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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 CPR Guidance

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. There have been 4 winners of the Scholarship to date;

2014 – Lucy Mann & Charlie Pearson, 2 Staff Nurses from the NICU at James Cook University Hospital (“Increasing the effectiveness of neonatal nursing handovers at the NICU cot side”).

2015 – Emily Cameron, Sister from the NICU at Sunderland (“Debriefing following Neonatal Death”).

2016 – “PEAPOD” (Parental Early Attachment in Promoting Optimal Development) team from the NICU at the RVI, Newcastle (“Promoting skin to skin contact – the neonatal unit and beyond”).

Building on the success of previous Scholarships, applications were again opened up in late 2017 and the entries once more proved to be of a very high level indeed. The eventual winner as picked by the judging panel was the RVI Neonatal Bereavement Team. Their proposal was entitled “Memory making in end of life care – include siblings to offer complete family centred care”. The team are focussing their work on identifying ways to support siblings following the loss of their brother or sister and offer the opportunity for personal keepsakes to remember them by.  The hope is that this will give the child the opportunity to feel involved in their journey and also a feeling of importance at a time when they are often overlooked. Recent research by a team also based at the RVI for the “Purple Butterfly Project” highlighted that this was an issue following loss in twin or multiple births, which helped prompt this new initiative to try and address this.

Martyn Boyd, Manager of the Northern Neonatal Network 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. We had some excellent entries for the Award we ran in late 2017 and the Neonatal Bereavement Team from Newcastle was the judges winning choice and we look forward to following their progress as their study progresses. Part of this will include a presentation at our 9th annual Network Conference in September.  We hope that what the Team achieve could be taken on and adopted by other baby units across our own network and beyond in the way that siblings are supported when they lose a baby brother or sister, a really important area of neonatal care that is rarely focussed on.”

 

The RVI Bereavement Team receiving their Award (Back row, standing left – right): Kristina Anderson, Vicky Graham, Jane Couch, Sarah Stephenson, Ken Bremner ;” (CEO, Sunderland & host Sponsor of the Northern Neonatal Network), Dr Majd Abu-Harb (Consultant Neonatologist, Sunderland and colleague & close friend of Sam and Liz), Martyn Boyd (Manager, Northern Neonatal Network), Liz Richmond. (Front row, seated left – right): Sasha Stephenson, Amy Wenn, Brenda Toole.

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.paterson2@nhs.net or on 01642 854871 

or

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