Nosocomial InfectionsNCT02600195
Reduction of Infection in Neonatal Intensive Care Units Using the Evidence-based Practice for Improving Quality
A study testing Evidence-based Practice for Improving Quality (EPIQ) method in people with Nosocomial Infections, run by Children's Hospital of Fudan University at 24 sites in China.
Trial 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). Read more about this study
- Who is it for?
- Ages Up to 120 days
- Conditions the study is for
- Nosocomial Infections
- What is being tested?
- Evidence-based Practice for Improving Quality (EPIQ) method
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 15,600 participants
- Where
- 24 sitesChina
- Study dates
- May 2015to 30 Apr 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Up to 120 days
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- 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
Who cannot join
- Infants with major congenital anomalies
- Infants who are moribund on admission (a decision is made to provide only palliative care)
Trial locations and contacts
24 sites in 1 country.
24 sites in 1 country
China24 sites
Beijing Children's Hospital
Beijing, Beijing Municipality
The Third Xiangya Hospital of Central South University
Changsha, Hunan
Fujian Maternity and Child Health Care Hospital
Fuzhou, Fujian
Guiyang Children's Hospital
Guiyang, Guizhou
The First Affiliated Hospital of Anhui Medical University
Hefei, Anhui
Jinan Children's Hospital
Jinan, Shandong
Gansu Maternity and Child Health Care Hospital
Lanzhou, Gansu
Jiangxi Children's Hospital
Nanchang, Jiangxi
Nanjing Children's Hospital
Nanjing, Jiangsu
Nanjing Maternity and Child Health Care Hospital
Nanjing, Jiangsu
Guangxi Maternity and Child Health Care Hospital
Nanning, Guangxi
Qingdao Maternity and Child Health Care Hospital
Qingdao, Shandong
Shanghai First Maternity and Child Health Care Hospital
Shanghai
Shenzhen Maternity and Child Health Care Hospital
Shenzhen, Guangdong
Children's Hospital of Hebei Province
Shijiazhuang, Hebei
Suzhou Municipal Hospital
Suzhou, Jiangsu
Shanxi Maternity and Child Health Care Hospital
Taiyuan, Shanxi
The First Affiliated Hospital of Xinjiang Medical University
Ürümqi, Xinjiang
The Second Affiliated Hospital of Wenzhou Medical College
Wenzhou, Zhejiang
Hubei Maternity and Child Health Care Hospital
Wuhan, Hubei
Tongji Hospital Affiliated to Tongji Medical College
Wuhan, Hubei
Wuxi Maternity and Child Health Care Hospital
Wuxi, Jiangsu
Shanxi Maternity and Child Health Care Hospital
Xian, Shanxi
Zhengzhou Children's Hospital
Zhengzhou, Henan
About this study
Official title: Reduction of Infection in Neonatal Intensive Care Units Using the Evidence-based Practice for Improving Quality: A Cluster Randomised Trial
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).
Read the 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.
- Conditions
- Nosocomial Infections
- Being tested
- Evidence-based Practice for Improving Quality (EPIQ) method
- Keywords
- Intensive Care, Neonatal, Nosocomial Infections, Quality Improvement
- Medical subject headings
- Cross Infection
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Evidence-based Practice for Improving Quality (EPIQ) methodBehavioural
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.
| Study group | Role | What they receive |
|---|---|---|
| EPIQ sites | Experimental | Use Evidence-based Practice for Improving Quality (EPIQ) method to develop and implement evidence-based practice changes to reduce hospital-acquired infection Receives: Behavioral: Evidence-based Practice for Improving Quality (EPIQ) method |
| Control sites | No intervention | Continue current practices |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of hospital-acquired infection
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
Measured: Three years
Secondary outcomes (13)
Incidence of ventilation associated pneumonia
Measured: Three years
Incidence of central line-associated blood stream infection
Measured: Three years
Incidence of blood stream infection excluding CLABSI
Measured: Three years
Incidence of meningitis
Measured: Three years
Incidence of clinical sepsis
Measured: Three years
Incidence of urinary tract infections
Measured: Three years
Incidence of stage ≥2 necrotizing enterocolitis
Measured: Three years
Days on ventilation support
Measured: Three years
Days on total parenteral nutrition
Measured: Three years
Days on antibiotics
Measured: Three years
Days on inotropes
Measured: Three years
All cause mortality
Measured: Three years
Infection-related mortality
Measured: Three years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Nov 2015 (estimated)
- Study startMay 2015
- Primary completionApr 2018
- Study completion30 Apr 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for Nosocomial InfectionsStudies of the same condition, open and under way.
