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Introduction: Parenteral nutrition, usually indicated for preterm infants with a birthweight<1500 g and sick newborns, enables the supply with critical nutrients. As a high degree of therapy safety is required, a European guideline provides recommendations for safe therapy procedures. The present project aimed to evaluate the implementation of the European guideline in German perinatal centers and to identify possible barriers that impede its implementation. A further goal was to develop solution approaches to overcome possible barriers., Methods and Results: A multidisciplinary cooperation conducted an online survey questioning the current implementation procedures of the European guideline among pediatricians and hospital pharmacists. Results show barriers in the provisioning process of parenteral nutrition that hinder a guideline-compliant implementation in practice. Based on results of this survey, an expert network developed an interactive toolkit with simplified guideline recommendations, guideline-compliant advice for practice, best-practice examples, forms, and handouts. It seeks to encourage critical reflection of routine processes and provides concrete solutions to overcome barriers in practice., Conclusion: The current procedures related to parenteral nutrition deviate from guideline recommendations. The developed toolkit provides practice-oriented support aiming to enhance the guideline-compliant implementation of parenteral nutrition in perinatal centers., Competing Interests: EFCNI erhielt einen Educational Grant von Baxter zur Projektdurchführung. Es bestehen keine weiteren Interessenskonflikte., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Background: NEO-KISS is a national surveillance system generating reference data for nosocomial infections among very low birth weight infants (VLBW) and was established 2000 as a voluntary based system. Since 2006 exist an official decision that participation in NEO-KISS is a prerequisite for the care of VLBW at level III NICUs in Germany., Method: Comparing the reference data before and after the resolution and analysing the structure and the infection rates between the departments participating since 2006 (new-departments) and the neonatology departments participating voluntary before 2006 (old-departments)., Results: Since 2006 the number of participating departments increased clarion. The characteristic of the 110 new-departments differs from the 46 old-departments in many ways. The old-departments treated more VLBW per month, have more beds and are located at larger hospitals. The distribution of the treated VLBW shows a trend to lower birth-weights in the old-departments. However, the comparison of the reference data 2005, generated only from data from old-departments, shows no systematic changes to the reference data 2006 (including data from numerous new-departments). Also the comparison of the infection rates from for an identical time period separated for new and old-departments shows only minor differences., Conclusion: The inclusion of many new departments in NEO-KISS shows no influence to the reference data. And also the comparison of infection rates between new and old-departments shows no systematic discrepancy. It follows the unnecessary of separating the data from old-departments and new-departments and the appropriateness of the entire databank to generate the national reference data.