted StSC for optimised KC, while component 2 is the implementation support to put in place a tailored implementation strategy.,

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* European NICUs that provide routine care of extremely premature infants (\< 28 weeks' gestational age).
* Minimum number of 12 beds offering highest level of neonatal intensive care.
* Availability of or access to -70 to -80°C freezer for storage of research samples.
* Willing to implement optimised KC if allocated to the intervention group.
* Willing to commit to offering the minimum expected target duration or an increase of 50% if NICU is already offering the minimum expected target duration, if allocated to the intervention arm.
* Prepared to implement NeoIPC surveillance
* Adequate resources and expertise and approvals from relevant Research Ethics Committees, as appropriate.

Exclusion Criteria

However, the neonatal intensive care units will have to meet the following criteria to be involved in the study:


* NICU already practices 'long-term' StSC of \> 18 hours. Major expected changes in resistant bacterial colonisation pressure during the study period, for example due to planned move to a new ward.
* Participation in other interventional IPC research projects which might directly influence the study intervention or outcome.
Maximum Eligible Age

36 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St George's, University of London

OTHER

Sponsor Role collaborator

European Clinical Research Alliance for Infectious Diseases (ECRAID)

OTHER

Sponsor Role collaborator

University of Zurich

OTHER

Sponsor Role collaborator

Universiteit Antwerpen

OTHER

Sponsor Role collaborator

Charite University, Berlin, Germany

OTHER

Sponsor Role collaborator

UMC Utrecht

OTHER

Sponsor Role collaborator

Swiss Tropical & Public Health Institute

OTHER

Sponsor Role collaborator

PENTA Foundation

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Julia Bielicki, PhD

Role: STUDY_CHAIR

St George's, University of London

Locations

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University General Hospital Attikon

Attiki, , Greece

Site Status RECRUITING

University Hospital of Heraklion

Heraklion, , Greece

Site Status RECRUITING

Ioannina University Hospital

Ioannina, , Greece

Site Status RECRUITING

Hippokration Hospital - Thessaloniki

Thessaloniki, , Greece

Site Status RECRUITING

Papageorgiou Hospital

Thessaloniki, , Greece

Site Status RECRUITING

University of Basel Children's Hospital

Basel, , Switzerland

Site Status RECRUITING

Inselspital - University Hospital of Bern

Bern, , Switzerland

Site Status RECRUITING

Hôpitaux Universitaires de Genève

Geneva, , Switzerland

Site Status RECRUITING

Children's Hospital of Eastern Switzerland St.Gallen

Sankt Gallen, , Switzerland

Site Status RECRUITING

Universitätsspital Zürich - University Hospital Zurich

Zurich, , Switzerland

Site Status RECRUITING

Countries

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Greece Switzerland

Central Contacts

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Federica D'Ambrosio

Role: CONTACT

Phone: +39 378 302 9089

Email: [email protected]

Facility Contacts

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Vana Papaevangelou, MD

Role: primary

Eleftheria Hatzidaki, MD

Role: primary

Vasileios Giapros, MD

Role: primary

Kosmas Sarafidis, MD

Role: primary

Georgios Mitsiakos, MD

Role: primary

Kerstin Jost, MD

Role: primary

Benedikt Bubl, MD

Role: primary

Flavia Rosa Mangeret, MD

Role: primary

Stefanie Grabner, MD

Role: primary

Susanne Böttger, MD

Role: primary

Related Links

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https://neoipc.org/

NeoDeco study is part of the NeoIPC project funded by the European Commission.

Other Identifiers

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NeoDeco

Identifier Type: -

Identifier Source: org_study_id