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1. Asian Neonatal Network Collaboration (AsianNeo): a study protocol for international collaborative comparisons of health services and outcomes to improve quality of care for sick newborn infants in Asia – survey, cohort and quality improvement studies

Author

Yumi Kono, Hidehiko Nakanishi, Satoshi Kusuda, Hirokazu Arai, Maki Sato, Hiroaki Imamura, Takahide Yanagi, Moriharu Sugimoto, Hiroshi Matsumoto, Takashi Nakano, Satoshi Watanabe, Tomoaki Ioroi, Shigeharu Hosono, Makoto Nabetani, Osuke Iwata, Naho Morisaki, Bin Huey Quek, Kaoru Okazaki, Hideaki Harada, Masaki Kobayashi, Yuh-Jyh Lin, Yayoi Miyazono, Isamu Hokuto, Hiroshi Komatsu, Hiroshi Suzuki, Chayatat Ruangkit, Yuko Maruyama, Daisuke Nishi, Shanika Kosarat, Kapila Jayaratne, Tetsuya Isayama, Toshinori Nakashima, Tsutomu Ogata, Takashi Yamagami, Zubair Amin, Shinya Hirano, Seiji Yoshimoto, Chih-Cheng Chen, Yuji Ito, Rinawati Rohsiswatmo, Pertin Sianturi, Rocky Wilar, Dwi Hidayah, Risa Etika, Afifa Ramadanti, Pudji Andayani, Ema Alasiry, Ellen Sianipar, Yosuke Shima, Takashi Tachibana, Takahiro Okutani, Soon Min Lee, Hitoshi Yoda, Ichiro Morioka, Woei Bing Poon, Asao Yara, Akira Nishimura, Masato Ito, Tadayuki Kumagai, Hiroshi Yoshida, Takashi Okuno, Mei-Jy Jeng, Ee-Kyung Kim, Buranee Swatesutipun, Kei Inomata, Yuichi Kato, Kiyoaki Sumi, Atsushi Uchiyama, Narongsak Nakwan, Juyoung Lee, Keiji Goishi, Hiroshi Yamamoto, Hsiu-Ling Chen, Masahiro Kobayashi, Kazumasa Takahashi, Masayuki Ochiai, Fumihiko Ishida, Seok Chiong Chee, Siew Hong Neoh, Ee Lee Ang, Ann Cheng Wong, Masaru Shirai, Toru Ishioka, Toshihiko Mori, Toru Huchimukai, Kyone Ko, Akira Shimazaki, Tatsuya Yoda, Azusa Kobayashi, Yasushi Uchida, Mitsuhiro Ito, Kuniko Ieda, Toshiyuki Ono, Masashi Hayashi, Kanemasa Maki, Kozue Shiomi, Koji Nozaki, Taho Kim, Yasuyuki Tokunaga, Akihiro Takatera, Hiroshi Sumida, Yae Michinomae, Yoshio Kusumoto, Takeshi Morisawa, Tamaki Ohashi, Takahiko Saijo, Kosuke Koyano, Mikio Aoki, Koichi Iida, Mitsushi Goshi, Miho Sato, Hung-Yang Chang, Hironobu Tokumasu, Yoichi Kondo, Arif Budiman, Arief Budiman, Ken Nagaya, Fumihiko Namba, Yun Sil Chang, Masaru Yamakawa, Atsushi Nakao, Masaki Shimizu, Ming-Chih Lin, Jui-Hsing Chang, Shu-Chi Mu, Hung-Chih Lin, Fuyu Miyake, Rizalya Dewi, Yuri Ozawa, Seiichi Tomotaki, Ma Lourdes S Imperial, Belen Amparo E Velasco, Su Jin Cho, YoungAh Youn, Saman