NeoIPC (Establishing innovative approaches for optimal infection prevention of resistant bacteria in NICUs by integrating research, implementation science and surveillance in a sustainable global platform) – WP3 – NeoIMPLEMENT

Newborns in neonatal intensive care units (NICUs) are particularly vulnerable to healthcare-associated infections (HAIs), making infection prevention and control (IPC) crucial in this setting. Evidence suggests that kangaroo care (KC)—skin-to-skin contact between caregivers and neonates—not only supports neurodevelopment but also strengthens immunological development. However, the implementation of KC remains inconsistent across settings.

Designed as a multicenter hybrid type II cluster-randomized trial, NeoIPC’s study, named NeoDeco. evaluates the clinical effectiveness of KC for IPC, alongside the effectiveness of applied implementation strategies. The study is being conducted in 24 NICUs in Switzerland, Greece, Spain, Italy and the United Kingdom. Sites will be randomized 1:1 to the intervention (KC) or control (standard of care) arm. The following descriptions are focused on the trial activities in relation to WP3 NeoIMPLEMENT, the implementation evaluation.

The primary objectives of the implementation evaluation led by researchers at the Institute for Implementation Science in Health Care (IfIS) of the University of Zurich, are

• To identify barriers and facilitators for implementing KC,
• To assess intervention fidelity of KC
• To evaluate acceptability, feasibility, and sustainability of the KC intervention
• To evaluate employed implementation strategies, particularly with regards to implementation fidelity, acceptability, feasibility, and sustainability,
• To evaluate the cost-effectiveness of implementation strategies

The study team will initiate and facilitate implementation strategies (core implementation strategies) to support the implementation of KC at intervention sites. Further, sites will design and execute tailored implementation strategies based on their respective needs and context for the duration of the trial.

NeoIPC and the NeoDeco study will contribute to the emerging knowledge on KC implementation for infection prevention and control in high-resource settings.