The Tennessee Initiative for Perinatal Quality Care (TIPQC) recently awarded Williamson Medical Center’s Neonatal Antibiotic Stewardship Project team with the Tennessee Initiative for Perinatal Quality Care Gold Award at the 2019 TIPQC Annual Meeting in Franklin.
The award, as part of a statewide antibiotic stewardship initiative, recognizes the neonatal team for its dedication to decreasing the overall use of antibiotics in its NICU.
The misuse of antibiotics contributes to the growing threat of antibiotic resistance, which has become one of the most urgent public health challenges. The CDC estimates each year in the U.S., at least 2 million people are infected with antibiotic-resistant bacteria, and at least 23,000 people die as a result.
In 2016, Williamson Medical Center joined a national collaborative to better understand antibiotic use in the neonatal population (babies less than one month of age). Groups in Tennessee also expressed interest in a smaller, more intensive, collaborative effort at the state level. In 2018, the TIPQC created a statewide Antibiotic Stewardship project focused solely on babies in the neonatal intensive care unit and newborn nursery.
According to Courtney Sutton, clinical pharmacist specialist at Williamson Medical Center and Neonatal Antibiotic Stewardship Project team member, the goal of the statewide project was to reduce the use of antibiotics by 25% in a one-year period.
“Williamson Medical Center was eager to participate and quickly formed a multidisciplinary team that consisted of a neonatal nurse practitioner, neonatal nursing leadership, a pediatric pharmacist and an infectious diseases physician,” she said. “Each month, this team met with the larger state group to provide progress reports on how the project was being implemented at Williamson Medical Center, to hear how other institutions were implementing antibiotic stewardship activities and to collaborate on next steps at both the state and local level.”
The Williamson Medical Center team worked diligently to accomplish the goals for its neonatal population, which was to reduce antibiotic use by 25% by eliminating misuse and unnecessary use of antibiotics, and to increase parental awareness of antibiotic therapy.
Williamson Medical Center has successfully implemented an “antibiotic time out,” where the care team pauses to discuss if antibiotics are still needed after 48 hours of treatment. Previously, more than 50% of infants were receiving antibiotics beyond 48 hours. Now, less than 30% of patients receive antibiotic therapy after 48 hours, significantly reducing the number of antibiotic doses administered.
The Williamson Medical Center team understands the value of parent involvement in the care and well-being of their infants, and wants to ensure that parents understand when and why antibiotics are sometimes necessary. The team created educational materials specific to neonatal infections to help parents understand why antibiotics were started, what the team is monitoring, what questions to ask their providers and when antibiotics may no longer be needed. The NICU bedside nurses provide this information to families for every infant started on antibiotics and readily answer questions the families may have.
While a few members led this project, the efforts of all members of the NICU team were essential in reaching the project goals. The entire NICU team is dedicated to ensuring that antibiotics are used appropriately. As a result, Williamson Medical Center has not only reached its goal of decreasing antibiotic use, but also exceeded it with antibiotic use in neonates at Williamson Medical Center decreasing by 37%.