400 - Collaborating to Improve Newborn Antibiotic Stewardship in the Community

Poster Number: 400

Jordan Silberg, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Colleen Malloy, Ann & Robert H. Lurie Children's Hospital of Chicago, Hinsdale, IL, United States; Tina O'Sullivan, Silver Cross Hospital, New Lenox, IL, United States; Marysusan FAJMAN, Silver Cross Hospital, Channahon, IL, United States

Background: The standard of care for evaluating newborns for sepsis has changed over the last decade leading to opportunities for change by introduction of a sepsis calculator tool in a newborn nursery and level II special care nursery of a community hospital. As a member of the Illinois Perinatal Quality Collaborative (ILPQC), Silver Cross Hospital joined the Babies Antibiotic Stewardship Improvement Collaborative (BASIC) with a global aim to implement the right antibiotics for the right babies for the right duration, with a local aim to standardize newborn sepsis evaluation.

Objective: In collaboration with BASIC, our primary aim was to decrease the percentage of newborns born at >= 35 weeks who receive antibiotics to < 4% within 12 months. Our secondary aim was to decrease the percentage of newborns born at >= 35 weeks with a negative blood culture who receive antibiotics longer than 36 hours by 20% within 12 months.

Design/Methods: Baseline data was collected by chart review from October 2020 through December 2020 and the Quality Improvement (QI) project data collection began in January 2021 and is ongoing. Developing a key driver diagram led to seven different interventions to support our aim and four of these interventions were prioritized: implementing a newborn sepsis pathway, utilizing and documenting a sepsis risk calculator, optimizing blood culture processing, and creating a sepsis order set with specific antibiotic dosing and stop times. Countermeasures to these interventions include delayed antibiotic initiation, emergent transfer, and neonatal death.

Results: After our interventions, the percentage of blood cultures drawn on newborns >= 35wk has decreased from 12% to 8.4% a significant shift from baseline. The percentage of newborns on antibiotics is stable and consistently below our goal of < 4%. The percentage of newborns receiving antibiotics longer than 36hr is down-trending from our baseline, without a significant shift. There were no negative outcomes of any of our three countermeasures.Conclusion(s): Silver Cross Hospital met antibiotic quality goals at start of BASIC and maintained that goal over the past year. In joining this statewide collaborative, we identified an alternate upstream opportunity to standardize blood culture collection that was separate from our initial aims. By standardizing our newborn sepsis evaluation in line with 2020 American Academy of Pediatric (AAP) guidelines, our QI team has been able to decrease the percentage of blood cultures collected on newborns >= 35wk over 10 months. During this time we have not had any significant morbidity or mortality associated with our interventions, which included the adoption of a sepsis calculator tool.

Designed by Cadmium |Technical Support
© Copyright 2024 Cadmium. All Rights Reserved.