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What are the networks doing?

Australian and New Zealand neonatal network (ANZNN)

ANZNN is a network of clinicians involved in caring for newborn infants in neonatal intensive care and neonatal units across Australia. It aims to improve the care of high-risk newborn infants and their families. It brings together over 20 of Australia’s leading perinatal centres. With support from NICS' evidence uptake networks program, ANZNN is currently working to improve the management of procedural pain in newborn infants.

Painful procedures can have immediate and long term adverse effects for the newborn that can be reduced with analgesia.

ANZNN found that despite strong evidence that simple interventions like sucrose, breast feeding, swaddling or topical analgesics can reduce the physiological response to pain, less than 20 per cent of units have clear policies to manage procedural pain. An even lower proportion use these interventions in practice.

Evidence suggests that to maximise benefits and minimise harms, narcotic analgesia for ventilated newborns should be targeted at those most likely to benefit, based on assessment of pain, rather than given routinely to all infants. Most Australian neonatal intensive care units use narcotic analgesics but do not routinely use pain assessment tools.

To improve care in these areas, ANZNN is working with staff of all disciplines (neonatologists, paediatricians, neonatal nurses and midwives) in each of the participating hospitals to close the gap. A key to the network’s program is the development of interdisciplinary ‘teams’ in each neonatal unit that will not only focus on improving care for these issues, but can address others now and in the future. Teams will be trained in evidence appraisal, ways to implement best evidence and ways to evaluate current practice. A central network group facilitates sharing of resources and problem solving strategies between the units.

Diabetes collaborative network (DCN)

DCN is a network of over 10 of Australia’s leading diabetes outpatient centres who came together in 2004 to understand, compare and improve the quality of care in the participating centres.

With support from NICS' evidence uptake networks program, participating centres are working to close gaps between evidence and practice in managing cardiovascular disease risk factors in people with type 2 diabetes, specifically blood pressure, lipid control, and use of aspirin.

Heart disease is the leading cause of death in people with diabetes. There is strong research evidence that shows one of the best ways to reduce heart disease in diabetes is to improve blood pressure and reduce cholesterol. However, despite this evidence, many people with diabetes do not achieve target blood pressure or cholesterol levels.

The project is examining barriers to individual doctors, diabetes educators and patients tackling the gaps between evidence and practice in the treatment of heart disease in diabetic patients. The network aims to address these issues through:

  • education sessions within participating sites;
  • establishing agreed targets between health professionals and the person with diabetes;
  • diabetes educators working with  individuals to identify and help overcome barriers to reaching the agreed targets; and 
  • collecting information about current practice through the Australian National Information Audit and Benchmarking audit.