A quality improvement project on reducing antibiotic use duration in very low birth weight preterm infants in the neonatal intensive care unit
10.7499/j.issn.1008-8830.2311037
- VernacularTitle:降低新生儿重症监护室极低出生体重早产儿抗生素使用时间的质量改进研究
- Author:
Mei-Ying QUAN
1
;
Shu-Ju FENG
;
Yu ZHANG
;
Chen WANG
;
Le-Jia ZHANG
;
Zheng-Hong LI
Author Information
1. 中国医学科学院北京协和医院儿科/疑难重症及罕见病国家重点实验室,北京 100730
- Keywords:
Quality improvement;
Antibiotic management;
Neonatal intensive care unit;
Very low birth weight infant;
Preterm infant
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(7):736-742
- CountryChina
- Language:Chinese
-
Abstract:
Objective To develop effective measures to reduce antibiotic use duration in very low birth weight(VLBW)preterm infants in the neonatal intensive care unit through quality improvement methods.Methods The study population consisted of hospitalized VLBW preterm infants,with the percentage of hospitalization time during which antibiotics were used from November 2020 to June 2021 serving as the baseline.The specific quality improvement goal was to reduce the duration of antibiotic use.Factors affecting antibiotic use duration in preterm infants were analyzed using Pareto charts.Key drivers were identified,and specific interventions were formulated based on the stages of antibiotic use.Changes in the percentage of antibiotic use duration were monitored with run charts until the quality improvement target was achieved.Results From November 2020 to June 2021,the baseline antibiotic use duration percentage was 49%,with a quality improvement target to reduce this by 10%within 12 months.The Pareto analysis indicated that major factors influencing antibiotic duration included non-standard antibiotic use;delayed cessation of antibiotics when no infection evidence was present;prolonged central venous catheter placement;insufficient application of kangaroo care;and delayed progress in enteral nutrition.The interventions implemented included:(1)establishing sepsis evaluation and management standards;(2)educating medical staff on the rational use of antibiotics for preterm infants;(3)supervising the enforcement of antibiotic use standards during ward rounds;(4)for those without clear signs of infection and with negative blood cultures,discontinued the use of antibiotics 36 hours after initiation;(5)reducing the duration of central venous catheterization and parenteral nutrition to lower the risk of infection in preterm infants.The control chart showed that with continuous implementation of interventions,the percentage of antibiotic use duration was reduced from 49%to 32%,a statistically significant decrease.Conclusions The application of quality improvement tools based on statistical principles and process control may significantly reduce the antibiotic use duration in VLBW preterm infants.
