Improving Antibiotic Use Across the Continuum of Care: Stewardship Opportunities in the Outpatient Setting
|
|
- Ambrose Gordon
- 5 years ago
- Views:
Transcription
1 Improving Antibiotic Use Across the Continuum of Care: Stewardship Opportunities in the Outpatient Setting Chloe Bryson-Cahn, MD Chief Fellow, Infectious Disease University of Washington UW Tele-Antimicrobial Stewardship Program (UW TASP) This presentation is intended for educational use only, and does not in any way constitute medical consultation or advice related to any specific patient.
2 Learning Objectives Recognize the role of antimicrobials in health care and how misuse leads to unintended consequences. Identify ways to improve antibiotic use in outpatient settings. Identify the Four Core Elements of Outpatient Antibiotic Stewardship and describe methods of achieving them.
3 Disclosures Financial Disclosures: None
4 A Local Reality 19 year old man suffered a traumatic open leg injury in India arrives at Harborview Medical Center in Seattle for surgical revision of his amputation. Wounds found to be infected with MDR Pseudomonas aeruginosa and Klebsiella pneumoniae.
5 Global Antimicrobial Resistance
6 Global Antimicrobial Resistance
7 Antibiotic Overuse
8 Albrich, Emerg Infect Dis 2004 Antibiotic Use and Resistance
9 From the CDC Antibiotics are in the top three drug classes leading to adverse drug event related ER visits for all ages. Antibiotic resistant infections -> higher healthcare costs poor health outcomes more toxic treatments Antibiotic overuse strongly associated with the rise of C.diff infection
10 Antibiotic Prescribing for Dental Procedures in Community Associated Clostridium difficile cases, Minnesota, Dentists prescribe 10% of outpt antibiotics 15% of antibiotic associated C.diff infection cases in this study were dentist prescribed Conclusion: Dental antibiotic prescribing rates and sideeffects are likely underestimated C.diff infections from dentist prescribed antibiotics are not reported back Bye, IDWeek 2017
11 The Bright Side A 10% decrease in inappropriate antibiotic prescribing in the community -> nearly 20% reduction in C.diff infection. Effective stewardship programs Decrease rates of antibiotic associated nephrotoxicity Increase guideline concordant treatment (shown to impact mortality) Decrease resistance at the population level Dantes, OFID 2015 Schuts, Lancet 2016
12 Why Care about Outpatient Stewardship Per Year in the US 35 million hospitalizations 141 million ED visits ~ 1 Billion outpatient visits 75%+ of antibiotic prescribing is done in the outpatient setting
13
14
15 Barnett, JAMA 2014 Antibiotic Prescribing for Bronchitis
16 Results from the Health Waste Calculator Guess Antibiotics for ARI, Pre-op Labs, PSA PSA ABx Labs Necessary Wasteful Washington Health Alliance, First Do No Harm
17 CDC Core Elements Antibiotic Stewardship Nursing Home
18 Commitment Demonstrate dedication to and accountability for optimizing antibiotic prescribing and patient safety. Opportunities/ Evidence based strategies: Identify a leader Regular meetings for priority setting Commitment from all team members Commitment posters
19 Public Commitment Letter % of antibiotic inappropriate visits receiving antibiotics Baseline Level -20% Meeker, JAMA 2014 Control Intervention
20
21 CDC Core Elements Antibiotic Stewardship
22 Action for Policy and Practice Implement at least one policy or practice to improve antibiotic prescribing, assess whether it is working, and modify as needed. Opportunities/ Evidence based strategies: Use evidence-based diagnosis/ treatment (IDSA, A2SC) Local antibiograms Diagnostic stewardship Written justification Improve triage systems
23 Improving Triage Systems 454,484 calls for URI symptoms managed by RN over the phone Harper, A J Manag Care, 2015
24 CDC Core Elements Antibiotic Stewardship
25 Tracking and Reporting Monitor antibiotic prescribing practices and offer regular feedback to clinicians, or have clinicians assess their own antibiotic prescribing practices themselves. Goal: individual prescriber level, use data Opportunities/ Evidence based strategies: Monitor documentation of indication for Rx Adherence to facility guidelines Peer comparison
26 What are you Going to Measure? Measures of antibiotic use: Prescription Pharmacy dispense Consumption (pill counts?) Inappropriate Guideline concordance Volume of antibiotic prescribed Prescription per unit time Percent prescribing by individuals/ season Linder, IDWeek 2017
27 What are you Going to Measure? Denominator Per visit Per population Primary Outcome This is the real target of your stewardship project Secondary Outcome Recommend eval for squeeze or dx shifting All antibiotic prescribing Linder, IDWeek 2017
