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Volume 5
Journal of Pediatric Care
ISSN: 2471-805X
JOINT EVENT
Neonatology 2019
Pediatrics Surgery 2019
April 23-24, 2019
April 23-24, 2019 London, UK
&
23
rd
Edition of International Conference on
Neonatology and Perinatology
4
th
International Conference on
Pediatrics and Pediatric Surgery
Implementation of early-onset sepsis calculator in the newborn nursery at local community medical center
in Baltimore, Maryland
Ke-Ni Niko Tien, Janice Wilson, Carmel A. McComiskey
and
Susan J. Dulkerian
University of Maryland, USA
A
ntibiotics are the most commonly prescribed medications in the neonatal population. Early antibiotic exposure
is associated with asthma, allergic reaction, autoimmune disease and obesity later in childhood. In this newborn
setting, the providers most commonly refer to the 2010 CDC guideline for managing infants at risk for early-
onset sepsis (EOS). However, the interpretation of the guideline varies among providers. Evidence suggests that
implementing a neonatal earlyonset sepsis (EOS) calculator decreases the number of infants requiring antibiotic
prophylaxis and reduces antibiotic exposure safely. The purpose of this quality improvement (QI) scholarly project
was to implement the EOS calculator for infants ≥35 weeks gestational age (GA) with infection risk factors but
well appearing in a newborn nursery (NBN) at an urban medical center setting in Maryland to reduce the need
for laboratory evaluation and antibiotic exposure, as well as to standardize the practice. Focus-Analyze-Develop-
Execute/Evaluate (FADE) was the quality improvement (QI) model used for this project. All infants born at ³ 35
0/7 weeks’ gestation (n= 190) at the study hospital were enrolled over 11 weeks, September 9, 2018, to November
22, 2018. A retrospective chart review was also conducted to establish a baseline of comparison (n= 144). Based
on the data, 174 out of 190 infants (91.6%) were managed utilizing the EOS calculator from birth to 12 hours of
life. Seven out of one hundred and seventy-four infants (4%) received sepsis laboratory evaluation, compared to
25 infants out of 144 (17.3%) before the implementation. The percentage of infants needing laboratory evaluation
significantly decreased with the use of the EOS calculator (p < 0.05). The results of this project reveal a decrease in
laboratory evaluation and prophylactic antibiotic use by utilizing the EOS calculator. The significant declines suggest
that continued and widespread use of the EOS calculator has a significant impact on antibiotic usage in this well
newborn nursery.
Biography
Ke-Ni N Tien has been in Neonatal Clinical Practice sine 1991, having worked in Taiwan and some of the Nation’s top ranked Neonatal Intensive Care Units. She
currently serves as a Neonatal Nurse Practitioner (NNP) full-time with Cleveland Clinic Children’s and part-time with Johns Hopkins Children’s Center. He holds
an earned Master of Science in Nursing atArizona State University in 2007 and is currently a Doctoral Candidate in Nursing Practice (DNP) with the University of
Maryland. Her interests concentrate on the synthesis of neonatal research, education and quality improvement projects, transforming data driven interdisciplinary
team approaches into tangible improvement outcomes.
niko0929@yahoo.comKe-Ni Niko Tien et al., J Pediatr Care 2019, Volume 5
DOI: 10.21767/2471-805X-C1-021