Implementing Vancomycin Reducing Practices (VRP) in Preterm Infants

What this Trial Is About

Researchers are evaluating methods to improve the use of vancomycin reduction practices (VRP) in neonatal intensive care units (NICUs) to support antibiotic stewardship and manage late-onset neonatal sepsis. This study is a multi-center, cluster randomized trial that compares the effect of providing external facilitation guidance against no external facilitation on how well NICUs follow VRP core components. The lead sponsor is the Children's Hospital of Philadelphia. The study involves two groups of hospital sites: one group receives support through external facilitators who conduct monthly meetings with local champions, using a detailed facilitation guide to help implement VRP with fidelity. The other group does not receive this external facilitation. Both groups have access to interventions aimed at hospital staff, including identifying local champions, educational outreach, unit-level audits and feedback, and a clinical decision support tool. Participants, meaning the NICU sites, will be observed over 2.5 years from the start of VRP implementation through the sustainment phase. Researchers will assess how faithfully the centers implement VRP and evaluate the appropriateness and acceptability of these practices. The study does not involve masking or blinding and focuses on site-level outcomes related to antibiotic use and sepsis management in preterm infants.

Vancomycin Reduction Practices (VRP) in the NICU