Kumara, Hsiang Yu Lin, Pracha Nuntnarumit, Sopapan Ngerncham, Chatchay Prempunpong, Pathaporn Prempraphan, Sarayut Supapannachart, Isra Firmansyah, Eny Yantri, Henri Azis, Ied Imelda, Mustarim ­, Benny Sana Putra, Leni Ervina Jumnalis, Andhika Tiurmaida Hutapea, Nadia Dwi Insani, Agnes Yunie Purwita Sari, Naomi Esthernita Dewanto, Thomas Harry Adoe, Tetty Yuniarti, Adhie Nur Radityo S, Tunjung Wibowo, Kartika Darma Handayani, Dina Djojo Husodo, Brigitta Ida Resita Vebrianti Corebima, Retno Wulandari, Made Sukmawati, I Ketut Adi Wirawan, Made Yuliari, James Thimoty, Sandra Bulan, Takashi Nasu, Yukiteru Tachibana, Ayumu Noro, Toshiya Saito, Yosuke Kaneshi, Nobuko Shiono, Nobuhiro Takahashi, Yusuke Ohkado, Tatsuro Satomi, Mika Nakajima, Eiki Nakamura, Tomofumi Ikeda, Genichiro Sotodate, Mari Ishii, Takahide Hosokawa, Rikio Suzuki, Masatoshi Sanjo, Michiya Kudo, Takushi Hanita, Satoshi Niwa, Masanari Kawamura, Yousuke Sudo, Tsutomu Ishii, Takashi Imamura, Yoshiya Yukitake, Goro Asada, Yasuaki Kobayashi, Yasushi Oki, Kenji Ichinomiya, Toru Fujiu, Hideaki Fukushima, Tetsuya Kunikata, Chika Morioka, Motoichiro Sakurai, Naoto Nishizaki, Satoshi Toishi, Harumi Otsuka, Masahiko Sato, Kenichiro Hirakawa, Kenichiro Hosoi, Hiromichi Shoji, Atsuo Miyazawa, Yuko Nagaoki, Naoki Ito, Ken Masunaga, Reiko Kushima, Sakae Kumasaka, Manabu Sugie, Daisuke Haruhara, Satsuki Kakiuchi, Riki Nishimura, Daisuke Ogata, Ayako Fukuyama, Kuriko Nakamura, Kanji Ogo, Masahiko Murase, Katsuaki Toyoshima, Maha Suzuki, Yoshio Shima, Atsushi Nemoto, Yukihide Miyosawa, Takehiko Hiroma, Gen Kuratsuji, Yoshihisa Nagayama, Tohei Usuda, Rei Kobayashi, Takeshi Hutani, Taketoshi Yoshida, Kazuhide Ohta, Shuya Nagaoki, Yasuhisa Ueno, Toru Ando, Ritsuyo Taguchi, Takeshi Arakawa, Shinji Usui, Tokuso Murabayashi, Shigeru Oki, Reiji Nakano, Taizo Ueno, Masami Shirai, Akira Oishi, Hikaru Yamamoto, Hiroshi Takeshita, Koji Takemoto, Masashi Miyata, Makoto Ohshiro, Masanori Kowaki, Osamu Shinohara, Yasunori Koyama, Takahiro Muramatsu, Akinobu Taniguchi, Naoki Kamata, Hiroshi Uchizono, Kenji Nakamura, Masahito Yamamoto, Jitsuko Ohira, Machiko Sawada, Ryosuke Araki, Daisuke Kinoshita, Ryuji Hasegawa, Shinsuke Adachi, Toru Yamakawa, Masahiko Kai, Hirotaka Minami, Kenji Mine, Reiko Negi, Satoru Ogawa, Ryoko Yoshinare, Atsushi Ogihara, Satoshi Onishi, Hiroyuki Ichiba, Misao Yoshii, Hitomi Okabe, Hiroshi Mizumoto, Masaaki Ueda, Kazumichi