There is growing interest in the Kaiser early-onset sepsis (EOS) risk calculator though institutions are hesitant to deviate from the Centers for Disease Control and Prevention guidelines and implement this in their hospitals. We describe the process of implementing routine use of the risk calculator in term and late preterm newborns delivered to mothers with chorioamnionitis in a level III neonatal intensive care unit (NICU). A retrospective chart review of infants delivered to mothers with chorioamnionitis from 2011 to 2014 was performed. Implementation of routine use of the calculator began in January 2015; preintervention and postintervention data were analyzed after a 9-month period of routine use. Following implementation, NICU admission rates, number of blood cultures drawn, and rates of antibiotic use dropped by 54%, 42%, and 59%, respectively ( P < .001). No negative outcomes were reported. In this article, we describe how the calculator was safely implemented in our NICU while decreasing the number of interventions.

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The scope of practice for newborn care in nonintensive hospital settings is ever changing, with obstetric care advances, shorter length of stay (LOS), and increased family-centered care. 1 In response to the US Surgeon General' s call to support breastfeeding and Baby Friendly USA, more infants receive care in their mothers' rooms. 2,3 Newborn clinicians require skills including diagnostic expertise and critical thinking, adaptability and sensitivity, and an understanding of this critical period of infant bonding. They also require leadership skills to manage hospital policies and link families with targeted community resources. This overview is based on the experience and research of a working group of the Academic Pediatric Association Newborn Nursery Special Interest Group (NN SIG), which consists of medical directors and physicians with expertise in newborn care from across the United States. The workgroup consisted of 17 newborn physicians ranging from young faculty to full professors at urban and rural academic and community hospitals in 17 cities and