Shorter stays for our smallest patients
Josef M. Cortez, M.D.
Families are now bringing their newborns home sooner after treatment in the NICU.
Infants are admitted to UF Health Jacksonville's Level III Neonatal Intensive Care Unit for a variety of reasons, but the goal for each and every one remains the same — to get them healthy enough to go home to their families. At UF Health Jacksonville, this family reunion is happening sooner. Providers and staff credit decreased antibiotic use and implementing cluster-care sessions for advancements in the NICU.
For many years, the methodology was to give NICU patients five to seven days of antibiotics for suspected infection. New research found connections between prolonged use and antibiotic resistance, and also between secondary infections and complications. When this happens, patients may have to stay in the NICU longer.
“It’s important to monitor infants for clear evidence of infection before administering antibiotics,” said Josef Cortez, MD, medical director of the NICU. “With the right tools, we can now closely track antibiotic usage rates to prevent prolonged treatment.”
Since 2016, UF Health Jacksonville has reduced the amount of antibiotics administered in the NICU by 25 percent. With the decrease came earlier discharges for infants. During the past two years, the average length of stay in the NICU has decreased from 38 days to 30 days, allowing families to bring babies home up to a week sooner.
UF Health Jacksonville’s NICU participates in Choosing Antibiotics Wisely, an international, web-based collaborative for data reporting. In addition, UF Health Jacksonville created a NICU-specific antibiotic stewardship program to monitor and track patient statistics that include antibiotic use. This multidisciplinary approach has enhanced communication with neonatologists, pharmacists, nursing staff and parents.
“Overusing antibiotics can cause many issues,” pharmacist Bill Renfro said. “It’s important to see how we measure against other NICUs, and look at long-term results.”
Other practices supporting antibiotic use and length of stay goals include the use of donor breast milk, and education of nurses, staff and patient families about medication use and quality procedures.
One quality improvement recently initiated in the NICU involves scheduled coordination by nursing staff and providers to limit disruptions for the babies. Clustering important duties, such as diaper changing, changing IV lines, drawing blood and administering medications, can be done within the same time block.
“Cluster care has enabled the nursing staff to better control the therapeutic environment for the babies,” said Mark Yeoman, a NICU nurse. “It reduces the stress caused by multiple interruptions.”
Patient quality — even for the tiniest patients — is an important measurement for all providers and staff at UF Health Jacksonville. For the dedicated neonatologists and NICU providers, advancements in technology, research and best practices improve the health and experience for not just their patients, but the patients’ families as well.
Josef M. Cortez, M.D.