Date of Graduation

Summer 8-7-2018

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Dr. Nancy Taquino

Second Advisor

Dr. Elena Capella


Improving the Timing of Antibiotic Administration in High-Risk Neonates


Problem: The rapid nurse turnover and improper use of the golden hour flowsheet are some of the factors that affect the timing of antibiotic administration. A review of 38 patient charts was done and only shows 20% received antibiotics within 1 hour.

Context: This microsystem is a 22-bed neonatal intensive care unit with an average of 900 admissions per year. The team is composed of doctors, nurses, respiratory therapist, and pharmacists. The budget needed for this project consists of the overtime pay needed to compensate nurses for attending additional staff meetings. The return on investment will consist of the savings delivered by a shorter average hospital-wide length of stay for patients.

Interventions: The staff was re-oriented on how to use the flowchart and how role delegation works per said flow chart. Mock codes drill on high-risk admissions were performed on skills day.

Measures: The outcome measure of this project is the percent of high-risk infants that receive antibiotics within 1 hour after a physician’s order. The target percentage is 60%.

Results: After the project was implemented, 15 high-risk admissions were reviewed and the antibiotic administration within one-hour rate was 46% for Ampicillin and 39% for Gentamicin. This represents an increase in the one-hour antibiotic administration rate for this group of patients.

Conclusions: The impact of this improvement project is already evident in the results produced recently. Sustainability in this improvement project will be achieved when provided with appropriate staffing and nurses training with the golden hour admission process