28 Meeker, JAMA 2016 Peer Comparison
29 Meeker, JAMA 2016 Peer Comparison
30 CDC Core Elements Antibiotic Stewardship
31 Education and Expertise Provide educational resources to clinicians and patients on antibiotic prescribing, and ensure access to needed expertise on optimizing antibiotic prescribing. Opportunities/ Evidence based strategies: Effective communication with patients Patient education Staff and clinician education Ensure access to expertise
32 Strivers, J Fam Practice 2003 Communication Education
33 Communication Education A forthcoming publication
34 Expertise: TASP Provide: Once weekly meeting between WA state critical access hospitals and UW 2 ID trained faculty, many ID fellows ID trained Pharmacists Microbiology fellow Pharmacy and Medical Students and Residents Washington DOH CE credits available (CME, CNE, and pharmacy)
35 Natalia Martínez Paz, MA, MPA TASP ECHO Program Manager John Lynch, MD, MPH Medical Director Paul Pottinger, MD Co-Founder Zahra Kassamali, PharmD ASP Pharmacist Rupali Jain, PharmD ASP Pharmacist John Scott, MD, MSc Director of Telehealth Rob Cybulski, PhD Micro Fellow Erica Stohs, MD, MPH ID Fellow Chloe Bryson-Cahn, MD ID Fellow Ted Wright, MD ID Fellow Marisa D Angeli, MD, MPH Washington DOH
36 Project ECHO: How it works min didactic De-identified cases sent in advance Clinicians present cases to specialist panel Multi-specialty co-management Learning Loops
37 Hospital Stewardship Program Teams Physicians Infection Prevention Pharmacy Microbiology
38 ZOOM: Face to face
39
40
41 Resources to Achieve the Elements atorysettings.pdf
42 Jump Start Stewardship Baseline assessment, organized by Core Element Full of specific ideas for action/ tracking/ reporting Example Facility Profiles Educational Resources Free atorysettings.pdf
43 Summary Antibiotic use is the most important modifiable driver of antibiotic resistance Fortunately antimicrobial stewardship works implementation is tough Find a leader Assess your baseline Pick your (one) target and intervention Assess and reassess and reassess again Use your resources
44 Additional Resources Core Elements of Outpatient Stewardship Educational Materials for Patients and Providers Print Materials for Healthcare Professionals
45 Questions or Thoughts? Questions about TSAP? Please
46 References Barnett ML, Linder JA. Antibiotic prescribing for adults with acute bronchitis in the United States, Jama May 21;311(19): Dantes R, et al. Association between outpatient antibiotic prescribing practices and community-associated Clostridium difficile infection. InOpen forum infectious diseases 2015 Sep 1 (Vol. 2, No. 3). Oxford University Press. Schuts EC, et al. Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis. The Lancet Infectious Diseases Jul 1;16(7): Bye M, Whitten T, Holzbauer S. Antibiotic Prescribing for Dental Procedures in Community-Associated Clostridium difficile cases, Minnesota, InOpen forum infectious diseases 2017 (Vol. 4, No. Suppl 1, p. S1). Oxford University Press. Sanchez GV, Fleming-Dutra KE, Roberts RM, Hicks LA. Core elements of outpatient antibiotic stewardship. MMWR 2016; 65(6):1 12.
47 References Albrich WC, Monnet DL, Harbarth S. Antibiotic selection pressure and resistance in Streptococcus pneumoniae and Streptococcus pyogenes. Emerging infectious diseases Mar;10(3):514. Meeker D, et al. Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial. JAMA Mar 1;174(3): Harper R, Temkin T, Bhargava R. Optimizing the use of telephone nursing advice for upper respiratory infection symptoms. The American journal of managed care Apr;21(4): Linder J. Antimicrobial Stewardship Programs in Non-Acute Settings. IDWeek 2017 Symposium. Meeker D, et al. Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: a randomized clinical trial. Jama Feb 9;315(6): Stivers T, Mangione-Smith R, Elliott MN, McDonald L, Heritage J. Why do physicians think parents expect antibiotics? What parents report vs what physicians believe. Journal of Family Practice. 2003;52(2):140-7.
48 ICD-9 Codes for Antibiotic Inappropriate/ Appropriate Diagnoses Meeker, JAMA, 2014
49
Core Elements of Outpatient Antibiotic Stewardship Implementing Antibiotic Stewardship Into Your Outpatient Practice
National Center for Emerging and Zoonotic Infectious Diseases Core Elements of Outpatient Antibiotic Stewardship Implementing Antibiotic Stewardship Into Your Outpatient Practice Katherine Fleming-Dutra,
More information5/15/17. Core Elements of Outpatient Antibiotic Stewardship: Implementing Antibiotic Stewardship Into Your Outpatient Practice.
