Pharmacist Coordinated Antimicrobial Therapy: OPAT and Transitions of Care
|
|
- Adam Heath
- 5 years ago
- Views:
Transcription
1 Pharmacist Coordinated Antimicrobial Therapy: OPAT and Transitions of Care Jennifer McCann, PharmD, BCCCP State Director of Clinical Pharmacy Services St. Vincent Health Indiana
2 Conflicts of Interest No actual conflicts of interest.
3 Objectives Describe the growing pace of IV antimicrobials in transitions of care Evaluate a patient for safety and efficacy IV antimicrobials List complications associated with IV antimicrobials Generate changes at a practice site that will improve the success of OPAT treatment courses
4 OPAT Background Definition: provision of parenteral antimicrobial therapy of at least 2 doses on different days without intervening hospitalization Outpatient refers to any of the following: Home Physician office Hospital based ambulatory care clinic Emergency departments Hemodialysis centers Free standing infusion centers Long term care facilities Skilled nursing care facilities Rehabilitation centers Estimated 25% of patients will develop adverse reactions Up to 10% of which will lead to early discontinuation of therapy Tice AD, et al. Practice Guidelines for OPAT; CID 2004:38 (15 June) Chapman ALN, et al. Journal of Antimicrobial Chemotherapy May 2012
5 OPAT Prescribing Common Indications Prosthetic joint infections Osteomyelitis Endocarditis Complicated SSKI Bacteremia Common Antimicrobials Vancomycin Daptomycin Cefazolin Ceftriaxone Antipseudomonal or broad spectrum antimicrobials: Carbapenems Piperacillin/Tazobactam Cefepime
6 Think, Pair and Share What are the most common reasons IV antimicrobials are is discontinued early or changed to alternative drugs?
7 Provider Reports Lane, MA, et al. Infect Control Hosp Epidemiol Jul
8 Example Vancomycin - NSAIDS - Diuretics - Antimicrobials - Not drawn - Safety - Wrong time - Unnecessary lab re-draws - Suspension in therapy - Patient sticks - Costs
9 Think, Pair and Share List the most significant adverse effects associated with the gram negative or broad spectrum antimicrobials.
10 Clostridium difficile infection (CDI) Estimated costs 1 billion dollars/year in the US Exposure to healthcare facility is associated with 70% 80% of cases Clinical signs: Acute onset watery diarrhea Unexplained leukocytosis of 15,000 Elevation in serum Cr >1.5 Most commonly associated with: Antimicrobial selections 3 rd generation cephalosporins: Ceftriaxone Clindamycin Broad spectrum antimicrobial agents Prolonged courses of antimicrobials Lambert PJ, et al. Infect Control Hosp Epidemiol 2009; McGlone SM,et al. Clin Microbiol Infect 2012; Slimings C, Riley TV. J Antimicrob Chemother 2014
11 Think, Pair and Share amazon List the components of a complete OPAT antimicrobial order.
12 Order completeness The Basics Medication Dose Route Frequency The Safeguards Routine laboratory monitoring Line care & removal plan Duration of therapy (end date) Appropriate provider follow up Communication plan with team amazon
13 Frequency of Laboratory Monitoring Antibiotic <1x/Week N (%) 1x/Week N (%) 2x/Week N (%) 3x/Week N (%) >3x Week N (%) Daptomycin 33 (8) 385 (88) 20 (5) 1 (0) 0 (0) 439 Vancomycin 16 (4) 343 (77) 84 (19) 2 (0) 0 (0) 445 Oxacillin/Nafcillin 38 (9) 385 (87) 17 (4) 2 (0) 0 (0) 442 Total Cephalosporins 44 (10) 384 (87) 11 (2) 1 (0) 1 (0) 441 Carbapenems 44 (10) 388 (87) 12 (3) 0 (0) 0 (0) 444 Amphotericin 22 (5) 98 (24) 194 (47) 91 (22) 10 (2) 415 Aminoglycosides 23 (5) 130 (30) 247 (57) 31 (7) 4 (1) 435 Lane, MA, et al. Infect Control Hosp Epidemiol Jul
14 Franciscan Health Indianapolis PCAT Program Founded in 2015 Pharmacist dedicated to program since Nov 2016 Patient criteria for inclusion in program: Inpatient hospitalization Consult received during index hospital stay ID provider consulted Discharged on IV antimicrobials
15 Program Overview Support of discharge planning process Antimicrobial stewardship Dose optimization conducive for home administration Post discharge weekly monitoring
16 Overview of Demographics Consult Volume Disposition at Discharge Antimicrobial Prescribing Trends Readmission or ED use
17 Consult Volume Total patient consults: 546 pts Discharged on IV therapy: 421 patients 125 patients excluded post discharge: 48 switched to PO 13 completed in house 6 no ID consult 7 hospice 51 other reasons Missing data Left AMA
