About us

The Australian and New Zealand Neonatal Network (ANZNN) is a collaborative network that monitors the care of high risk newborn infants by pooling data to provide quality assurance for this resource consuming care. The Network was established in 1994 under the recommendation of the National Health and Research Council's (NHMRC) Expert Panel on Perinatal Morbidity.

Since its establishment the Network has developed a minimum data set and implemented a data collection that monitors the mortality and morbidity of infants admitted to neonatal intensive care units across Australia and New Zealand.

History

In 1993 the NHMRC's Expert Panel on Perinatal Morbidity (chaired by Professor David Henderson-Smart) recommended that "The Australian Institute of Health and Welfare National Perinatal Statistics Unit, in collaboration with the directors and staff of all neonatal intensive care units, should develop a national minimum data set and implement a data collection to monitor mortality and morbidity of infants admitted to such units".

A prospective audit commenced in 1994 with all neonatal intensive care (level III) units in Australia and New Zealand contributing data on babies from 1 January 1995. In 1998, all level II units in New Zealand joined the Network and began contributing data. The level II unit in Tasmania joined in 1999, and most recently five level II units in New South Wales, four in Queensland, one in Northern Territory and one in Victoria have joined the Network. The Network has now begun to expand beyond Australia and New Zealand, with one neonatal intensive care unit from nearby Singapore joining in 2015.

Until 2008 the Network was hosted by the Centre for Perinatal Health Services Research at the University of Sydney. In 2008, the Network moved to be under the umbrella of the National Perinatal Epidemiology and Statistics Unit (NPESU) (formerly Perinatal and Reproductive Epidemiology Research Unit) at the University of New South Wales. The relationship between the ANZNN and NPESU was set out in a Memorandum of Understanding between the parties, which was effective from 1st January 2008 until 31st December 2012. A renewed agreement extends this period from 1st January 2013 to 31st December 2017.

Aims

The aim of the ANZNN is to improve the care of high-risk newborn infants and their families in Australia and New Zealand by enabling benchmarking and so collaborative audit, plus facilitating research.

This is achieved through the following objectives:

  • provide a core data set that will:
    • provide information on neonatal outcomes, adjusted for case mix and disease severity, to participating neonatal units to assist with quality improvement
    • identify trends and variations in morbidity or mortality
    • assist with the identification of areas of priority for research
    • enhance the ability to carry out multicentre studies and randomised controlled trials through collaboration
  • monitor the clinical indicators for perinatal care and improving clinical practice while maintaining national standards of evidence-based care
  • monitor the use of new technologies, e.g. high flow/oxygen air usage by patient type and outcome
  • achieve consistency in national data collections

Registration criteria

Babies admitted to a neonatal unit who meet one or more of the following criteria are eligible for registration with the audit:

  • born at less than 32 weeks gestation, or
  • weighed less than 1,500 grams at birth, or
  • received assisted ventilation (mechanical ventilation) including intermittent positive pressure ventilation (IPPV) or continuous positive airways pressure (CPAP) or high flow nasal cannulae for four or more consecutive hours, or died while receiving mechanical ventilation prior to four hours of age, or
  • received major surgery (surgery that involved opening a body cavity), or
  • received therapeutic hypothermia

Babies who were discharged home and readmitted to a neonatal intensive care unit (NICU) during their neonatal period are not eligible for registration in the ANZNN audit. The hospital of registration was the first level III NICU in which the baby, aged less than 28 days, stayed for four or more hours. Babies who received their entire care in a level II hospital or who were not transferred to a level III NICU during the first 28 days were registered to the first level II centre that they remained in for four or more hours.

Funding support

Currently the major share of funding is from annual contributions received from the neonatal intensive care units. The contribution was a voluntary and unanimous decision made by the unit directors. In return, individual units receive a feedback report that enables them to benchmark their unit against other member units as well as against the combined ANZNN data set.

Emerge (Australia), Douglas Pharmaceuticals (New Zealand) and Ikaria Australia make an annual contribution and the ANZNN thanks them for their generosity and continuing support.