The Incubator #386 - 🟢 HOT TOPICS 2025 COVERAGE - The work of quality improvement in the NICU
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Dec 8, 2025 Dr. Kavya Rao shares her insights on quality improvement initiatives in neonatal care. She highlights the successful implementation of antibiotic stewardship, safely discontinuing antibiotics after 24 hours for well infants with negative cultures. The discussion includes reducing blood transfusions based on updated guidelines and the importance of passion-driven QI topics. Rao's enthusiasm for mentoring fellows and her work with the Tiny Baby Collaborative showcases innovative approaches to caring for 22-week infants.
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Find QI Projects From Passion And Data
- Look for QI topics where you feel passion or see a performance gap in daily clinical work.
- Use baseline data and benchmarking (Vermont Oxford Network, CHNC) before designing interventions.
Stop Empiric Antibiotics At 24 Hours
- Implement antibiotic stewardship by stopping empiric antibiotics at 24 hours for clinically well infants with negative blood cultures.
- Use PDSA cycles, education, and EMR prompts to increase adoption and monitor results.
Early Success With 24-Hour Stop Policy
- Their unit started the 24-hour stop policy six months ago and is seeing promising early results.
- They used education and EMR changes to overcome initial resistance from some team members.