National Center for Emerging and Zoonotic Infectious Diseases Core Elements of Outpatient Antibiotic Stewardship: Implementing Antibiotic Stewardship Into Your Outpatient Practice Melinda Neuhauser, PharmD,
More informationGeriatric Mental Health Partnership
Geriatric Mental Health Partnership September 8, 2017 First, let s test your knowledge about antibiotics http://www.cdc.gov/getsmart/community/about/quiz.html 2 Get Smart Antibiotics Quiz Antibiotics fight
More informationOutpatient Antibiotic Use and Stewardship in Minnesota. Catherine Lexau, PhD, MPH, RN Epidemiologist Principal Emma Leof, MPH CSTE Fellow May 1, 2018
Outpatient Antibiotic Use and Stewardship in Minnesota Catherine Lexau, PhD, MPH, RN Epidemiologist Principal Emma Leof, MPH CSTE Fellow May 1, 2018 Agenda Outpatient Antibiotic Use Summary Measuring Antibiotic
More informationAntimicrobial Stewardship:
Antimicrobial Stewardship: Inpatient and Outpatient Elements Angela Perhac, PharmD afperhac@carilionclinic.org Disclosure I have no relevant finances to disclose. Objectives Review the core elements of
More informationAntimicrobial Stewardship in the Outpatient Setting. ELAINE LADD, PHARMD, ABAAHP, FAARFM OCTOBER 28th, 2016
Antimicrobial Stewardship in the Outpatient Setting ELAINE LADD, PHARMD, ABAAHP, FAARFM OCTOBER 28th, 2016 Abbreviations AMS - Antimicrobial Stewardship Program OP - Outpatient OPS - Outpatient Setting
More informationASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies
ASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies Theresa Jaso, PharmD, BCPS (AQ-ID) Network Clinical Pharmacy Specialist Infectious Diseases Seton Healthcare Family Ascension
More information11/22/2016. Antimicrobial Stewardship Update Disclosures. Outline. No conflicts of interest to disclose
Antimicrobial Stewardship Update 2016 APIC-CI Conference November 17 th, 2016 Jay R. McDonald, MD Chief, ID Section VA St. Louis Health Care System Assistant Professor of medicine Washington University
More informationWho is the Antimicrobial Steward?
Who is the Antimicrobial Steward? J. Njeri Wainaina, MD FACP Assistant Professor of Medicine Division of Infectious Diseases and Section of Perioperative Medicine Disclosures None 1 Objectives Highlight
More informationUpdates in Antimicrobial Stewardship
Updates in Antimicrobial Stewardship Andrew Hunter, Pharm.D., BCPS Infectious Diseases Clinical Pharmacy Specialist Michael E. DeBakey VA Medical Center andrew.hunter@va.gov Disclosures No disclosures
More informationAntibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE
Antibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE Crisis: Antibiotic Resistance Success Strategy WWW.optimistic-care.org
More informationUnited States Outpatient Antibiotic Prescribing and Goal Setting
National Center for Emerging and Zoonotic Infectious Diseases United States Outpatient Antibiotic Prescribing and Goal Setting Katherine Fleming-Dutra, MD Office of Antibiotic Stewardship Division of Healthcare
More informationCMS Antibiotic Stewardship Initiative
CMS Antibiotic Stewardship Initiative Mary Fermazin, MD, MPA Chief Medical Officer Vice President, Health Policy and Quality Measurement Health Services Advisory Group (HSAG) March 11, 2017 Disclosure
More informationOptimizing Antimicrobial Stewardship Activities Based on Institutional Resources
Optimizing Antimicrobial Stewardship Activities Based on Institutional Resources Andrew Hunter, PharmD, BCPS Infectious Diseases Clinical Pharmacy Specialist Michael E. DeBakey VA Medical Center Andrew.hunter@va.gov
More informationAntimicrobial Stewardship in the Hospital Setting
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 12 Antimicrobial Stewardship in the Hospital Setting Authors Dan Markley, DO, MPH, Amy L. Pakyz, PharmD, PhD, Michael Stevens, MD, MPH Chapter Editor
More informationUPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM
UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM Diane Rhee, Pharm.D. Associate Professor of Pharmacy Practice Roseman University of Health Sciences Chair, Valley Health
More informationAntibiotic Stewardship Beyond Hospital Walls
Antibiotic Stewardship Beyond Hospital Walls Katie Burenheide Foster, PharmD, MS, BCPS, FCCM Pharmacy Clinical Manager & PGY1 Pharmacy Residency Director OBJECTIVES 1. Review what Antibiotic Stewardship
More information10/9/2017. Evidence-Based Interventions to Reduce Inappropriate Prescription of Antibiotics. Prescribing for Respiratory Tract Infections
Evidence-Based Interventions to Reduce Inappropriate Prescription of Antibiotics Ann Thomas, MD, MPH Oregon Public Health Division Prescribing for Respiratory Tract Infections Antibiotic use is primary
More informationAntibiotic Stewardship in Human Health- Progress and Opportunities
National Center for Emerging and Zoonotic Infectious Diseases Antibiotic Stewardship in Human Health- Progress and Opportunities CAPT Lauri A. Hicks, D.O. Director, Office of Antibiotic Stewardship Division
More informationAntibiotic Stewardship and Critical Access Hospitals. Robert White, BA, PT, CPHQ Program Manager TMF Quality Innovation Network
Antibiotic Stewardship and Critical Access Hospitals Robert White, BA, PT, CPHQ Program Manager TMF Quality Innovation Network Antibiotic-Resistant Bacteria A serious threat to public health and the economy
More informationAntimicrobial Stewardship 101: Fighting Fatal Infection
Antimicrobial Stewardship 101: Fighting Fatal Infection Target Audience: Pharmacists ACPE#: 0202-0000-18-005-L01-P Activity Type: Knowledge-based Target Audience: ACPE#: Activity Type: Disclosures I have
More informationANTIMICROBIAL STEWARDSHIP FOR AMBULATORY CARE SETTINGS
ANTIMICROBIAL STEWARDSHIP FOR AMBULATORY CARE SETTINGS Jeffrey S Gerber, MD, PhD Children s Hospital of Philadelphia University of Pennsylvania School of Medicine DISCLOSURE STATEMENT I have no conflicts
More informationUsing Data to Track Antibiotic Use and Outcomes
Using Data to Track Antibiotic Use and Outcomes Michelle Nemec, PharmD Thrifty White Drug Pharmacy Objectives Describe the Antibiotic Stewardship Core Element of tracking and the specific interventions
More informationAntimicrobial Stewardship in the Long Term Care and Outpatient Settings. Carlos Reyes Sacin, MD, AAHIVS
Antimicrobial Stewardship in the Long Term Care and Outpatient Settings Carlos Reyes Sacin, MD, AAHIVS Disclosure Speaker and consultant in HIV medicine for Gilead and Jansen Pharmaceuticals Objectives
More informationOBJECTIVES. Fast Facts 3/23/2017. Antibiotic Stewardship Beyond Hospital Walls. Antibiotics are a shared resource and becoming a scarce resource.
