Baby Steps, Big Improvements for Sepsis Monitoring in the Nursery

Clinicians often err on the side of caution when it comes to treating suspected neonatal sepsis, but the risks of antibiotic overuse include adverse drug reactions, resistance to antibiotics, and changes in the infant microbiome that might lead to chronic disease. At the University of Utah Health, a tool for calculating sepsis risk led to a decrease in the rate of antibiotic orders for infants admitted to a newborn nursery from 7% to 1% without any negative effects on the quality of care.

Researchers at Kaiser Permanente developed the early-onset sepsis risk calculator, an online tool to calculate the risk of developing neonatal sepsis. The calculator uses information like gestational age and infant clinical presentation to offer clinicians an estimate of an infant’s risk for developing sepsis. University of Utah researchers integrated a link to the calculator into the nursery admission note in Epic to remind clinicians to use the calculator. As a result, nursery clinicians increased calculator use to 85% of the time, up from 59% when they had to remember to access the calculator in a browser. The Utah clinicians entered the calculated risk of sepsis in Epic and selected a plan for the patient, with access to recommendations from the calculator on the same screen.

The Utah researchers noted that hospital costs are 2.5 times higher for infants who receive antibiotics than for infants who do not. For this single institution, which admits 3,500 infants to their nursery annually, the observed reduction of antibiotic overuse might save more than $1 million each year.

Read more about the University of Utah Health’s work in the American Academy of Pediatrics journal Pediatrics and about another Epic community member’s pediatric sepsis protocols.