Exploring internal facilitators’ experience with NeoECHO to foster NEC prevention and timely recognition through the iPARIHS lens

Background: Necrotizing enterocolitis (NEC) remains a major complication in the neonatal population. Standard practices regarding the care of premature infants and attitudes toward NEC prevention strategies vary across neonatal intensive care units (NICUs). Evidence-based best practice dissemination was presented through the NEC-Zero bundle. To close gaps between evidence and practice, a telehealth-delivered intervention (ie, NeoECHO) was provided to NICUs. Purpose: The purpose of this study was to enable adoption of best practice for NEC prevention using NeoECHO through describing the local volunteer unit leaders’, or internal facilitators’ (IFs’), experiences in participating in NeoECHO and identifying the extent to which the facilitation activities within the NeoECHO experience were consistent with constructs from the integrated Promoting Action on Research Implementation in Health Services (iPARHIS) framework. Methods: The design of this study was qualitative descriptive. Six IFs were recruited in the Southwest. After 6 NeoECHO sessions, Individual interviews were conducted and transcribed verbatim. Content analysis was applied. Codes were informed by the iPARIHS framework. Results: Major themes were (1) Innovation: Quality Improvement Projects, Bundles of Care, and Huddle; (2) Recipient: Reluctant Stakeholders and Technical Modalities; (3) Context: Buy-In, Timing, Resources, Leadership, and Blame; (4) Facilitation: Betterment, Buddy System, Passionate Care, and Empowerment; and (5) Adoption: Continuous Quality Improvement, Evidence-Based Practice, and Honest Discussions. Implications for Practice and Research: NeoECHO fostered a learning community to share current practices, policies, and strategies for NEC prevention, but the IFs were essential to foster local participation. The long-term impacts of NeoECHO are the focus of current research.