Dr Pei Sen Tee
Dr Pei Sen Tee, Dr Amanda Ogilvy-Stuart Department of Neonatology, Rosie Hospital, Cambridge
Title: Audit Of Antibiotic Administration In Suspected Early Onset Neonatal Sepsis
Biography
Biography: Dr Pei Sen Tee
Abstract
Background: Sepsis remains a major cause of morbidity and mortality1 . NICE guidance stated that there should not be any delay in starting antibiotics, pending test results. Aim: To assess compliance with NICE guidelines on antibiotic administration for babies with suspected EONS on postnatal ward and delivery unit (DU) Method: • Audit of antibiotic administration in babies with suspected EONS born in the month of December 2018 in Rosie Hospital, Cambridge. • Babies admitted to NICU before antibiotic administration were excluded. • The process from decision to treat to antibiotic administration was mapped in order to identify areas where compliance might be improved. Standards: NICE guidance CG1492 “Neonatal infection (early onset): antibiotics for prevention and treatment”: -100% of newborns with suspected EONS receive antibiotics within 1 hour of decision to treat. Results: 61 babies with suspected EONS in the postnatal ward/DU were started on antibiotics in December 2018. 13 had unclear documentation of the time of decision to start antibiotics and were excluded. Time from decision to treat to antibiotic administration: -Compliance with antibiotic administration <1 hour from decision to treat: 17% -Longest time: 7 hours 54 mins -Shortest time: 33 mins -Average time: 2 hours 15 mins Conclusion: • The target timeframe for antibiotic administration in most cases of suspected EONS of babies on the postnatal wards and DU is not being achieved. • Process mapping identified that most delay arises during transfer of the baby to the neonatal unit for the infection screen and lack of immediate availability of neonatal nurses for antibiotic administration. Action Plan: 1. Raise awareness of the importance of prompt antibiotic administration to medical, midwifery and nursing staff 2. Involvement of midwifery and neonatal nursing team leads to change practice: i. Introduction of “septic screen pack” containing essential equipment required for septic screen so screen can be performed on delivery suite ideally beside the mother ii. Training of midwifery staff to administer antibiotics