Antibiotic Stewardship Beyond Hospital Walls Katie Burenheide Foster, PharmD, MS, BCPS, FCCM Pharmacy Clinical Manager & PGY1 Pharmacy Residency Director OBJECTIVES 1. Review what Antibiotic Stewardship
More informationPromoting Appropriate Antimicrobial Prescribing in Secondary Care
Promoting Appropriate Antimicrobial Prescribing in Secondary Care Stuart Brown Healthcare Acquired Infection and Antimicrobial Resistance Project Lead NHS England March 2015 Introduction Background ESPAUR
More informationAntimicrobial Stewardship Programs The Same, but Different. Sara Nausheen, MD Kevin Kern, PharmD
Antimicrobial Stewardship Programs The Same, but Different Sara Nausheen, MD Kevin Kern, PharmD Antimicrobial Stewardship Programs The Same, but Different Objectives: Outline the overall function of an
More informationAntimicrobial Stewardship/Statewide Antibiogram. Felicia Matthews Senior Consultant, Pharmacy Specialty BD MedMined Services
Antimicrobial Stewardship/Statewide Antibiogram Felicia Matthews Senior Consultant, Pharmacy Specialty BD MedMined Services Disclosures Employee of BD Corporation MedMined Services Agenda CMS and JCAHO
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Preventing the Spread of Antibiotic Resistance and Improving Patient Care (Adapted from the Centers for Disease Control and Prevention) What is Stewardship? Antimicrobial stewardship
More information6/15/2017 PART 1: THE PROBLEM. Objectives. What is Antimicrobial Resistance? Conflicts of Interest Disclosure Statement
Conflicts of Interest Disclosure Statement Getting a grasp on Antibiotic Use and Resistance: Principles of Antimicrobial Stewardship Speaker has nothing to disclose. Jacob M Kesner, PharmD UNMH PGY-2 Infectious
More informationObjective 1/20/2016. Expanding Antimicrobial Stewardship into the Outpatient Setting. Disclosure Statement of Financial Interest
Expanding Antimicrobial Stewardship into the Outpatient Setting Michael E. Klepser, Pharm.D., FCCP Professor Pharmacy Practice Ferris State University College of Pharmacy Disclosure Statement of Financial
More informationMHA/OHA HIIN Antibiotic Stewardship/MDRO Collaborative
MHA/OHA HIIN Antibiotic Stewardship/MDRO Collaborative Place picture here Nov. 14, 2017 Reminders For best sound quality, dial in at 1-800-791-2345 and enter code 11076 Please use the chat box to ask questions!
More informationPreventing and Responding to Antibiotic Resistant Infections in New Hampshire
Preventing and Responding to Antibiotic Resistant Infections in New Hampshire Benjamin P. Chan, MD, MPH NH Dept. of Health & Human Services Division of Public Health Services May 23, 2017 To bring a greater
More informationCommonwealth of Kentucky Antibiotic Stewardship Practice Assessment For Long-Term Care Facilities
Commonwealth of Kentucky Antibiotic Stewardship Practice Assessment For Long-Term Care Facilities Introduction As the problem of antibiotic resistance continues to worsen in all healthcare setting, we
More informationThe Big Picture: Using Antibiotic Use and Surveillance Data to Better Inform Stewardship in Healthcare Settings
The Big Picture: Using Antibiotic Use and Surveillance Data to Better Inform Stewardship in Healthcare Settings Becky Roberts, MS Get Smart: Know When Antibiotics Work Office of Antibiotic Stewardship
More informationUnderstand the application of Antibiotic Stewardship regulations in LTC. Understand past barriers to antibiotic management concepts
Objectives Understand the application of Antibiotic Stewardship regulations in LTC Understand past barriers to antibiotic management concepts Understand benefits of adoption of antibiotic stewardship regulations
More informationIt s Time to Regulate Antimicrobial Stewardship Standards in Acute Care Settings. Emily Heil, PharmD, BCPS-AQ ID, AAHIVP
It s Time to Regulate Antimicrobial Stewardship Standards in Acute Care Settings Emily Heil, PharmD, BCPS-AQ ID, AAHIVP Conflict of Interest I have no conflicts of interest to disclose related to the content
More informationPhysician Rating: ( 23 Votes ) Rate This Article:
From Medscape Infectious Diseases Conquering Antibiotic Overuse An Expert Interview With the CDC Laura A. Stokowski, RN, MS Authors and Disclosures Posted: 11/30/2010 Physician Rating: ( 23 Votes ) Rate
More informationANTIBIOTIC STEWARDSHIP
ANTIBIOTIC STEWARDSHIP S.A. Dehghan Manshadi M.D. Assistant Professor of Infectious Diseases and Tropical Medicine Tehran University of Medical Sciences Issues associated with use of antibiotics were recognized
More informationCore Elements of Antibiotic Stewardship for Nursing Homes
Core Elements of Antibiotic Stewardship for Nursing Homes Nimalie D. Stone, MD, MS Medical Epidemiologist for LTC Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Antimicrobial
More informationOutpatient Antimicrobial Stewardship. Jeffrey S Gerber, MD, PhD Division of Infectious Diseases The Children s Hospital of Philadelphia
Outpatient Antimicrobial Stewardship Jeffrey S Gerber, MD, PhD Division of Infectious Diseases The Children s Hospital of Philadelphia Overview The case for outpatient antimicrobial stewardship Interventions
More informationReady to Launch: Antimicrobial Stewardship for All!
