{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T12:03:29Z","timestamp":1779365009291,"version":"3.53.0"},"reference-count":45,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title>\n                  <jats:p>An early-onset sepsis (EOS) risk calculator tool to guide evaluation and treatment of infants at risk for sepsis has reduced antibiotic use without increased adverse outcomes. We performed an electronic health record (EHR)\u2013driven quality improvement intervention to increase calculator use for infants admitted to a newborn nursery and reduce antibiotic treatment of infants at low risk for sepsis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>This 2-phase intervention included programming (1) an EHR form containing calculator fields that were external to the infant\u2019s admission note, with nonautomatic access to the calculator, education for end-users, and reviewing risk scores in structured bedside rounds and (2) discrete data entry elements into the EHR admission form with a hyperlink to the calculator Web site. We used statistical process control to assess weekly entry of risk scores and antibiotic orders and interrupted time series to assess trend of antibiotic orders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>During phase 1 (duration, 14 months), a mean 59% of infants had EOS calculator scores entered. There was wide variability around the mean, with frequent crossing of weekly means beyond the 3\u03c3 control lines, indicating special-cause variation. During phase 2 (duration, 2 years), mean frequency of EOS calculator use increased to 85% of infants, and variability around the mean was within the 3\u03c3 control lines. The frequency of antibiotic orders decreased from preintervention (7%) to the final 6 months of phase 2 (1%, P &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>An EHR-driven quality improvement intervention increased EOS calculator use and reduced antibiotic orders, with no increase in adverse events.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2018-3464","type":"journal-article","created":{"date-parts":[[2019,7,5]],"date-time":"2019-07-05T12:25:12Z","timestamp":1562329512000},"source":"Crossref","is-referenced-by-count":22,"title":["Early-Onset Sepsis Risk Calculator Integration Into an Electronic Health Record in the Nursery"],"prefix":"10.1542","volume":"144","author":[{"given":"Carole H.","family":"Stipelman","sequence":"first","affiliation":[{"name":"Division of General Pediatrics, Department of 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Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie H.","family":"Shakib","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2019,8,1]]},"reference":[{"issue":"6","key":"2021121020473764600_B1","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/2042098614554919","article-title":"Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem.","volume":"5","author":"Llor","year":"2014","journal-title":"Ther Adv Drug Saf"},{"key":"2021121020473764600_B2","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piy066","article-title":"US emergency department visits for adverse drug events from antibiotics in children, 2011-2015 [published online ahead of print August 23, 2018].","author":"Lovegrove","journal-title":"J Pediatric Infect Dis 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