Implementation of the sepsis risk score for chorioamnionitis-exposed newborns

Background: To prevent early onset sepsis (EOS), ~10% of neonates receive antibiotics based on CDC recommendations regarding chorioamnionitis exposure. A sepsis risk score (SRS) predicts EOS and spares unnecessary evaluation and treatment. Local problem: Chorioamnionitis-exposed neonates utilize sig...

Full description

Saved in:
Bibliographic Details
Published in:Journal of perinatology 2018-11, Vol.38 (11), p.1581-1587
Main Authors: Gievers, Ladawna L, Sedler, Jennifer, Phillipi, Carrie A, Dukhovny, Dmitry, Geddes, Jonah, Graven, Peter, Chan, Benjamin, Khaki, Sheevaun
Format: Article
Language:English
Subjects:
692/699/255/1318
692/700/1720
Algorithms
Antibiotics
Care and treatment
Chorioamnionitis
Evaluation
Exposure
Health risk assessment
Infection
Laboratories
Medical schools
Medicine
Medicine & Public Health
Methods
Neonates
Newborn babies
Newborn infants
Pediatric research
Pediatric Surgery
Pediatrics
Process mapping
Quality Improvement Article
Resource utilization
Risk factors
Sepsis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: To prevent early onset sepsis (EOS), ~10% of neonates receive antibiotics based on CDC recommendations regarding chorioamnionitis exposure. A sepsis risk score (SRS) predicts EOS and spares unnecessary evaluation and treatment. Local problem: Chorioamnionitis-exposed neonates utilize significant resources. Methods: An SRS algorithm was implemented to decrease resource utilization in chorioamnionitis-exposed neonates ≥35 weeks’. Outcome measures included antibiotic exposure, time in NICU, laboratory evaluations, and length of stay (LOS). Balancing measures were missed cases of EOS and readmissions. Data were assessed using run charts. Interventions: Plan-Do-Study-Act cycles were utilized to process map, implement and reinforce the algorithm. Results: A number of 356 patients met inclusion criteria. After algorithm implementation, antibiotic exposure reduced from 95 to 9%, laboratory evaluation from 96 to 22%, NICU observation from 73 to 10%. LOS remained unchanged. No missed cases of EOS, nor sepsis readmissions. Conclusions: Algorithm implementation decreased antibiotic and resource utilization without missing cases of EOS.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-018-0207-7