Dmitry Dukhovny1, Madge E Buus-Frank2,3, Erika M Edwards2,4,5, Timmy Ho6,7, Kate A Morrow2, Arjun Srinivasan8, Daniel A Pollock8, John A F Zupancic6,7, DeWayne M Pursley6,7, Donald Goldmann9, Karen M Puopolo10,11, Roger F Soll2,4, Jeffrey D Horbar2,4. 1. Department of Pediatrics, Oregon Health & Science University, Portland, Oregon; dukhovny@ohsu.edu. 2. Vermont Oxford Network, Burlington, Vermont. 3. Children's Hospital at Darmouth-Hitchcock and Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. 4. Department of Pediatrics, The Robert Larner, MD, College of Medicine, and. 5. Department of Mathematics and Statistics, University of Vermont, Burlington, Vermont. 6. Beth Israel Deaconess Medical Center, Boston, Massachusetts. 7. Harvard Medical School, Harvard University, Boston, Massachusetts. 8. Centers for Disease Control and Prevention, Atlanta, Georgia. 9. Institute for Healthcare Improvement, Boston, Massachusetts. 10. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and. 11. Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Abstract
OBJECTIVES: To determine if NICU teams participating in a multicenter quality improvement (QI) collaborative achieve increased compliance with the Centers for Disease Control and Prevention (CDC) core elements for antibiotic stewardship and demonstrate reductions in antibiotic use (AU) among newborns. METHODS: From January 2016 to December 2017, multidisciplinary teams from 146 NICUs participated in Choosing Antibiotics Wisely, an Internet-based national QI collaborative conducted by the Vermont Oxford Network consisting of interactive Web sessions, a series of 4 point-prevalence audits, and expert coaching designed to help teams test and implement the CDC core elements of antibiotic stewardship. The audits assessed unit-level adherence to the CDC core elements and collected patient-level data about AU. The AU rate was defined as the percentage of infants in the NICU receiving 1 or more antibiotics on the day of the audit. RESULTS: The percentage of NICUs implementing the CDC core elements increased in each of the 7 domains (leadership: 15.4%-68.8%; accountability: 54.5%-95%; drug expertise: 61.5%-85.1%; actions: 21.7%-72.3%; tracking: 14.7%-78%; reporting: 6.3%-17.7%; education: 32.9%-87.2%; P < .005 for all measures). The median AU rate decreased from 16.7% to 12.1% (P for trend < .0013), a 34% relative risk reduction. CONCLUSIONS: NICU teams participating in this QI collaborative increased adherence to the CDC core elements of antibiotic stewardship and achieved significant reductions in AU.
OBJECTIVES: To determine if NICU teams participating in a multicenter quality improvement (QI) collaborative achieve increased compliance with the Centers for Disease Control and Prevention (CDC) core elements for antibiotic stewardship and demonstrate reductions in antibiotic use (AU) among newborns. METHODS: From January 2016 to December 2017, multidisciplinary teams from 146 NICUs participated in Choosing Antibiotics Wisely, an Internet-based national QI collaborative conducted by the Vermont Oxford Network consisting of interactive Web sessions, a series of 4 point-prevalence audits, and expert coaching designed to help teams test and implement the CDC core elements of antibiotic stewardship. The audits assessed unit-level adherence to the CDC core elements and collected patient-level data about AU. The AU rate was defined as the percentage of infants in the NICU receiving 1 or more antibiotics on the day of the audit. RESULTS: The percentage of NICUs implementing the CDC core elements increased in each of the 7 domains (leadership: 15.4%-68.8%; accountability: 54.5%-95%; drug expertise: 61.5%-85.1%; actions: 21.7%-72.3%; tracking: 14.7%-78%; reporting: 6.3%-17.7%; education: 32.9%-87.2%; P < .005 for all measures). The median AU rate decreased from 16.7% to 12.1% (P for trend < .0013), a 34% relative risk reduction. CONCLUSIONS: NICU teams participating in this QI collaborative increased adherence to the CDC core elements of antibiotic stewardship and achieved significant reductions in AU.
Authors: Catalina Morales-Betancourt; Javier De la Cruz-Bértolo; Bárbara Muñoz-Amat; Elena Bergón-Sendín; Carmen Pallás-Alonso Journal: Front Pediatr Date: 2022-05-31 Impact factor: 3.569
Authors: Dustin D Flannery; Sagori Mukhopadhyay; Erik A Jensen; Jeffrey S Gerber; Molly R Passarella; Kevin Dysart; Zubair H Aghai; Jay Greenspan; Karen M Puopolo Journal: J Pediatric Infect Dis Soc Date: 2021-03-26 Impact factor: 3.164
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