Ready to Launch: Antimicrobial Stewardship for All! Lucas Schulz, PharmD, BCPS AQ ID Clinical Coordinator Infectious Diseases PGY2 Infectious Diseases Residency Program Director Disclosures Consultant
More informationAntimicrobial stewardship
Antimicrobial stewardship Magali Dodemont, Pharm. with the support of Wallonie-Bruxelles International WHY IMPLEMENT ANTIMICROBIAL STEWARDSHIP IN HOSPITALS? Optimization of antimicrobial use To limit the
More informationHot Topics in Antimicrobial Stewardship. Meghan Brett, MD Medical Director, Antimicrobial Stewardship University of New Mexico Hospital
Hot Topics in Antimicrobial Stewardship Meghan Brett, MD Medical Director, Antimicrobial Stewardship University of New Mexico Hospital Antimicrobial Stewardship Goals Primary Goal Optimize clinical outcomes
More informationAntibiotic Stewardship in Nursing Homes
National Center for Emerging and Zoonotic Infectious Diseases Antibiotic Stewardship in Nursing Homes Greater New York Hospital Association February 15 2018 Sarah Kabbani, MD, MSc Medical Officer, Office
More informationCHAPTER 9 ANTIMICROBIAL STEWARDSHIP PROGRAM (ASP)
DEPARTMENT OF THE ARMY HEADQUARTERS, UNITED STATES ARMY MEDICAL DEPARTMENT ACTIVITY FORT POLK, LOUISIANA 71459-5110 MEDDAC Regulation 29 August 2017 Number 500a-59 CHAPTER 9 ANTIMICROBIAL STEWARDSHIP PROGRAM
More informationAntimicrobial Stewardship Basics Why, What, Who, and How. Philip Chung, PharmD, MS, BCPS ASAP Community Network Pharmacy Coordinator October 12, 2017
Antimicrobial Stewardship Basics Why, What, Who, and How Philip Chung, PharmD, MS, BCPS ASAP Community Network Pharmacy Coordinator October 12, 2017 Objectives List reasons for developing antimicrobial
More informationWENDY WILLIAMS, MT(AMT) MSAH DIRECTOR LABORATORY AND PATHOLOGY SERVICES. Appalachian Regional Healthcare System apprhs.org
Incorporating Automation and Rapid Diagnostic Technologies into the Micro Lab's Lean Workflow to Boost Productivity, Shorten Length of Stay, and Improve Antibiotic Utilization WENDY WILLIAMS, MT(AMT) MSAH
More informationCommunicating about AR: It s complicated but not impossible! Mary Beth Wenger Health Communications Specialist New York State Department of Health
Communicating about AR: It s complicated but not impossible! Mary Beth Wenger Health Communications Specialist New York State Department of Health So, why are antibiotics inappropriately prescribed? 2
More informationPresenter: Marc Meyer, BPharm, RPh, CIC, FAPIC Clinical Pharmacists, Infection Preventionist, Antibiotic Stewardship Pharmacist Southwest Health
Presenter: Marc Meyer, BPharm, RPh, CIC, FAPIC Clinical Pharmacists, Infection Preventionist, Antibiotic Stewardship Pharmacist Southwest Health System, Cortez, Colorado None How do AU vendors and NHSN
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Background Why Antimicrobial Stewardship 30-50% of antibiotic use in hospitals are unnecessary or inappropriate Appropriate antimicrobial use is a medication-safety and patient-safety
More informationAntibiotic Stewardship in the LTC Setting
Antibiotic Stewardship in the LTC Setting Joe Litsey, Director of Consulting Services Pharm.D., Board Certified Geriatric Pharmacist Thrifty White Pharmacy Objectives Describe the Antibiotic Stewardship
More informationAntibiotic Stewardship: The Facility Role and Implementation. Tim Cozad, LPN, Lead LTC Health Facilities Surveyor
Antibiotic Stewardship: The Facility Role and Implementation Tim Cozad, LPN, Lead LTC Health Facilities Surveyor Phase II CMS Regulatory Changes Current information available includes: New Survey Process
More informationHealthcare Facilities and Healthcare Professionals. Public
