Babies Antibiotic Stewardship Improvement Collaborative (BASIC)
Fill out and submit your BASIC sustainability plan to info@ilpqc.org !
Hospital teams across Illinois work to provide the right antibiotics to the right babies for the right length of time
Working with hospital-based teams, the Illinois Perinatal Quality Initiative (ILPQC) in 2020 launched a statewide neonatal initiative to implement American Academy of Pediatrics and Centers for Disease Control and Prevention guidelines. ILPQC will work with hospital teams to implement system changes such protocols and tools for Early Onset Sepsis (EOS) risk assessment, identification, and response, as well as clinical culture change using neonatal/pediatric provider & nursing education, clinical debriefs of newborns receiving antibiotics to improve care, and regular data review to improve care for all newborns at risk for EOS.
Key Strategies:
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1.
Increase percentage of physicians and nurses educated about early-onset sepsis (EOS) risk factors, assessment tools, and guidelines
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2.
Increase percentage of newborns with documented use of EOS risk assessment tools at delivery
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3.
Increase percentage of newborns with a blood culture drawn prior to the initiation of antibiotics
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4.
Increase percentage of newborns with care team discussing and documenting plan for length of antibiotic course
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5.
Decrease percentage of newborns of any gestational
age with a negative blood culture at 36 hours that receive additional antibiotics -
6.
Increase percentage of parents/families provided education about antibiotics and EOS
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7.
Increase percentage of parents/families reporting respectful care from the care team during the
newborn stay
Toolkit
The BASIC Toolkit has been updated and rearranged by category in November 2021 to allow resources to be easily accessible. If you have trouble finding any resources reach out to ellie.suse@northwestern.edu
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Education Materials
- Patient and Family
- ILPQC BASIC Patient Education Handout with QR Code to video: Educational handout for parents whose newborns are receiving antibiotics
- ILPQC Patient Education Video (English) : Educational video for parents whose newborns are receiving antibiotics
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- ILPQC Patient Education Video (Spanish) : Educational video for parents whose newborns are receiving antibiotics
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- ILPQC Chorioamnionitis Educational Handout: Educational handout for parents who are diagnosed with Chorioamnionitis on Labor and Delivery
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- Clinical team
- ILPQC Neonatal Early Onset-Sepsis Risk Calculator Process Flow ≥ 35 weeks
- FHN Example ABX Guidelines for Newborns >34 weeks for EOS
- Resources for Implementation of Standardized Risk Assessment for < 34 6/7
- Properly and Consistently Obtain Blood Cultures
- Neonatal Peripheral Blood Culture Collection Checklist(Advocate Lutheran General Hospital)
- Neonatal Peripheral Blood Culture Collection Video(Advocate Lutheran General Hospital)
- Patient and Family
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Communication Tools
- ILPQC Newborn Admission Report (LD RN to Newborn RN): Use this template to standardize communication between L&D nurse and receiving newborn/postpartum nurse
- ILPQC Newborn Nurse to Pediatrician Communication Tool:Use this template to standardize communication between the newborn/postpartum nurse to the pediatrician on newborn status
- ILPQC Antibiotic Time-out Tool: Use this tool to determine if continuing antibiotics longer than 36 hours is appropriate
- Antibiotic time out video(PQCNC)
- Example Antibiotic Timeout Checklist
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National Guidelines, Publications, and Supportive Resources
- AAP: Management of Neonates Born at ≥35 0/7 Weeks’ Gestation With Suspected or Proven Early-Onset Bacterial Sepsis(2018): AAP guideline for early onset sepsis for late preterm and term infants
- AAP: Management of Neonates Born at ≤34 6/7 Weeks’ Gestation With Suspected or Proven Early-Onset Bacterial Sepsis(2018): AAP guideline for early onset sepsis for preterm infants
- AAP: Management of Infants at Risk for Group B Streptococcal Disease(2019): AAP guideline for infants at risk for GBS disease
- AAP: Empiric Antibiotic Dosing Chart for Neonatal EOS(2019) (Citation Here)
- JAMA Pediatrics: A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis(2017): A review of the science behind the NEOSC (Kaiser calculator)
- ACOG Committee Opinion: Intrapartum Management of Intraamniotic Infection(2017)
- ACOG Committee Opinion:Prevention of Group B Streptococcal Early-Onset Disease in Newborns (2020)
- Hosp Pediatr: Implementation of the Sepsis Risk Calculator at an Academic Birth Hospital(2018): An article reviewing implementation strategies for the NEOSC
- AJIC Publication on RN Impacts on ABX Stewardship Programs(2020): An article that reviews the role of the nurse in antibiotic stewardship
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Order Sets and Dosing Guidelines
- AAP: Empiric Antibiotic Dosing Chart for Neonatal EOS (2019) (Citation Here)
- Sample EMR order sets
- Example Antibiotic Dosing Regimens, Intervals of Administration, and Gentamicin/Vancomycin Dosing Guidelines (Shared by UIH 5.4.2020)
- Example >35 weeks orderset (Shared in 2020 by UIH)
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- Example Gentamicin EMR automated stop time order (Shared in 2020 by UIH)
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Helpful Initiative Tools
- ILPQC BASIC 1-Pager : a one page summary of the aims and intervention strategies for BASIC
- Link to Neonatal Early-Onset Sepsis Calculator (Kaiser Calculator)
- FAQ about NEOSC usage Calculator General
- EMR integration:
- Norwegian American Hospital Example Newborn Sepsis Screen and Management(7.6.2020)
- Example Chorio Nursery Information for Parents (NM Hospital, 2019)
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BASIC Data Collection and Tools
- BASIC Monthly Newborns Sustainability Data Form (Updated 6.7.2023)
- BASIC Monthly Newborns Data Form(Updated 3.3.2022)
- Reference Tool for Data Collection Terms(1.25.2021)
- 1-Sided Condensed Version(3.8.22)
- BASIC Monthly Hospital Data Form(Updated 3.19.2021)
- REDCap Data Forms
- BASIC FAQs (Updated 3.15.2021)
- How to find your reports in REDCap
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QI Resources
- 10 Steps to Getting Started with BASIC
- BASIC Key QI Strategies
- BASIC Readiness Survey
- BASIC Key Driver Diagram(12.14.2020)
- BASIC AIMs & Measures De-constructed Slides(Version 12.21.2020)
- Plan-Do-Study-Act Worksheet
- 30-60-90 Day Plan
- Prioritization Matrix
- Power of PQCs (paper)
- QI Leader Support Call Recording(11.13.2020)
- BASIC QI Team Meeting Agenda Template
The above materials are examples only and not meant to be prescriptive. The resources provided in this toolkit are for informational purposes only. The exclusion of a resource, program, or website does not reflect the quality of that resource, program or website. Note: websites and URLs are subject to change.
