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Research within Northern Neonatal Network

The care of preterm babies is a rapidly changing and developing field. Outcomes for preterm and sick infants have improved dramatically over the past two decades. Research has been one of the main drivers for this improvement, following the development of new treatments and interventions to improve the care we give to our babies. As a network, we participate in national and international trials as well as develop research studies within the region.

Current research studies ongoing within the region are:

ELFIN https://www.npeu.ox.ac.uk/elfin
MAGPIE http://www.neonatalresearch.net/uploads/4/8/1/2/48121423/magpie_pil_1400316_v1.4.pdf
Baby Oscar https://www.npeu.ox.ac.uk/baby-oscar
BPSU Life threatening bronchopulmonary dysplasia www.rcpch.ac.uk/bpsu/bpd
SERVIS http://www.neonatalresearch.net/servis-study- -blood- salvaging.html
MARINAC Magnetic Resonance in Infection-Primed Neonatal Encephalopathy and N-acetyl cysteine
Great North Neonatal Biobank https://www.npeu.ox.ac.uk/minidex
INDIGO

 

An overview of some of the research studies and presentations can be found at:
http://www.neonatalresearch.net/

 

 

A research study designed to test whether giving lactoferrin, a naturally-occurring milk protein (often used as a food supplement), to babies born very early can help to protect them against infections and other serious illnesses during their stay in hospital.
Further details can be found at https://www.npeu.ox.ac.uk/elfin

 

 

The ELFIN study will tell us whether lactoferrin is a useful treatment for preterm babies. If lactoferrin is useful it might work in different ways. For example, it might work by increasing the numbers of ‘healthy bacteria’ or by affecting how the immune system works. The MAGPIE study aims to find out
how lactoferrin might work.
Further details can be found at:
http://www.neonatalresearch.net/uploads/4/8/1/2/48121423/magpie_pil_1400316_v1.4.pdf 

 

 

Babies born preterm commonly have a condition called Patent Ductus Arteriosus (PDA). This is when the blood vessel (Ductus arteriosus, which allows during pregnancy, blood to bypass the baby’s developing lungs and reach the mother’s placenta, remains open after birth. The word ‘patent’ here means ‘open’. A PDA is associated with a number of very serious and life threatening complications which can include brain damage and chronic breathing difficulties. The condition can be treated with ibuprofen, but giving extremely preterm babies can result in significant complications. Medical opinion is therefore divided on how best to care for extremely preterm babies with a PDA. In Baby Oscar, Babies will be randomly allocated to receive either treatment with ibuprofen or a matched placebo. Information will be collected about if/when the PDA closes and other health outcomes.
More information can be found at: https://www.npeu.ox.ac.uk/baby-oscar

In late 2012, the network embarked on a project to enhance the care of babies with terminal and life-limiting conditions, building on some of the excellent work that was already taking place across our Units with the aim of learning and spreading best practice. This was initially focused on a comprehensive “Neonatal Comfort care Bundle” (NCCP) as a means of providing a practical tool to try and standardise and enhance this key aspect of neonatal care.

Under the leadership of Stacy Williams (Staff Nurse, UHNT & Network Project Lead), Dr Yifan Liang (Consultant Paediatrician, JCUH & Chair, North east Children’s Palliative Care Forum) & Dr Rob Tinnion (Consultant Neonatologist, JCUH), the NCCP was piloted over several months across the Network’s four NICUs. The valuable feedback gained during this time was then translated into a major revision of the approach and a new Network “Care Bundle” published in April 2015. This is intended to provide a tool for all Baby Units and other health care professionals involved in the pathways of care that babies with terminal or life-limiting conditions.

Printed as a hard copy binder available as a resource on all 11 Network of our Units, the files contained are also now listed and made available for download below, in the order and various sections they were published in. Please note these form the intellectual property of the Northern Neonatal Network and should not be further distributed for other purposes without the permission of the Network Manager.

File 1 – Care Bundle Foreword

File 2 – Care Bundle Flow Chart

File 3 – Care Bundle Overview

File 4 – Antenatal Congenital Abnormality MDT Form

File 5 – Care Bundle Checklist 1 (Acutely unwell baby, at risk of dying/in process of dying)

File 6 – Care Bundle Checklist 2 (Transfer Checklist – baby with life-limiting illness, not necessarily dying/baby for transfer to different setting; a more local hospital, paediatric ward, home, community, children’s hospice)

File 7 – Neonatal Comfort Care Plan (NCCP)

File 8 – After Death Checklist

File 9 – NCCP Extras (Death certification, donor guidelines, useful contact numbers)