Fujioka, Takeshi Utsunomiya, Toshiya Nishikubo, Ken Kumagaya, Akiko Tamura, Masumi Miura, Yuki Hasegawa, Rie Kanai, Kei Takemoto, Koichi Tsukamoto, Misao Kageyama, Rie Fukuhara, Yutaka Nishimura, Seiichi Hayakawa, Yasuhiko Sera, Masahiro Tahara, Shinosuke Fukunaga, Keiko Hasegawa, Hiroshi Tateishi, Tomomasa Terada, Toru Kuboi, Osamu Matsuda, Shinosuke Akiyoshi, Takahiro Motoki, Yusei Nakata, Toshiharu Hikino, Shutaro Suga, Mitsuaki Unno, Hiroshi Kanda, Yasushi Takahata, Hiroyasu Kawano, Takayuki Kokubo, Toshimitsu Takayanagi, Muneichiro Sumi, Fumiko Kinoshita, Masanori Iwai, Naoki Fukushima, Yuki Kodama, Shuichi Yanagibe, Takuya Tokuhisa, Yoriko Kisato, Tatsuo Oshiro, Kazuhiko Nakasone, ChangWon Choi, Young-Ah Youn, Jae Won Shim, Jang Hoon Lee, Ga Won Jeon, Byong Sop Lee, Jin A Lee, Jae Woo Lim, Zuraidah Abdul Latif, Zainah Shaikh Hedra, Baizura Jamaluddin, Hasri Hafidz, Zainab Ishak, Geok Hoon Ngian, Chiong Hung Kiew, Mehala Devi Baskaran, Maslina Mohamad, Chee Sing Wong, Rozitah Razman, Maneet Kaur, Choo Hau Lim, Maizatul Akmar, Sheila Gopal Krishnan, Chae Hee Chieng, Chong Meng Choo, Eric Boon- Kuang Ang, AngShiau Chuen Diong, Angeline Seng- Lian Wan, Sharifah Huda Engku Alwi, Kwee Ching See, Rohani Abdul Jalil, Agnes Suganthi, Mei Ling Lee, Pauline Poh-Ling Choo, Lee Ser Chia, Azanna Ahmad Kamar, Anand Mohan A/L Mohana Lal, Agnes Huei- Hwen Foo, Abdul Nasir Mohamed Abdul Kadher, Ma. Lourdes Imperial, Belen Velasco, Ma. Esterlita V. Uy, Daisy Evangeline Garcia, Jacinto Blas Mantaring, Nethmini Thenuwara, Ming-Chou Chiang, Lan-Wan Wang, Xiao-Ping Wang, Yi-Li Hung, Yung Chieh Lin, Pen-Hua Su, Yung-Ning Yang, Po-Nein Tsao, Liang-Ti Huang, Yi-Yu Su, Shau-Ru Ho, Yan-Yan Ng, Kai-Ti Tseng, Yi-Yin Chen, Tsung-Yu Wu, Wei-Tse Chiu, Li-Jung Fang, Kao-Hsian Hsieh, Anavat Bupphachareonsuk, Anchalee Limrungsikul, Anita Luvira, Anucha Thatrimontrichai, Buranee Yangthara, Cholticha Laohajeeraphan, Hathitip Chaiprapa, Junya Jirapradittha, Kanmalee Jenjarat, Kannikar Booranavanich, Namtip Intub, Patcharin Thanomsingh, Pirarat Kotcharit, Piyawan Phummaphuti, Pornpimon Janyoungsak, Prapaiporn Chongkongkiat, Rapeephun Hansuebsai, Roongrawee Torbunsupachai, Santi Punnahitanan, Sommon Jindakul, Sopida Tanthawat, Sudarat Sirichaipornsak, Sudatip Kositamongkol, Supamas Supabanpot, Suparat Tipprasert, Tanin Pirunnet, Thanatda Siriporn, Usakorn Taesiri, Vasita Jirasakuldech, and Eleanor DR Cuarte

