Antibiotic Stewardship in Newborn Care
VON teams are choosing antibiotics wisely to combat misuse and overuse.
Improving Antibiotic Use in Newborns
Reducing antibiotic use has many benefits beyond combating antibiotic resistance. By using a sepsis risk calculator and employing current evidence-based practices for antibiotic use, VON teams are reducing length of separation of mothers and infants, which improves breastfeeding rates, and reducing unnecessary length of stay.
Hospitals often have antibiotic stewardship teams focused on adult patients but caring for infants, especially in the NICU, brings unique challenges that we address with standardized protocols and evidence-based successful practices.
In collaboration with the CDC in 2015, VON teams made a commitment to reduce antibiotic use rates by 25%. Three years later, 187 centers from 38 states and 7 countries surpassed that goal and achieved a 34% reduction in AUR. We are now committed to reducing the rate to 45% by 2022.
Wide Variation of Antibiotic Use in Newborn Care
Using data collected as part of the Internet-based Newborn Improvement Collaborative for Quality (iNICQ) VON Day Audits, our paper, Adherence of Newborn-Specific Antibiotic Stewardship Programs to CDC Recommendations (Pediatrics, December 2018), found significant gaps between CDC recommendations to improve antibiotic stewardship and actual antibiotic practices in neonatal intensive care units, as well as variation in antibiotic use among centers providing newborn care.
Importantly, we recognize the opportunity for improvement as three-quarters of infants who received antibiotics for more than 48 hours did not have infections proven by using cultures.
Quality Improvement at VON
Dedicated to continuous improvement
More than 700 teams in VON quality improvement collaboratives and have accelerated improvement for the entire neonatal community of practice.
Teams learn how to use data to inform improvement plans that lead to measurable results, which are presented at the VON Annual Quality Congress and elsewhere.
The QI methodologies that teams become proficient in through hands-on work in VON collaboratives inform improvement in other areas of their work with infants and families in the NICU and other care settings.
The most successful teams integrate parents into the improvement teams and partner with families to advance family-integrated care.
Ultimately, participation in VON quality improvement gives teams the tools, guidance, and momentum they need to sustain continuous improvement.