A study conducted at a Neonatal Intensive Care Unit (NICU) in Brazil has demonstrated the effectiveness of simulation-based training in improving compliance with infection prevention practices for central venous catheters. This research highlights the potential of innovative educational interventions to improve patient safety in critical neonatal care settings.   The study, led by researchers from the Federal University of Minas Gerais, Brazil, focused on the use of peripherally inserted central catheters (PICCs) in newborns. These devices, while essential for many preterm infants, carry a risk of central line-associated bloodstream infections (CLABSIs), which can have serious consequences for vulnerable neonates.   Improvements in several critical areas of infection prevention The research team observed 41 nursing professionals before and after the implementation of a simulation-based educational intervention. The results revealed significant improvements in several critical areas of infection prevention, including increased compliance with surgical hand antisepsis, better adherence to skin antisepsis protocols using chlorhexidine, improved waiting times for antiseptic action, and enhanced compliance with sterile technique during catheter insertion. These improvements are crucial in reducing the risk of CLABSIs, a major concern in NICUs worldwide. The study’s findings support global efforts to adopt evidence-based “bundles” of care practices to prevent catheter-related infections.   Innovative training approach The educational intervention utilised clinical simulation which allows nursing staff to practice and refine their skills in a safe, controlled environment. This approach bridges the gap between theoretical knowledge and practical application, addressing a common challenge in healthcare education. Dr. Bruna Figueiredo Manzo, one of the study’s authors, emphasises the importance of ongoing education and that targeted, hands-on training can significantly improve adherence to best practices, which is particularly crucial in high-stakes environments like the NICU.   Implications for neonatal care The study’s findings have important implications for neonatal care units globally. By demonstrating the effectiveness of simulation-based training, it provides a model for other institutions seeking to enhance their infection prevention protocols. Moreover, the research underscores the critical role of nursing professionals in maintaining patient safety. As the primary caregivers responsible for PICC insertion and maintenance, nurses and nursing technicians are at the forefront of infection prevention efforts. However, sustained improvement requires ongoing education and monitoring. The researchers therefore suggest that future research could explore the long-term impact of such interventions on clinical outcomes and patient safety metrics. As healthcare systems worldwide strive to reduce hospital-acquired infections, particularly in vulnerable populations like preterm infants, this study offers valuable insights into effective educational strategies. By investing in innovative training approaches, NICUs can empower their staff to provide safer, higher-quality care to their tiny patients.   Paper available at: SciFlo Brazil Full list of authors: Thayane Gusmão Pires de Oliveira, Juliana de Oliveira Marcatto, Allana dos Reis Corrêa, Luciano Marques dos Santos, Patrícia Kuerten Rocha, Delma Aurélia da Silva Simão, Bruna Figueiredo Manzo DOI: https://doi.org/10.1590/0034-7167-2022-0574  

A guest article by Pani Pantelides* *Pani Pantelides is a NIDCAP professional, Neonatal Physiotherapist and Early Intervention Specialist, Senior Faculty of the Family and Infant Neurodevelopmental Education (FINE) programme, and Ambassador of the European Standards of Care for Newborn Health © Preemie Success Programme (PSP) After attending the last EFCNI conference, we were amazed by Prof. Dr Dieter Wolke’s research from the University of Warwick (UK) on the “Long term development after very preterm/VLBW birth” and potential resiliency factors. What surprised us most was the finding that the ability of very preterm or Very Low Birth Weight (VLBW) children to succeed in life tasks as adults—such as health, wealth, and relationships—is not only determined by their health/level of disability. Rather, it is influenced by the quality of parenting they receive, followed by their academic achievements, which are also shaped by the quality of that parenting. Consequently, Prof. Dr Dieter Wolke emphasises the importance of monitoring preterm children until school age, recommending that assessments and interventions focus not only on motor and language development but also on parent-child interactions, the child’s social life, support during the transition into school, and academic assistance. Based on Prof. Dr Wolke’s findings, the Scientific Committee of Thermokoitida Agapis has designed a developmental follow-up service. The “Preemie Success Programme (PSP) – A choice to thrive!” is a developmental follow-up, prevention, and intervention programme for preterm-born infants and children. It aims to prevent learning difficulties and optimise academic potential by empowering early parent-infant interaction from the moment of discharge from the NICU. PSP is a new initiative in Cyprus aimed at evaluating, preventing, and providing early intervention for preterm-born children, with a focus on optimising their school readiness. The ultimate goal is to facilitate a smoother transition into kindergarten while also predicting their future academic trajectory. Our programme is also based on the European Standards of Care for Newborn Health (ESCNH), particularly those under the umbrella of the Topic Follow-up & continuing care. Who is it for? It is designed for all preterm-born children (those born between 24 and 36+6 weeks gestation) and their parents, starting from the day of discharge from the NICU until preschool age, specifically from 0 months to 4 years old. Statement of the Preemie Success Programme – A choice to thrive! Research shows that all preterm children have an increased risk of poor academic performance, learning difficulties and special educational needs. Other than the quality of early mother-child interaction, the developmental sequelae of prematurity that can impact a child’s ability to learn, as well as their social and emotional skills, include: motor coordination disorders, deficits in executive functions (such as inadequate attention span, inhibitory control, and cognitive flexibility), slower processing speed, difficulties with fine motor skills and visual-motor integration, deficits in executive function (such as working memory, organisation of thought and behaviour), general cognitive weaknesses, language problems, and difficulties with sensory processing. Those developmental skills that determine a preterm child’s school readiness and academic trajectory are not established just before school entry; rather, they begin forming and have their neural foundations in the neonatal period, evolving throughout the child’s developmental journey. For this reason, we have designed the “Preemie Success Programme – A choice to thrive!”, which begins as soon as the infant is discharged from the NICU and follows their development until preschool age.     © Preemie Success Programme (PSP)   The PSP has two main pillars: The first pillar concerns the developmental follow-up of preterm infants and children. The second pillar concerns prevention and therapeutic intervention programmes. The developmental follow-up of preterm infants and children in the PSP is carried out using specific assessment tools for all areas of their development: Following the basic algorithm proposed by ICHOM, ensuring that Cyprus has comparable results with other countries. Additionally, this algorithm is enriched with other assessment tools to cover the developmental needs of the first year and toddler period as well as sensory development. The prevention or/and intervention programmes follow the principles of infant and family-centred developmental care, supported by the ESCNH.   Possible benefits of the “Preemie Success Programme – A choice to thrive!” for the child and the family:   Short-term benefits Monitoring/evaluation of the infant’s development at all levels, from the first day after discharge from the NICU and individualised support for parents to ensure a smooth transition from NICU to home. Prevention and intervention practices to help the infant or child achieve the developmental milestones of their age, through individualised meetings or/and parent-child groups or/and parent groups. Mutual support between parents through parent-groups of preterm children. Long-term benefits Early identification of children at increased risk of learning difficulties. Timely implementation of prevention and intervention strategies to optimise developmental outcomes. Timely development of an individualised educational plan and initiation of intervention for children with developmental problems or low school readiness. Improved educational outcomes and better life prospects. Improved quality of life for preterm children and their families. Improvement of the child’s socialisation and emotional regulation skills at school. Parental counselling. Improved communication between parents, teachers, and healthcare professionals (with parental consent). National benefits over time Documentation of preterm children who needed support for school. Creation of a national preterm registry for school readiness. Development of policies to support preterm children in school. Comparison of national results for the school readiness of preterm children with other countries. The scientific team of the “Preemie Success Programme – A choice to thrive!” (in alphabetical order) Klearchos Demiris (Paediatric Neurologist) Giannis Lemonis (NBO professional, Occupational Therapist for neonates and children) Anastasios Mokas (Speech and Language Therapist, Special Educator) Pani Pantelides* The PSP is funded (partially or fully) by Thermokoitida Agapis, based on income criteria of the families which will participate.  

A recent study from the Medical University of Graz, Austria, has revealed that regular interprofessional in situ simulation training can significantly reduce latent safety threats (LSTs) in neonatal emergencies. Conducted over nearly eight years, this research underscores the importance of immersive, on-site training in improving patient safety by identifying and addressing previously unrecognised risks.    Study overview  The study involved 13 simulation training sessions at the Department of Gynaecology and Obstetrics at the Medical University of Graz, Austria. The training targeted a range of healthcare professionals, including anaesthesiologists, obstetricians, and nurses, focusing on identifying LSTs, i.e.system-based threats to patient safety. A total of 67 LSTs were identified, primarily related to equipment (62.7%), followed by resource/system (20.9%) and medication (16.4%). Remarkably, 91% of these threats were rectified by the next training session. The study found a significant negative correlation between the number of training sessions and the frequency of identified LSTs, indicating a sustained decrease in safety threats over time.    Impact on patient safety  The findings underscore the positive impact of simulation training on patient safety. By simulating real-life scenarios, healthcare teams can practice critical skills such as airway management and emergency drug administration, leading to improved teamwork and communication. Given the high stakes in neonatal care, the ability to quickly identify and address safety threats is crucial. The training sessions effectively prepared healthcare teams for emergencies, enhancing their readiness and response capabilities.    Challenges and future directions  While the study demonstrated significant improvements, it acknowledged limitations, such as not assessing the direct impact of training on clinical outcomes. Future research could focus on evaluating patient-related parameters to provide a more comprehensive understanding of the benefits of simulation training.   The study highlights the effectiveness of regular in situ simulation training in neonatal care. By fostering a culture of continuous improvement, healthcare teams can significantly reduce safety threats and enhance patient outcomes, paving the way for safer healthcare practices.      Paper available at: BMJ Open Quality Full list of authors: Lukas Peter Mileder,Bernhard Schwaberger, Nariae Baik-Schneditz, Mirjam Ribitsch, Jasmin Pansy, Wolfgang Raith, Angelika Rohrleitner, Günter Mesaric, Berndt Urlesberger DOI: 10.1136/ bmjoq-2023-002567