Document Title: DOH Guidelines for Antimicrobial Stewardship Programs Document Ref. Number: DOH/ASP/GL/1.0 Version: 1.0 Approval Date: 13/12/2017 Effective Date: 14/12/2017 Document Owner: Applies to:
More informationBehavioral Economic Principles to Understand and Change Physician Behavior
Behavioral Economic Principles to Understand and Change Physician Behavior NIH Collaboratory Grand Rounds January 12, 2018 Jeffrey A. Linder, MD, MPH, FACP Professor of Medicine and Chief Division of General
More informationJump Starting Antimicrobial Stewardship
Jump Starting Antimicrobial Stewardship Amanda C. Hansen, PharmD Pharmacy Operations Manager Carilion Roanoke Memorial Hospital Roanoke, Virginia March 16, 2011 Objectives Discuss guidelines for developing
More informationAntimicrobial Stewardship-way forward. Dr. Sonal Saxena Professor Lady Hardinge Medical College New Delhi
Antimicrobial Stewardship-way forward Dr. Sonal Saxena Professor Lady Hardinge Medical College New Delhi Lets save what we have! What is Antibiotic stewardship? Optimal selection, dose and duration of
More informationAntimicrobial Stewardship: Guidelines for its Implementation
Antimicrobial Stewardship: Guidelines for its Implementation Loliet Gonzalez Martinez, Pharm.D. Palmetto General Hospital PGY-1 Pharmacy Resident Disclosure The author of this presentation has nothing
More informationClostridium difficile Surveillance Report 2016
Clostridium difficile Surveillance Report 2016 EMERGING INFECTIONS PROGRAM Clostridium difficile Surveillance Report 2016 Minnesota Department of Health Emerging Infections Program PO Box 64882, St. Paul,
More informationANTIBIOTICS IN THE ER:
ANTIBIOTICS IN THE ER: EXPLORING THE ROLE OF ANTIMICROBIAL STEWARDSHIP IN THE EMERGENCY DEPARTMENT ANGELINA DAVIS, PHARMD, MS, BCPS (AQ-ID) LIAISON CLINICAL PHARMACIST DUKE ANTIMICROBIAL STEWARDSHIP OUTREACH
More informationThe Rise of Antibiotic Resistance: Is It Too Late?
The Rise of Antibiotic Resistance: Is It Too Late? Paul D. Holtom, MD Professor of Medicine and Orthopaedics USC Keck School of Medicine None DISCLOSURES THE PROBLEM Antibiotic resistance is one of the
More informationBest Practices: Goals of Antimicrobial Stewardship
Best Practices: Goals of Antimicrobial Stewardship Gail Scully, M.D, M.P.H. and Elizabeth Radigan, PharmD, BCPS UMass Memorial Medical Center Division of Infectious Disease Department of Medicine September
More informationDefine evidence based practices for selection and duration of antibiotics to treat suspected or confirmed neonatal sepsis
GLOBAL AIM: Antibiotic Stewardship Perinatal Quality Improvement Teams (PQITs) will share strategies and lessons learned to develop potentially better practices and employ QI methodologies to establish
More informationBugs, Drugs, and No More Shoulder Shrugs: The Role for Antimicrobial Stewardship in Long-term Care
Bugs, Drugs, and No More Shoulder Shrugs: The Role for Antimicrobial Stewardship in Long-term Care Molly Curran, PharmD, BCPS Clinical Assistant Professor The University of Texas College of Pharmacy Clinical
More informationCollecting and Interpreting Stewardship Data: Breakout Session
Collecting and Interpreting Stewardship Data: Breakout Session Michael S. Calderwood, MD, MPH Regional Hospital Epidemiologist, Dartmouth-Hitchcock Medical Center March 20, 2019 None Disclosures Outline
More informationDisclosures. Astellas. The Medicines Company. Theravance Biopharma
Disclosures Astellas The Medicines Company Theravance Biopharma Objectives Define antimicrobial stewardship using nationally accepted criteria Identify strategies to provide antimicrobial stewardship Review
More informationWhat is an Antibiotic Stewardship Program?
