Melanie Mason, RN
Neonatal Intensive Care Unit
Melanie was nominated for a quality improvement project she led.
Melanie is the resource nurse for the NICU. Vancomycin and Gentamicin are commonly used antibiotics in the neonatal population and need close adherence to timed dosing to ensure the accuracy of therapeutic drug monitoring and achievement of desired therapeutic level. First dose antibiotics should be given as soon as possible and ideally within one hour of the decision to treat. Early initiation of antibiotics with suspected sepsis reduces mortality and morbidity. In looking at the data for the prior 6 months, Melanie and NICU leaders noted that >185 doses of Gentamicin or Vancomycin were administered outside of the UAMS policy guidelines of within 30 minutes of the scheduled administration time. This averaged to 37.2 retimed doses per month. The goal of the project was to reduce the number of retimed doses of Vancomycin and Gentamcin.
Following staff education about the importance of proper timing of antibiotics, the average number of rescheduled doses fell to 21 per month (net result of a 40% decrease in retiming of Vancomycin and Gentamicin dosing). Melanie’s leadership in auditing, educating, providing coaching, and keeping antibiotics on the forefront of everyone’s mind led to better antibiotic administration practices in the NICU.