DNP Project Improving Antibiotic Use in Newborns

Written byHope Aucoin

After spending his career as a registered nurse and then a neonatal nurse practitioner in neonatal units across Louisiana and Texas, Martin Begnaud says he was interested in developing quality improvement initiatives within those systems.

He enrolled in UL Lafayette小蝌蚪APP檚 Doctor of Nursing Practice online program. The nationally-ranked program culminates with a rigorous Synthesis Project, through which students make lasting impacts on healthcare systems and outcomes within their communities and beyond.

Begnaud小蝌蚪APP檚 project aimed to reduce costs and improve patient care for an especially vulnerable population: newborns.

Begnaud works for a national healthcare company that partners with hospitals, health systems and healthcare facilities to offer clinical services, including neonatology services. The company maintains a database to allow clinicians to compare their units to similar units within the company.

小蝌蚪APP淚 knew our unit was an outlier with antibiotic use in the evaluation of early onset sepsis and newborns,小蝌蚪APP Begnaud says. 小蝌蚪APP淢y initial question was: 小蝌蚪APP榃hat is contributing to the high antibiotic use in our unit?小蝌蚪APP櫺◎蝌紸PP

Begnaud says unwarranted antibiotic use in newborns can be costly for both the healthcare system and for patient outcomes, having been associated with late onset sepsis, necrotizing enterocolitis, atopy, bronchopulmonary dysplasia, multidrug-resistant organisms and death.

He collected six months of data to evaluate antibiotic use trends and the factors driving extended antibiotic use. After performing a statistical analysis and ancillary lab tests, Begnaud was able to formulate new guidelines for antibiotic use in newborns.

In April 2018, Begnaud began educating providers and nurses to implement those guidelines along with a neonatal early onset sepsis calculator for newborns greater than 34 weeks gestation.

July began the project小蝌蚪APP檚 prospective period to collect data to compare to baseline collections. Begnaud says he was looking for outcomes, including:

  • Reduction of overall antibiotic use
  • Reduction of unwarranted antibiotic use beyond a 48-hour rule-out period
  • Reduction of early onset sepsis evaluations and lab tests

小蝌蚪APP淲ith the implementation of evidence based guidelines, we were able to reduce overall antibiotic treatment days, overall empiric use, and reduce unwarranted antibiotic use beyond 48-hour rule-out period,小蝌蚪APP he says. 小蝌蚪APP淲ith the introduction of the neonatal early onset sepsis calculator, we reduced empiric antibiotic use in that population, also.小蝌蚪APP

In addition to the potential impacts to patient care, an initial cost analysis showed a potential $300,000 reduction in cost for the healthcare system.

Throughout his research and coursework to earn his DNP, Begnaud balanced time with his wife and two children while also working 小蝌蚪APP渕ore than full-time,小蝌蚪APP at newborn intensive care units in rural Texas and Louisiana.

He says his family has cheered him on throughout the process.

小蝌蚪APP淢y wife and I graduated together from nursing school so she was familiar with my writing style and able to provide editorial corrections throughout this process,小蝌蚪APP Begnaud says. 
小蝌蚪APP淭hey supported me throughout, although they小蝌蚪APP檝e seen me stress out and have some difficult moments at times.小蝌蚪APP

As Begnaud prepares to walk across the stage May 17 to accept his degree, he says his research and quality improvement implementation is ongoing.

小蝌蚪APP淚t小蝌蚪APP檚 just the beginning, to be honest,小蝌蚪APP he says. 小蝌蚪APP淣ow my focus is on the sustainability of the quality improvement project and the dissemination of project through presentations and publications.小蝌蚪APP

Begnaud says earning his doctorate reinforced his belief in questioning assumptions in healthcare best practices.

小蝌蚪APP淚 think the DNP program provided a holistic perspective about healthcare,小蝌蚪APP he says. 小蝌蚪APP淎s you advance in your career, you have adapt and change and question the way things were done in the past.

小蝌蚪APP淚 think change is difficult 小蝌蚪APP it小蝌蚪APP檚 been difficult for me at times 小蝌蚪APP but it should be ongoing and accepted in order to improve health care at the bedside.小蝌蚪APP


Make lasting impacts in health care and become a leader in an increasingly complex field. Apply today for the DNP online program, or request more Information to get started.