What is an Antibiotic Stewardship Program? Jane Rogers, R.N. Anne Messer, MPH Learning Session #4 August 15, 2017 National Nursing Home Quality Care Collaborative Change Package Change Bundle: To prevent
More informationAntibiotic stewardship in long term care
Antibiotic stewardship in long term care Shira Doron, MD Associate Professor of Medicine Division of Geographic Medicine and Infectious Diseases Tufts Medical Center Boston, MA Consultant to Massachusetts
More information3/1/2016. Antibiotics --When Less is More. Most Urgent Threats. Serious Threats
Antibiotics --When Less is More Ralph Gonzales, MD, MSPH Associate Dean, Clinical Innovation School of Medicine VP, Clinical Innovation, UCSF Health Most Urgent Threats Serious Threats Multidrug-Resistant
More informationAntimicrobial Stewardship 201: It s Time to Act. Michael E. Klepser, Pharm.D., FCCP, FIDP Professor Ferris State University College of Pharmacy
Antimicrobial Stewardship 201: It s Time to Act Michael E. Klepser, Pharm.D., FCCP, FIDP Professor Ferris State University College of Pharmacy Target Audience: Pharmacists ACPE#: 0202-0000-18-006-L04-P
More informationAntibiotics in the trenches: An ER Doc s Perspective
Antibiotics in the trenches: An ER Doc s Perspective Peter Currie, MD Medical Director for Quality Emergency Physicians Professional Association (EPPA) Agenda Emergency Medicine Specific Disease Processes
More informationUpdate on CDC Antibiotic Stewardship Activities
National Center for Emerging and Zoonotic Infectious Diseases Update on CDC Antibiotic Stewardship Activities CAPT Lauri Hicks, DO CAPT Arjun Srinivasan, MD Division of Healthcare Quality Promotion National
More information8/17/2016 ABOUT US REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM
Mary Moore, MS CIC MT (ASCP) Infection Prevention Coordinator Great River Medical Center, West Burlington REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM ABOUT
More informationOverview of Antimicrobial Stewardship
Overview of Antimicrobial Stewardship Kurt B. Stevenson, MD, MPH Professor of Medicine and Epidemiology Colleges of Medicine and Public Health Medical Director, Antimicrobial Stewardship Program The Ohio
More informationM.L. Avent* 1,2, E.Waddell 1, K.Daveson 1 and K. Hajkowicz 1 1. Queensland Statewide Antimicrobial Stewardship 2. UQCCR, The University of Queensland
@MinyonAvent #ruralhealthconf M.L. Avent* 1,2, E.Waddell 1, K.Daveson 1 and K. Hajkowicz 1 1. Queensland Statewide Antimicrobial Stewardship 2. UQCCR, The University of Queensland Queensland State- Wide
More informationThe ABCs of Antibiotic Stewardship
The ABCs of Antibiotic Stewardship Sarah Brinkman, MBA, MA, CPHQ Program Manager Stratis Health 2018 Flex Program Reverse Site Visit July 18, 2018 Stratis Health Independent, nonprofit, Minnesota-based
More informationAntimicrobial Stewardship Advisory Committee Meeting
Antimicrobial Stewardship Advisory Committee Meeting August 25, 2016 3:00 PM-4:30 PM Washington State Dept of Health Room A42 1610 NE 150th St Shoreline, WA 98155 Call in: (571) 317-3116 Access Code: 211-449-029
More informationCommunity-Associated C. difficile Infection: Think Outside the Hospital. Maria Bye, MPH Epidemiologist May 1, 2018
Community-Associated C. difficile Infection: Think Outside the Hospital Maria Bye, MPH Epidemiologist Maria.Bye@state.mn.us 651-201-4085 May 1, 2018 Clostridium difficile Clostridium difficile Clostridium
More informationMDRO s, Stewardship and Beyond. Linda R. Greene RN, MPS, CIC
MDRO s, Stewardship and Beyond Linda R. Greene RN, MPS, CIC linda_greene@urmc.rochester.edu Evolving Threat of Antimicrobial Resistance Why are MDROs important? Limited treatment options Associated with:
More information2016/LSIF/FOR/007 Improving Antimicrobial Use and Awareness in Korea
2016/LSIF/FOR/007 Improving Antimicrobial Use and Awareness in Korea Submitted by: Asia Pacific Foundation for Infectious Diseases Policy Forum on Strengthening Surveillance and Laboratory Capacity to
More informationDr. Charles Onunkwo, Infectious Disease Medicine Erika Ingram, Infectious Disease/Critical Care Clinical Pharmacy Specialist Southeastern Regional
Dr. Charles Onunkwo, Infectious Disease Medicine Erika Ingram, Infectious Disease/Critical Care Clinical Pharmacy Specialist Southeastern Regional Medical Center Cancer Treatment Centers of America May
More informationINFECTIOUS DISEASES STRATEGIES TO LIMIT HOSPITALIZATION,REDUCE RISK AND ADD VALUE
INFECTIOUS DISEASES STRATEGIES TO LIMIT HOSPITALIZATION,REDUCE RISK AND ADD VALUE Ronald G Nahass, MD, MHCM, FIDSA President ID CARE Clinical Professor of Medicine-Rutgers University Robert Wood Johnson
More informationANTIMICROBIAL STEWARDSHIP: THE ROLE OF THE CLINICIAN SAM GUREVITZ PHARM D, CGP BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCES
ANTIMICROBIAL STEWARDSHIP: THE ROLE OF THE CLINICIAN SAM GUREVITZ PHARM D, CGP BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCES 1 Crisis: Antibiotic Resistance Success Strategy 2 OBJECTIVES Discuss
More informationTelligen Outpatient Antibiotic Stewardship Initiative. The Renal Network March 1, 2017
Telligen Outpatient Antibiotic Stewardship Initiative The Renal Network March 1, 2017 Who is Telligen? What is the QIN-QIO Program? Telligen: The Medicare Quality Innovation Network (QIN)-Quality Improvement
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Report: 11 th August 2016 Issue: As part of ensuring compliance with the National Safety and Quality Health Service Standards (NSQHS), Yea & District Memorial Hospital is required
More informationAntibiotic Stewardship in LTC What does this mean?
