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Peer-reviewedCC BY 4.0Journal of Perinatology

Implementation of an antimicrobial stewardship program in a multicenter neonatal intensive care unit collaborative: a mixed-methods staff resource needs evaluation

  • Cynthia L. Gong1
  • Nabeel Qureshi2
  • Peter Mendel3
  • Kurlen S. E. Payton4
  • Henry C. Lee5
  • Kenneth M. Zangwill6
6 affiliations
  1. 1Division of Neonatology, Department of Pediatrics, Children’s Hospital Los Angeles, Keck School of Medicine, Fetal and Neonatal Institute, University of Southern California, Los Angeles, CA USA
  2. 2RAND Corporation and Pardee RAND Graduate School, Santa Monica, CA USA
  3. 3RAND Corporation, Santa Monica, CA USA
  4. 4Division of Neonatology, Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA USA
  5. 5Division of Neonatology, University of California San Diego, La Jolla, CA USA
  6. 6Division of Pediatric Infectious Diseases and The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA USA
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Abstract

Objective: Staffing needs for an antimicrobial stewardship program (ASP) in the neonatal intensive care unit setting are undefined.

Study design: In an ASP collaborative of 29 California NICUs, we surveyed sites to determine full-time equivalents (FTE) for ASP implementation effort by clinical role, clinical acuity, patient volume, and other NICU characteristics.

Results: 146 staff members performed ASP implementation, including neonatologists, nurses, hospitalists, nurse practitioners, pharmacists, information technology personnel, and infectious disease specialists. The 8-month preparation and 12-month intervention phases required a median (IQR) of 0.015 (0.011–0.025) and 0.071 (0.056–0.091) FTEs (0.6 and 2.8 hours per week), respectively. Neonatologists and nurses performed 43% and 19% of the workload, respectively; effort for site-level stewardship activities and collaborative learning dissemination varied 3.3-fold over the collaborative. Higher clinical acuity and patient volume were associated with higher neonatologist effort.

Conclusion: Driven by neonatologists and nurses, NICU ASP requires demonstrable effort, and staff needs vary considerably.

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Cite

BibTeXRIS
BibTeX
@article{gong2026implementation,
  title = {{Implementation of an antimicrobial stewardship program in a multicenter neonatal intensive care unit collaborative: a mixed-methods staff resource needs evaluation}},
  author = {Cynthia L. Gong and Nabeel Qureshi and Peter Mendel and Kurlen S. E. Payton and Henry C. Lee and Kenneth M. Zangwill},
  journal = {Journal of Perinatology},
  year = {2026},
  month = jun,
  doi = {10.1038/s41372-026-02758-y},
  url = {https://doi.org/10.1038/s41372-026-02758-y},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Implementation of an antimicrobial stewardship program in a multicenter neonatal intensive care unit collaborative: a mixed-methods staff resource needs evaluation
AU  - Cynthia L. Gong
AU  - Nabeel Qureshi
AU  - Peter Mendel
AU  - Kurlen S. E. Payton
AU  - Henry C. Lee
AU  - Kenneth M. Zangwill
PY  - 2026
DA  - 2026/06/22
JO  - Journal of Perinatology
DO  - 10.1038/s41372-026-02758-y
UR  - https://doi.org/10.1038/s41372-026-02758-y
AB  - Objective: Staffing needs for an antimicrobial stewardship program (ASP) in the neonatal intensive care unit setting are undefined.  Study design: In an ASP collaborative of 29 California NICUs, we surveyed sites to determine full-time equivalents (FTE) for ASP implementation effort by clinical role, clinical acuity, patient volume, and other NICU characteristics.  Results: 146 staff members performed ASP implementation, including neonatologists, nurses, hospitalists, nurse practitioners, pharmacists, information technology personnel, and infectious disease specialists. The 8-month preparation and 12-month intervention phases required a median (IQR) of 0.015 (0.011–0.025) and 0.071 (0.056–0.091) FTEs (0.6 and 2.8 hours per week), respectively. Neonatologists and nurses performed 43% and 19% of the workload, respectively; effort for site-level stewardship activities and collaborative learning dissemination varied 3.3-fold over the collaborative. Higher clinical acuity and patient volume were associated with higher neonatologist effort.  Conclusion: Driven by neonatologists and nurses, NICU ASP requires demonstrable effort, and staff needs vary considerably.
SN  - 0743-8346
SN  - 1476-5543
ER  -