- More trials run by Children's Hospital of Fudan UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 15,600 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Children's Hospital of Fudan University
- Sponsor type
- University, hospital or other
- Collaborators
- China Medical Board
- Responsible party
- Sponsor
- Investigators
- Yun Cao, MD, PHD, Principal investigator, Children's Hospital of Fudan UniversityVibhuti Shah, MD, Msc, Principal investigator, University of TorontoShoo K Lee, MD, PHD, Principal investigator, University of TorontoWeiping Wang, MD, PHD, Principal investigator, Fudan University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02600195
- Sponsor's protocol ID
- 14-194
- Status last verified
- Aug 2018
- First submitted
- 5 Nov 2015
- Last updated
- 7 Aug 2018
- Results posted
- No
- Data monitoring committee
- Yes
Publications
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.
PubMed 19667033Zhou 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.
PubMed 24041863Polin 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.
PubMed 22451712Fanaroff 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.
PubMed 14510318Horbar 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.
PubMed 20363446Peng 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.
PubMed 35236170Luo 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.
PubMed 33968845Peng 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.
PubMed 32078781
Study at a glance
From the registry record, last updated by the sponsor on 7 Aug 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Reduction of Infection in Neonatal Intensive Care Units Using the Evidence-based Practice for Improving Quality: A Cluster Randomised Trial
- ClinicalTrials.gov ID
- NCT02600195
- Acronym / sponsor ID
- 14-194
- Conditions
- Nosocomial Infections
- Keywords
- Intensive Care, Neonatal, Nosocomial Infections, Quality Improvement
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 15,600 participants (estimated)
- Lead sponsor
- Children's Hospital of Fudan UniversityUniversity, hospital or other
- Collaborators
- China Medical Board
- Study start
- May 2015
- Primary completion
- Apr 2018 (actual)
- Study completion
- 30 Apr 2018 (actual)
- First posted
- 9 Nov 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| EPIQ sites | Experimental | Behavioral: Evidence-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 |
| Control sites | No intervention | –Continue current practices |
Who may qualify
- Ages
- Up to 120 days
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (3 listed)
- 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
Key exclusion criteria (2 listed)
- Infants with major congenital anomalies
- Infants who are moribund on admission (a decision is made to provide only palliative care)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Evidence-based Practice for Improving Quality (EPIQ) methodThe 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. | Behavioural | EPIQ sites |
Primary outcome
Incidence of hospital-acquired infection
Time frame: Three 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
13 secondary outcomes
Incidence of ventilation associated pneumonia
Time frame: Three years
Incidence of central line-associated blood stream infection
Time frame: Three years
Incidence of blood stream infection excluding CLABSI
Time frame: Three years
Incidence of meningitis
Time frame: Three years
Incidence of clinical sepsis
Time frame: Three years
Incidence of urinary tract infections
Time frame: Three years
Incidence of stage ≥2 necrotizing enterocolitis
Time frame: Three years
Days on ventilation support
Time frame: Three years
Days on total parenteral nutrition
Time frame: Three years
Days on antibiotics
Time frame: Three years
Days on inotropes
Time frame: Three years
All cause mortality
Time frame: Three years
Infection-related mortality
Time frame: Three years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Aug 2018.
- Background: PubMed 19667033Lee 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.
- Background: PubMed 24041863Zhou 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.
- Background: PubMed 22451712Polin 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.
- Background: PubMed 14510318Fanaroff 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.
- Background: PubMed 20363446Horbar 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.
- Derived from this study: PubMed 35236170Peng 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.
- Derived from this study: PubMed 33968845Luo 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.
- Derived from this study: PubMed 32078781Peng 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.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Yun Cao, MD, PHD principal investigator
Children's Hospital of Fudan University
Vibhuti Shah, MD, Msc principal investigator
University of Toronto
Shoo K Lee, MD, PHD principal investigator
University of Toronto
24 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Evidence-based Practice for Improving Quality (EPIQ) method in people with Nosocomial Infections, run by Children's Hospital of Fudan University at 24 sites in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Aug 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 24 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incidence of hospital-acquired infection (time frame: Three years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02600195, which also lists 8 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Aug 2018.