Implementation of an antimicrobial stewardship program in a multicenter neonatal intensive care unit collaborative: a...

Area of Science:

• Neonatal intensive care unit (NICU) medicine
• Infectious disease control
• Healthcare management

Background:

• Antimicrobial stewardship programs (ASPs) are crucial for combating antimicrobial resistance in healthcare settings.
• The specific staffing requirements for implementing and maintaining ASPs within Neonatal Intensive Care Units (NICUs) remain largely undefined.
• Understanding these needs is vital for effective program development and resource allocation.

Purpose of the Study:

• To define the staffing needs for antimicrobial stewardship programs (ASPs) in the neonatal intensive care unit (NICU) setting.
• To quantify the full-time equivalent (FTE) effort required for ASP implementation based on various factors.
• To identify the clinical roles contributing to ASP efforts in NICUs.

Main Methods:

• A survey was conducted among 29 California NICUs participating in an ASP collaborative.
• Data collected included FTEs for ASP implementation effort, categorized by clinical role, patient volume, clinical acuity, and NICU characteristics.
• Effort was analyzed across preparation and intervention phases.

Main Results:

• 146 staff members, including neonatologists and nurses, contributed to ASP implementation.
• Median FTEs required were 0.015 for preparation and 0.071 for intervention (0.6 and 2.8 hours/week).
• Neonatologists and nurses accounted for 43% and 19% of the workload, respectively; higher acuity and volume correlated with increased neonatologist effort.

Conclusions:

• Implementing an ASP in a NICU requires substantial staff effort, predominantly from neonatologists and nurses.
• Staffing needs for NICU ASPs exhibit considerable variability.
• Further research into optimizing ASP staffing models in NICUs is warranted.