To celebrate World Patient Safety Day’s 2025 theme “Safe care for every child and for every newborn” we have invited a group of exceptional clinicians and researchers in the field to talk about their research and broader topics relevant to this year’s theme.

In this blog we are talking to Dr. Kylie Dougherty, a postdoctoral fellow at Northwestern University Feinberg School of Medicine, and new Nurse Scientist at Nationwide Children’s Hospital Center for Nursing Excellence.

Can you tell us a bit about your background and what led you to work in this area?

I began my career as a registered nurse, with early and formative clinical experiences in Haiti and Honduras that sparked my passion for improving maternal and newborn health in settings with limited medical resources. During my PhD at Columbia University, I became aware of how slowly evidence-based interventions developed for high-resource settings were adapted for use in lower-resource contexts, and how much healthcare improvements depended on context-specific collaborative approaches.

Now, as a postdoctoral fellow at Northwestern University, I use implementation research to support the NEST360 alliance, working to improve coverage and quality of care for small and sick newborns across five countries in sub-Saharan Africa, ensuring proven interventions are successfully implemented into diverse health systems and, ultimately, improve newborn health outcomes.

Can you tell us a bit more about the implementation research that you are doing to try and improve outcomes for newborns, and anything you are particularly proud of as part of this work?

One project I am most proud of is developing task-specific logic models to improve coverage and quality. These serve as blueprints for others to implement similar, successful activities across different contexts and help NEST360 identify priority areas for future intervention. The activities in these blueprints aim to ensure consistent availability of functional medical devices and advance improving quality initiatives. We are also refining an implementation model for the NEST360 program, which will serve as a resource for others to learn from NEST360’s experiences and adapt our strategies to meet the unique needs of other healthcare settings and newborn populations.

Using implementation research outcomes, our team has built a sustainable framework for identifying improvement opportunities, tracking progress, and scaling our work. We developed a comprehensive, multi-indicator change package that distils successful, context-specific change ideas from NEST360-supported hospitals into a generalizable knowledge base presented in a comprehensive change package. This work has accelerated the spread of local innovations and can be used to improve care coverage, strengthen quality, and ultimately save newborn lives.

In your opinion, what are the biggest challenges that prevent the delivery of safe care in newborns and children?

One of the biggest challenges to safe newborn care is the high ratio of newborns to nurses in many hospitals, especially in lower-resourced settings. When a nurse is responsible for 10, 20, or even 30+ newborns in a shift, it becomes harder to provide consistent, high-quality, and safe care. Compounding these challenges are the barriers that prevent nurses on the unit from accessing ongoing training, mentorship, and unit support. Without these opportunities, it is difficult for nurses to build the skills and the confidence needed to deliver lifesaving interventions for the smallest and sickest patients. My work with NEST360 shows through the data the essential role nurses play in ensuring high quality care and the critical need to focus on way to mitigate the nurse ratios, such leveraging float nurses or lobbying with leadership to fund additional positions.

What do you think is going to make the biggest difference in the field in the next 10 years?

In the next decade, I believe the most significant differences in the field will stem from empowering nurses in newborn care, ensuring appropriate nurse-to-newborn ratios, creating opportunities for them to take on leadership roles, involving them in decision-making processes to improve newborn care and safety, and supporting them with mentorship and continuous training. When nurses feel valued, supported, and confident in their capacity, we not only improve care quality and safety but also retain a skilled workforce that can mentor and sustain the next generation.

Alongside this, scaling context-adapted, evidence-based interventions and embedding implementation science into routine care can aid in the accelerated adoption of safe, effective innovations tailored to the realities of diverse, low-resource settings. Pairing empowered nurses with locally adapted solutions, in my view, is the most powerful path forward for newborn health.

In one sentence, what message would you like readers of the blog to take away?

Safe newborn care begins by empowering and supporting nurses, and by adapting proven interventions to fit the local contexts.