Reducing intravenous antibiotics in neonates born ≥35 weeks' gestation: A quality improvement study.

Grace, E; Jayakumar, N; Cooper, C; Andersen, C; Callander, E; Gomersall, J; Rumbold, A; Keir, A

Reducing intravenous antibiotics in neonates born ≥35 weeks' gestation: A quality improvement study.

Grace, E Jayakumar, N Cooper, C Andersen, C Callander, E

Gomersall, J Rumbold, A Keir, A

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: J Paediatr Child Health, 2024, 60, (4-5), pp. 139-146
Issue Date:: 2024

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Field	Value	Language
dc.contributor.author	Grace, E
dc.contributor.author	Jayakumar, N
dc.contributor.author	Cooper, C
dc.contributor.author	Andersen, C
dc.contributor.author	Callander, E https://orcid.org/0000-0001-7233-6804
dc.contributor.author	Gomersall, J
dc.contributor.author	Rumbold, A
dc.contributor.author	Keir, A
dc.date.accessioned	2024-09-24T01:29:10Z
dc.date.available	2024-03-18
dc.date.available	2024-09-24T01:29:10Z
dc.date.issued	2024
dc.identifier.citation	J Paediatr Child Health, 2024, 60, (4-5), pp. 139-146
dc.identifier.issn	1034-4810
dc.identifier.issn	1440-1754
dc.identifier.uri	http://hdl.handle.net/10453/180936
dc.description.abstract	AIM: To assess the impact of the Early Onset Sepsis (EOS) calculator, implemented as a quality improvement study, to reduce the rate of unnecessary antibiotics in neonates born ≥35 weeks' gestation. METHODS: An audit of routinely collected hospital data from January 2008 to March 2014 (retrospective) and from January 2018 to September 2019 (prospective) determined baseline incidence of EOS intravenous antibiotic use in neonates born ≥35 weeks' gestation in a tertiary level perinatal centre. Plan-do-study-act (PDSA) cycles were applied to implement the EOS calculator. Statistical process control methodology and time series analysis assessments were used to assess the potential impact of the PDSA cycles on the rate of intravenous antibiotics, blood culture collection, EOS, length of stay and health care costs (not adjusted for potential confounders). RESULTS: In the study population, from January 2008 to March 2014, the baseline incidence of intravenous antibiotic use was 10.49% (2970/28290), whilst only 0.067% (19/28290) neonates had culture proven EOS. From January 2018 to October 2019, prior to implementation of the EOS calculator, 13.3% (1119/8411) neonates were treated with intravenous antibiotic and the use decreased to 8.3% (61/734) post-implementation. The rate of blood culture collection decreased from 14.4% (1211/8411) to 11.9% (87/734). There were no cases of missed EOS. Length of stay decreased from 2.68 to 2.39 days, with an estimated cost saving of $366 per patient per admission. CONCLUSION: Implementing the EOS calculator in a tertiary hospital setting reduced invasive investigations for EOS and intravenous antibiotic use among neonates ≥35 weeks' gestation. This can result in reduced length of neonatal hospital stays, and associated health care cost savings and may reduce separation of mother and baby.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	J Paediatr Child Health
dc.relation.isbasedon	10.1111/jpc.16537
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Pediatrics
dc.subject.classification	3213 Paediatrics
dc.subject.mesh	Humans
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Quality Improvement
dc.subject.mesh	Administration, Intravenous
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Female
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Male
dc.subject.mesh	Neonatal Sepsis
dc.subject.mesh	Gestational Age
dc.subject.mesh	Length of Stay
dc.subject.mesh	Humans
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Length of Stay
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Gestational Age
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Quality Improvement
dc.subject.mesh	Administration, Intravenous
dc.subject.mesh	Neonatal Sepsis
dc.subject.mesh	Humans
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Quality Improvement
dc.subject.mesh	Administration, Intravenous
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Female
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Male
dc.subject.mesh	Neonatal Sepsis
dc.subject.mesh	Gestational Age
dc.subject.mesh	Length of Stay
dc.title	Reducing intravenous antibiotics in neonates born ≥35 weeks' gestation: A quality improvement study.
dc.type	Journal Article
utslib.citation.volume	60
utslib.location.activity	Australia
utslib.for	1103 Clinical Sciences
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2024-09-24T01:29:08Z
pubs.issue	4-5
pubs.publication-status	Published
pubs.volume	60
utslib.citation.issue	4-5

Abstract:

AIM: To assess the impact of the Early Onset Sepsis (EOS) calculator, implemented as a quality improvement study, to reduce the rate of unnecessary antibiotics in neonates born ≥35 weeks' gestation. METHODS: An audit of routinely collected hospital data from January 2008 to March 2014 (retrospective) and from January 2018 to September 2019 (prospective) determined baseline incidence of EOS intravenous antibiotic use in neonates born ≥35 weeks' gestation in a tertiary level perinatal centre. Plan-do-study-act (PDSA) cycles were applied to implement the EOS calculator. Statistical process control methodology and time series analysis assessments were used to assess the potential impact of the PDSA cycles on the rate of intravenous antibiotics, blood culture collection, EOS, length of stay and health care costs (not adjusted for potential confounders). RESULTS: In the study population, from January 2008 to March 2014, the baseline incidence of intravenous antibiotic use was 10.49% (2970/28290), whilst only 0.067% (19/28290) neonates had culture proven EOS. From January 2018 to October 2019, prior to implementation of the EOS calculator, 13.3% (1119/8411) neonates were treated with intravenous antibiotic and the use decreased to 8.3% (61/734) post-implementation. The rate of blood culture collection decreased from 14.4% (1211/8411) to 11.9% (87/734). There were no cases of missed EOS. Length of stay decreased from 2.68 to 2.39 days, with an estimated cost saving of $366 per patient per admission. CONCLUSION: Implementing the EOS calculator in a tertiary hospital setting reduced invasive investigations for EOS and intravenous antibiotic use among neonates ≥35 weeks' gestation. This can result in reduced length of neonatal hospital stays, and associated health care cost savings and may reduce separation of mother and baby.

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http://hdl.handle.net/10453/180936