Subjects
Medicine
Abstract

Introduction Reducing neonatal deaths in premature infants in low- and middle-income countries is key to reducing global neonatal mortality. International neonatal networks, along with patient registries of premature infants, have contributed to improving the quality of neonatal care; however, the involvement of low-to-middle-income countries was limited. This project aims to form an international collaboration among neonatal networks in Asia (AsianNeo), including low-, middle- and high-income countries (or regions). Specifically, it aims to determine outcomes in sick newborn infants, especially very low birth weight (VLBW) infants or very preterm infants, with a view to improving the quality of care for such infants.Methods and analysis Currently, AsianNeo comprises nine neonatal networks from Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Sri Lanka, Taiwan and Thailand. AsianNeo will undertake the following four studies: (1) institutional questionnaire surveys investigating neonatal intensive care unit resources and the clinical management of sick newborn infants, with a focus on VLBW infants (nine countries/regions); (2) a retrospective cohort study to describe and compare the outcomes of VLBW infants among Asian countries and regions (four countries/regions); (3) a prospective cohort study to develop the AsianNeo registry of VLBW infants (six countries/regions); and (4) implementation and evaluation of educational and quality improvement projects in AsianNeo countries and regions (nine countries/regions).Ethics and dissemination The study protocol was approved by the Research Ethics Board of the National Center for Child Health and Development, Tokyo, Japan (reference number 2020–244, 2022–156). The study findings will be disseminated through educational programmes, quality improvement activities, conference presentations and medical journal publications.

Published
2024
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2. Reducing intraventricular hemorrhage following the implementation of a prevention bundle for neonatal hypothermia.

Author

Wei-Tse Chiu, Yi-Hsuan Lu, Yin-Ting Chen, Yin Ling Tan, Yi-Chieh Lin, Yu-Lien Chen, Hung-Chieh Chou, Chien-Yi Chen, Ting-An Yen, and Po-Nien Tsao

Subjects
Medicine, Science
Abstract

IntroductionIn very low birth weight (VLBW) infants, hypothermia immediately following birth is common even in countries rich in medical resources. The purpose of this study is to design a standard prevention bundle that decreases the rate of hypothermia among infants after birth and to investigate efficacy of the bundle and short-term outcomes for VLBW infants.MethodsThis quality improvement project was conducted from February 2017 to July 2018 on all VLBW preterm infants admitted at a single referral level III neonatal intensive care unit. The infants were classified into the pre-intervention (February to September 2017) and post-intervention (October 2017 to July 2018) groups according to the time periods when they were recruited. During the pre-intervention period, we analyzed the primary causes of hypothermia, developed solutions corresponding to each cause, integrated all solutions into a prevention bundle, and applied the bundle during the post-intervention period. Afterwards, the incidence of neonatal hypothermia and short-term outcomes, such as intraventricular hemorrhage (IVH), acidosis, and shock requiring inotropic agents, in each group were compared.ResultsA total of 95 VLBW infants were enrolled in the study, including 37 pre-intervention, and 58 post-intervention cases. The incidence of hypothermia in preterm infants decreased significantly upon the implementation of our prevention bundle, both in the delivery room (from 45.9% to 8.6%) and on admission (59.5% to 15.5%). In addition, the short-term outcomes of VLBW infants improved significantly, especially with the decreased incidence of IVH (from 21.6% to 5.2%, P = 0.015).ConclusionsOur standardized prevention bundle for preventing hypothermia in VLBW infants is effective and decreased the IVH rate in VLBW infants. We strongly believe that this prevention bundle is a simple, low-cost, replicable, and effective tool that hospitals can adopt to improve VLBW infant outcomes.

Published
2022
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4. Reducing intraventricular hemorrhage following the implementation of a prevention bundle for neonatal hypothermia

Author

Wei-Tse Chiu, Yi-Hsuan Lu, Yin-Ting Chen, Yin Ling Tan, Yi-Chieh Lin, Yu-Lien Chen, Hung-Chieh Chou, Chien-Yi Chen, Ting-An Yen, and Po-Nien Tsao

Subjects
Multidisciplinary, Intensive Care Units, Neonatal, Infant, Newborn, Humans, Infant, Infant, Very Low Birth Weight, Hypothermia, Infant, Premature, Diseases, Infant, Premature, Cerebral Hemorrhage
Abstract