File 10 – Neonatal Death Referral Form for Coroners

File 11  – Supplemental Information & Resources

File 12 – Regional DNA PR Form

File 13 – Emergency Health Care Plan (EHCP) Form

File 14 – Neonatal Stratified Treatment Escalation Plan (nSTEP) Form

File 15 – A Guide to End of Life Care (Together For Short Lives publication)

File 16 – RCPCH Framework for Practice

File 17 – Decisions Relating to CPR (BMA/Resuscitation Council/RCN Publication)

File 18 – N East Palliative Care Helpline

File 19 – Useful Resources and contacts

File 20 – Guidelines for Health Professionals for Bereavement from a Twin/Multiple Pregnancy

 

The Butterfly Project

An initiative that has gained significant attention and credit has been the “Butterfly Project” that arose out of a piece of research looking at twin and multiple loss at the RVI. This has seen neonatal units from around the world adopt the idea and a dedicated website has a wealth of resources for professionals and those involved with the care of the babies and families who experience such tragic losses. To find out more, just follow the link here.

The Sam Richmond Nursing Scholarship

In 2014, the Network set up an annual Nursing Scholarship, named in memory of the late Dr Sam Richmond, who worked as a Consultant Neonatologist at Sunderland Royal Hospital for many years.

The idea of the Scholarship is simple – to encourage innovation and new ideas amongst our nursing staff. It is worth £1000 and the winner(s) also receive a trophy that Liz Richmond (Sam’s widow) had designed and commissioned especially by the Sunderland Glass Centre. The first joint winners for 2014 were Lucy Mann & Charlie Pearson, 2 staff nurses from James Cook University Hospital. Their application was entitled “Increasing the effectiveness of neonatal nursing handovers at the NICU cot side” and involved evaluating current approaches to nursing handovers and attempting to improve the effectiveness of them with the aim of enhancing communication and ultimately patient care. The second winner was Emily Cameron, who is currently working as a Sister on the NICU in Sunderland. Emily’s proposal was titled “Debriefing following Neonatal Death” and aims to set up a structured approach to facilitating team debriefing following neonatal deaths. 

Following the success of the previous Scholarships, the Network opened up applications for the third Award in late 2016. The level of entries was again very high, making the task of the panel of judges a very difficult one. However, a worthy winner was eventually chosen in a team from Newcastle’s Royal Victoria Infirmary Neonatal Intensive Care Unit. Entitled the “PEAPOD” (Parental Early Attachment in Promoting Optimal Development) project, the team are focussing their study on ‘Promoting skin to skin contact – the neonatal unit and beyond’. Skin to skin contact (or “kangaroo care” as it is also known) is a very beneficial aspect of neonatal care that encourages parents to hold their sick and premature babies closely. It is a well-established practice with many benefits to both baby and parent, but the team are researching the added value of using supportive slings both when the baby is an inpatient but also following discharge.

Martyn Boyd, Manager of the Northern Neonatal Unit said ‘Sam was passionate about nursing education research and a well-known figure in the delivery of new born life support (NLS) courses across the world. We set up the annual scholarship to encourage innovation and news ways of working that could improve neonatal care among nurses working across our neonatal units. This year’s entry by the PEAPOD team from Newcastle was the judges unanimous choice and we look forward to following their progress as their study progresses. We hope that this may then be adopted by other baby units across our own network and beyond.”

 

The PEAPOD team from the RVI NICU (left-right) Pat Dulson, Maria Douglass, Jolene Clark, Laura Robson & Adele Ritson

Applications for the next annual Scholarship will open in the Autumn – keep an eye out for more news on this and details about how to apply!

 

About the Sam Richmond Scholarship…

Introduced in 2014, the Northern Neonatal Network set up the annual Sam Richmond Scholarship in honour and memory of the late Dr Sam Richmond, the Scholarship is designed to foster and encourage a spirit of innovation amongst the nursing staff across the baby units within the Network. Sam was a consultant neonatologist who worked at the Sunderland Royal Hospital for many years and somebody who was very passionate about nursing education research and was a key and well-known figure in the delivery of New born Life Support (NLS) courses across the world.

The Scholarship of £1000 is awarded annually to the nurse who submits the best proposal for an innovative idea that can enhance and improve neonatal care. This may be a piece of research, a new way of working, an audit or a piece of equipment that could have benefits across the Network and beyond. Written proposals need to be submitted and a panel will then shortlist entries and pick a winner, overseen by senior Network officers.

Full details of the Scholarship and how to apply and what to include can found here. A set of FAQ has also been drafted to help answer any questions applicants may have and this can be found here.

 

Further help and guidance can be obtained by contacting;

Lynne Paterson (Network Nurse Lead) – lynne.paterson@stees.nhs.uk or on 01642 854871 

or

Martyn Boyd (Network Manager) – martyn.boyd@chsft.nhs.uk or on 0191 541 0139