Webinars
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Upcoming Webinars
BASIC Teams Call
Teams calls will be held on the 3rd Monday of the month at a NEW TIME from 2-3pm CST
Register for all upcoming webinars here: https://northwestern.zoom.us/meeting/register/tJcpc-qppjMpHdWBNEO8WJsLjfDDUz9ucmt2
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2023 Webinars
February 2023: Springing Forward to Sustainability (View Recording)
August 2023: Sustainability Call (View Recording)
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2022 Webinars
January 2022: Culture Negative Sepsis (View Recording)
February 2022: BASIC Data through an Equity Lens (View Recording)
March 2022: Engaging Private Pediatricians in our BASIC Work (View Recording)
April 2022: Integrating the NEOSC into your EMR (View Recording)
June 2022: Getting the Reports you need from REDCap (View Recording)
July 2022: Preparing to Accept your QI Excellence Award at the 2022 Annual Conference (View Recording)
August 2022: Using your Data to Tell a Story (View Recording)
September 2022: Preparing for the 2022 Annual Conference
November 2022: November Webinar (View Recording)
December 2022: 36 is the New 48 (View Recording)
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2021 Webinars
January 2021: Overview of ≥35 Risk Assessments for Early Onset Sepsis (EOS) (View Recording)
February 2021: Finding and Prioritizing your BASIC Opportunities (View Recording)
March 2021: Implementation Strategies for NEOSC for newborns ≥35 Weeks (View Recording)
April 2021: Using EMR for Data & Clinical Support (View Recording)
June 2021: Timely & Appropriate Initiation of Antibiotics (View Recording)
July 2021: July Monthly webinar (View Recording)
August 2021:Equitable Care in BASIC: Equity Data, Dashboards, Strategies to Collect Race/Ethnicity Data (View Recording)
September 2021: Implementation of Risk Assessments in Newborns <35 Weeks (View Recording)
November 2021: What’s my role? (View Recording)
December 2021: Automatic Stop Times
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2020 Webinars
- December 21st BASIC Teams Call Launch | 1pm – 3pm CST | Register here!
Ten Steps to Get Started with BASIC
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- Schedule regular, at least monthly, BASIC QI team meetings and register for the ILPQC monthly BASIC teams calls
- View recording of the ILPQC QI Team Lead Support Call. All team leads including provider and nurse champions should review the recording if not able to attend live webinar led on November 13th.
- Review the ILPQC BASIC Data Collection Forms (Monthly Newborn & Monthly Hospital) with your team and discuss strategies for data collection including the Data Dictionary. View slides and recording of the ILPQC REDCap Data Training Call to learn about submitting data and strategies for collecting retrospective and prospective data.
- Complete the BASIC Teams Readiness Survey. Please work together as a team to complete the survey. Choose one designee to fill out the BASIC Readiness Survey. This survey will help teams understand current barriers and opportunities for getting started with BASIC. There are no right answers! It’s ok to start with lots of opportunities for improvement!
- Create a process flow diagram to reflect your current process for antibiotic decision making and identify key opportunities for improvement. See ILPQC example BASIC process flow diagram in ILPQC toolkit.
- Reference the BASIC Key Driver Diagram to identify possible interventions and next steps. Focus first on understanding your team’s clinical culture around antibiotics and how that culture can better promote and support antibiotic stewardship, consider standardized Key QI strategies for BASIC
- Review the online ILPQC BASIC Online Toolkit for nationally vetted resources to support your improvement goals. Contact ILPQC if you need help identifying additional resources.
- Meet with your QI team to create a draft 30/60/90 day plan. This plan helps your team decide where to start and identify what you want to accomplish in the first 3 months. Call it the “where should we start” for your BASIC implementation plan.
- Plan your first PDSA cycle with your team to address your 30/60/90-day plan. These small tests of change help your hospital test process/system changes to reach initiative goals. Be sure to review results, make improvements and implement if successful, repeat cycle if improvements needed.
- Reach out to ILPQC for help (info@ilpqc.org) and celebrate your successes with your team early and often.
BASIC Clinical Leadership
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Leslie Caldarelli
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Justin Josephsen
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Sameer Patel
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Kenny Kronforst
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Patrick Lyons
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Gustave Falciglia
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Jodi Hoskins