Introduction In very low birth weight (VLBW) infants, hypothermia immediately following birth is common even in countries rich in medical resources. The purpose of this study is to design a standard prevention bundle that decreases the rate of hypothermia among infants after birth and to investigate efficacy of the bundle and short-term outcomes for VLBW infants. Methods This quality improvement project was conducted from February 2017 to July 2018 on all VLBW preterm infants admitted at a single referral level III neonatal intensive care unit. The infants were classified into the pre-intervention (February to September 2017) and post-intervention (October 2017 to July 2018) groups according to the time periods when they were recruited. During the pre-intervention period, we analyzed the primary causes of hypothermia, developed solutions corresponding to each cause, integrated all solutions into a prevention bundle, and applied the bundle during the post-intervention period. Afterwards, the incidence of neonatal hypothermia and short-term outcomes, such as intraventricular hemorrhage (IVH), acidosis, and shock requiring inotropic agents, in each group were compared. Results A total of 95 VLBW infants were enrolled in the study, including 37 pre-intervention, and 58 post-intervention cases. The incidence of hypothermia in preterm infants decreased significantly upon the implementation of our prevention bundle, both in the delivery room (from 45.9% to 8.6%) and on admission (59.5% to 15.5%). In addition, the short-term outcomes of VLBW infants improved significantly, especially with the decreased incidence of IVH (from 21.6% to 5.2%, P = 0.015). Conclusions Our standardized prevention bundle for preventing hypothermia in VLBW infants is effective and decreased the IVH rate in VLBW infants. We strongly believe that this prevention bundle is a simple, low-cost, replicable, and effective tool that hospitals can adopt to improve VLBW infant outcomes.

Published
2021

5. Reducing intraventricular hemorrhage following the implementation of a prevention bundle for neonatal hypothermia.

Author

Chiu, Wei-Tse, Lu, Yi-Hsuan, Chen, Yin-Ting, Tan, Yin Ling, Lin, Yi-Chieh, Chen, Yu-Lien, Chou, Hung-Chieh, Chen, Chien-Yi, Yen, Ting-An, and Tsao, Po-Nien

Subjects
INTENSIVE care units, HOSPITAL birthing centers, VERY low birth weight, INTRAVENTRICULAR hemorrhage, NEONATAL intensive care units, HYPOTHERMIA, PREMATURE infants, UMBILICAL cord clamping
Abstract

Introduction: In very low birth weight (VLBW) infants, hypothermia immediately following birth is common even in countries rich in medical resources. The purpose of this study is to design a standard prevention bundle that decreases the rate of hypothermia among infants after birth and to investigate efficacy of the bundle and short-term outcomes for VLBW infants. Methods: This quality improvement project was conducted from February 2017 to July 2018 on all VLBW preterm infants admitted at a single referral level III neonatal intensive care unit. The infants were classified into the pre-intervention (February to September 2017) and post-intervention (October 2017 to July 2018) groups according to the time periods when they were recruited. During the pre-intervention period, we analyzed the primary causes of hypothermia, developed solutions corresponding to each cause, integrated all solutions into a prevention bundle, and applied the bundle during the post-intervention period. Afterwards, the incidence of neonatal hypothermia and short-term outcomes, such as intraventricular hemorrhage (IVH), acidosis, and shock requiring inotropic agents, in each group were compared. Results: A total of 95 VLBW infants were enrolled in the study, including 37 pre-intervention, and 58 post-intervention cases. The incidence of hypothermia in preterm infants decreased significantly upon the implementation of our prevention bundle, both in the delivery room (from 45.9% to 8.6%) and on admission (59.5% to 15.5%). In addition, the short-term outcomes of VLBW infants improved significantly, especially with the decreased incidence of IVH (from 21.6% to 5.2%, P = 0.015). Conclusions: Our standardized prevention bundle for preventing hypothermia in VLBW infants is effective and decreased the IVH rate in VLBW infants. We strongly believe that this prevention bundle is a simple, low-cost, replicable, and effective tool that hospitals can adopt to improve VLBW infant outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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