Antibiotic Stewardship in LTC What does this mean? Kieran Moore FCFP,FRCPC, Diane Lu CCFP KFLA Public Health Disclosure The findings and conclusions represent those of the presenter and may not necessarily
More informationAntimicrobial Stewardship Program. Jason G. Newland MD, MEd Miranda Nelson, PharmD
Antimicrobial Stewardship Program Jason G. Newland MD, MEd Miranda Nelson, PharmD The Children's Mercy Hospital, 2015 Antibiotic Timeline Clatworthy 2007 Antibiotic Use in Freestanding Children s Hospitals
More informationAntimicrobial Stewardship: A Public Health Priority
Antimicrobial Stewardship: A Public Health Priority CLSI Workshop June 28, 2014 Kavita K. Trivedi, MD Principal, Trivedi Consults, LLC Adjunct Clinical Assistant Professor of Medicine, Stanford University
More informationToday s Presenter. Objectives. Presented 12/15/16. Think Smart About Antibiotics: Striking a Balance Between Sepsis and CDI
Think Smart About Antibiotics: Today s Presenter Katie Richards 2 Objectives Define antibiotic stewardship Understand upcoming CMS requirements Know the current data on sepsis and CDI Understand why sepsis
More informationConnecting Your Audio
Connecting Your Audio Want to ask a question over the audio? Make sure you are dialed-in. Number: 1-877-280-9413 Passcode: 54567205 Dialed-in? Check if the phone icon is next to your name. If not, connect
More informationInterdisciplinary Communication in Antimicrobial Stewardship. Jennifer Liao, PharmD September 29, 2017 Patient Safety Academy
Interdisciplinary Communication in Antimicrobial Stewardship Jennifer Liao, PharmD September 29, 2017 Patient Safety Academy Objectives 1. Define antimicrobial stewardship (AMS) teams across various settings
More informationEVIDENCE BASED MEDICINE: ANTIBIOTIC RESISTANCE IN THE ELDERLY CHETHANA KAMATH GERIATRIC MEDICINE WEEK
EVIDENCE BASED MEDICINE: ANTIBIOTIC RESISTANCE IN THE ELDERLY CHETHANA KAMATH GERIATRIC MEDICINE WEEK EPIDEMIOLOGY AND BACKGROUND Every year, more than 2 million people in the United States acquire antibiotic-resistant
More informationAntibiotic stewardship in North Carolina hospitals
Introduction Antibiotic stewardship in North Carolina hospitals Ralph Raasch a, Laini Jarrett-Echols b, Carol Koeble c, Christine Pittman d The benefits of hospital-based antibiotic stewardship programs
More informationImpact of Antimicrobial Stewardship Program
Impact of Antimicrobial Stewardship Program Ripal Joshi, Pharm.D. AAHIVP Tampa General Hospital January 28, 2016 Objectives Provide an overview on antimicrobial stewardship programs (ASP) Describe the
More informationIn Case of Technical Difficulties
Be Antibiotics Aware: Smart Use, Best Care Tuesday, November 14, 2017 12:00 PM ET In Case of Technical Difficulties If you hear an echo: Make sure you are only logged in once on your computer Select one
More informationHospital Antimicrobial Stewardship Program Assessment Checklist
Hospital Antimicrobial Stewardship Program Assessment Checklist This checklist should be used to determine which aspects of antimicrobial stewarship (AMS) programs are already in place to ensure optimal
More informationModels for stewardship in Hospital - UK Models Philip Howard Consultant Antimicrobial Pharmacist
Models for stewardship in Hospital - UK Models Philip Howard Consultant Antimicrobial Pharmacist philip.howard2@nhs.net Twitter: @AntibioticLeeds United Kingdom of England, Scotland, Wales & Northern Ireland
More informationANTIMICROBIAL STEWARDSHIP: ADVANCING PATIENT CARE BY IMPROVING MEDICATION USE
ANTIMICROBIAL STEWARDSHIP: ADVANCING PATIENT CARE BY IMPROVING MEDICATION USE ANTHONY M. CASAPAO, PHARM.D. ASSISTANT PROFESSOR OF PHARMACY PRACTICE HUSSON UNIVERSITY SCHOOL OF PHARMACY CLINICAL INFECTIOUS
More informationAntimicrobial Stewardship 101
Antimicrobial Stewardship 101 Betty P. Lee, Pharm.D. Pediatric Infectious Disease/Antimicrobial Stewardship Pharmacist Lucile Packard Children s Hospital Stanford Disclosure I have no actual or potential
More informationAntibiotic Resistance in the Post-Acute and Long-Term Care Settings: Strategies for Stewardship
Antibiotic Resistance in the Post-Acute and Long-Term Care Settings: Strategies for Stewardship J. Hudson Garrett Jr., PhD, MSN, MPH, FNP-BC, PLNC, CDONA, IP-BC, GDCN, CDP, CADDCT, CALN, VA-BC, AS-BC,
More information