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

Not Applicable
Completed
Conditions
Nosocomial Infections
Interventions
Behavioral: Evidence-based Practice for Improving Quality (EPIQ) method
Registration Number
NCT02600195
Lead Sponsor
Children's Hospital of Fudan University
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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
15600
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)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
EPIQ sitesEvidence-based Practice for Improving Quality (EPIQ) methodUse Evidence-based Practice for Improving Quality (EPIQ) method to develop and implement evidence-based practice changes to reduce hospital-acquired infection
Primary Outcome Measures
NameTimeMethod
Incidence of hospital-acquired infectionThree 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 Outcome Measures
NameTimeMethod
Days on antibioticsThree years
Days on total parenteral nutritionThree years
Incidence of ventilation associated pneumoniaThree years
Incidence of meningitisThree years
Incidence of central line-associated blood stream infectionThree years
Incidence of blood stream infection excluding CLABSIThree years
Incidence of clinical sepsisThree years
Incidence of urinary tract infectionsThree years
Incidence of stage ≥2 necrotizing enterocolitisThree years
Days on ventilation supportThree years
Days on inotropesThree years
All cause mortalityThree years
Infection-related mortalityThree years

Trial Locations

Locations (23)

Shanxi Maternity and Child Health Care Hospital

🇨🇳

Xian, Shanxi, China

The First Affiliated Hospital of Anhui Medical University

🇨🇳

Hefei, Anhui, China

Gansu Maternity and Child Health Care Hospital

🇨🇳

Lanzhou, Gansu, China

Hubei Maternity and Child Health Care Hospital

🇨🇳

Wuhan, Hubei, China

Nanjing Children's Hospital

🇨🇳

Nanjing, Jiangsu, China

Nanjing Maternity and Child Health Care Hospital

🇨🇳

Nanjing, Jiangsu, China

Guiyang Children's Hospital

🇨🇳

Guiyang, Guizhou, China

Wuxi Maternity and Child Health Care Hospital

🇨🇳

Wuxi, Jiangsu, China

Beijing Children's Hospital

🇨🇳

Beijing, Beijing, China

Tongji Hospital Affiliated to Tongji Medical College

🇨🇳

Wuhan, Hubei, China

Shenzhen Maternity and Child Health Care Hospital

🇨🇳

Shenzhen, Guangdong, China

Guangxi Maternity and Child Health Care Hospital

🇨🇳

Nanning, Guangxi, China

Children's Hospital of Hebei Province

🇨🇳

Shijiazhuang, Hebei, China

Zhengzhou Children's Hospital

🇨🇳

Zhengzhou, Henan, China

Fujian Maternity and Child Health Care Hospital

🇨🇳

Fuzhou, Fujian, China

Jiangxi Children's Hospital

🇨🇳

Nanchang, Jiangxi, China

Jinan Children's Hospital

🇨🇳

Jinan, Shandong, China

Qingdao Maternity and Child Health Care Hospital

🇨🇳

Qingdao, Shandong, China

Shanghai First Maternity and Child Health Care Hospital

🇨🇳

Shanghai, China

The Third Xiangya Hospital of Central South University

🇨🇳

Changsha, Hunan, China

Suzhou Municipal Hospital

🇨🇳

Suzhou, Jiangsu, China

The Second Affiliated Hospital of Wenzhou Medical College

🇨🇳

Wenzhou, Zhejiang, China

The First Affiliated Hospital of Xinjiang Medical University

🇨🇳

Urumqi, Xinjiang, China

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