Clinical Practice Guidelines

Leading development and implementation of NHMRC-Endorsed Clinical Practice Guidelines for children and adults born very Preterm across the continuum of care

We are leading the development of several NHMRC-endorsed clinical practice guidelines, with multiple initiatives focussed on extending, implementing, and disseminating these guidelines. The work aims to improve clinical care in acute settings such as the NICU, as well as care pathways and outcomes for children born preterm across the developmental continuum.

Published

1. Guideline for Growth, Health and Developmental Follow-up for Children Born Very Preterm

The Guideline for Growth, Health and Developmental Follow-up for Children Born Very Preterm presents the best current scientific evidence to assist decision making for the provision of follow-up services to infants born very preterm in Australia.

This clinical practice guideline was developed by the Centre of Research Excellence in Newborn Medicine, Murdoch Children’s Research Institute. Affiliation organisations include The University of Melbourne, Monash University, La Trobe University, The Royal Women’s Hospital and Life’s Little Treasures Foundation.

The Centre of Research Excellence in Newborn Medicine would like to thank all of the professionals, people with lived experience and members of the public that contributed to this guideline.

The guideline recommendations were approved by the Chief Executive Officer of the National Health and Medical Research Council (NHMRC) on 18 April 2024 under section 14A of the National Health and Medical Research Council Act 1992.  In approving the guideline recommendations, NHMRC considers that they meet the NHMRC standard for clinical practice guidelines. This approval is valid for a period of five years.

NHMRC is satisfied that the guideline recommendations are systematically derived, based on the identification and synthesis of the best available scientific evidence, and developed for health professionals practising in an Australian health care setting. This publication reflects the views of the authors and not necessarily the views of the Australian Government.

Current focus: (updated early 2026)

• Building dissemination strategy – i.e., journal publication, quick reference guides
• Supporting clinical teams - integrate the preschool guideline into routine care
• Implementing tailored strategies - facilitate adoption and sustainability
• Partnering with lived experience networks - ensure relevance and promote uptake

Click here to find supplementary documents & here to read more.

Navigate here to read about the SurPre Model built around family-centred care putting the guideline into practise. 

Under development:

 2. National Follow-up Guideline: School Age to Adulthood (2025-2027)

• Rationale:
• Improved survival rates among children born very preterm have resulted in a growing cohort of patients transitioning from paediatric to adult specialist care.
• Children born very preterm often live with chronic conditions originating at birth, require continuous, specialised, and age-appropriate healthcare.
• Increasing complexity with age, including the management and ongoing support for chronic conditions, heightened risk for multiple chronic and complex health issues (such as respiratory, cardiovascular, renal, musculoskeletal, and metabolic/endocrine disorders), alongside learning and social challenges, and critical life transitions.
• There is significant variability in practices across Australia, and currently there is no national guideline for the management of individuals born very preterm as they progress through school and into adulthood.  

• Commitment:
• Building on existing guidelines to improve long-term health outcomes for children born very preterm.
• Co-developing a national guideline to support children born very preterm through critical growth and development transitions by providing consistent, coordinated, and comprehensive evidence-based recommendations  from school years through adulthood.

• Impact:
• Early identification, coordinated transition planning and equitable management of long-term needs.
• Improved access to healthcare, education, and support services.
• Enhanced quality of life and optimised health trajectories across the life course.

3. Australian Living Guidelines for the Management of Respiratory Distress Syndrome (RDS)

 Clinical Context:

• RDS occurs when immature lungs lack sufficient surfactant, leading to significant breathing difficulties in preterm infants.
• It is the leading cause of early morbidity in preterm populations, commonly requiring mechanical ventilation and surfactant replacement therapy.
• RDS can lead to chronic lung disease and long-term respiratory complications.
• Treatment approaches vary considerably across centres, with new evidence and clinical trials constantly emerging.
• The rapid evolution of evidence necessitates a living guideline approach to ensure recommendations reflect the latest research.

 Project Overview:

• Timeline: 2025-2027 (with ongoing updates beyond initial publication)
• Scope: To be determined, will consider comprehensive clinical guidance covering prevention, acute management, respiratory support strategies, and monitoring for complications of RDS in preterm infants.
• Process Multi-disciplinary expert panel consensus incorporating clinical expertise, lived experience, and implementation considerations.
• Target users: Neonatal clinicians, wider critical care support teams, policymakers, and healthcare administrators across Australian neonatal networks.

 Living guideline approach:

• Continuous evidence surveillance: Systematic scanning and appraisal of emerging research to identify practice-changing evidence.
• Evidence-triggered updates: Revising recommendations when new high quality evidence demonstrates potential to change clinical practice.
• Responsive update cycle: updates occur as evidence emerges rather than on fixed schedules, ensuring timely translation of research into practice.
• Strategic prioritisation: focusing on interventions with significant impact on mortality. Morbidity and neurodevelopmental outcomes topics with high clinical impact or rapidly evolving evidence.

Impact:

• Reduces unwarranted practice variation across Australian centres.
• Delivers current, evidence-based recommendations that improve clinical outcomes for preterm infants with RDS.
• Supports quality improvement initiatives and policy development across neonatal networks.
• Provides families with assurance that their infant is receiving care based on the best available evidence.
• Reduces evidence-to-practice gaps in the management of one of the most common complications of prematurity.