18 Disposition at Discharge
19 Antimicrobial Prescribing Patterns Vancomycin SAR: 52.6% Home: 27% IVIC: 9.8% HD: 10.6% Anti-pseudomonal SAR: 51.7% Home: 37.8% IVIC: 10.5% Ceftriaxone Home or IVIC: 71%
20 Hospital Readmission or ED Utilization Sample of 95 patients over 6 month period 14 patient with hospital readmission or ED use within 30 days 60% patients returned to home Franciscan Health Indianapolis (n=95) Mace AO, et al. (n=242) 14.7% HCU within 30 days 6 month assessment 15% hospital readmission Pediatric patients Chan M, et al. (n=120) Lai A, et al. (n=333) 10% readmitted for worsening SSTI 24.4% HCU or complication from IV antibiotic SSTI only Included hospital readmission, ADR, line complication Huck D, et al. (n=400) 20.5% hospital readmission Cleveland clinic, 2 month ECF 36%
21 Program Goals 1. All patients are discharged with complete OPAT orders 2. Routine communication with pharmacist, ID and other providers 3. Routine documention in the patient medical record 4. Patients are informed and involved in their antimicrobial care decisions 5. Establish benchmarks for clinical and financial success of program
22 Transition to Home
23 Transition to Healthcare Facilities All patients are discharged with clear, complete, and accurate IV antibiotic and monitoring orders GAP Analysis Questions Answer YES if Recommendation Is Performed in the Majority of patients No Action Required Answer NO if GAP Has Been Identified (Currently NOT in practice) Answer SORT OF if Recommendation is Performed some of the time BUT not consistently OR Is Not Applicable OR is in Progress Reliance on the after visit summary (AVS) is error prone! Multiple changes Multiple people Multiple times Multiple systems
24 Our Stories Inadvertent continuation of IV antimicrobials for an additional 4 wks IV line remained in place for 4 weeks after completion Hospital readmissions with CLABSI Extended stay out of pocket Missed PO transition Wrong interpretation of serum concentrations Prolonged disruptions in therapy, disease relapse, hospital readmission Lack of routine laboratory monitoring Hospital readmissions with AKI
25 Think, Pair and Share Share your stories What suggestions do you have for your site to improve the safety and effectiveness of IV antimicrobials?
26 Take Home Points IV antimicrobial prescribing at hospital discharge is complex Opportunities for safer, simplified prescribing exists Complete treatment plans are necessary Treatment success relies on monitoring for safe and effective care Renal failure Line care CDI Share ways to improve the care of your IV antimicrobial treated patient
27 Pharmacist Coordinated Antimicrobial Therapy: OPAT and Transitions of Care Jennifer McCann, PharmD, BCCCP State Director of Clinical Pharmacy Services St. Vincent Health Indiana
Antimicrobial 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 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 informationSafety of an Out-Patient Intravenous Antibiotics Programme
Safety of an Out-Patient Intravenous Antibiotics Programme Chan VL, Tang ESK, Leung WS, Wong L, Cheung PS, Chu CM Department of Medicine & Geriatrics United Christian Hospital Outpatient Parental Antimicrobial
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 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 informationAntibiotic Stewardship in the Hospital Setting
Antibiotic Stewardship in the Hospital Setting G. Evans, MD FRCPC Medical Director, Infection Prevention & Control Kingston General Hospital & Hotel Dieu Hospital EOPIC September 26, 2012 Stewardship stew-ard-ship
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 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 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 information1. List three activities pharmacists can implement to support. 2. Identify potential barriers to implementing antimicrobial
OPTIMIZING ANTIMICROBIAL STEWARDSHIP: IT STARTS IN THE EMERGENCY DEPARTMENT! 1 2 Objectives 1. List three activities pharmacists can implement to support health-system antimicrobial stewardship programs
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 informationIncidence of hospital-acquired Clostridium difficile infection in patients at risk
Baptist Health South Florida Scholarly Commons @ Baptist Health South Florida All Publications 5-20-2016 Incidence of hospital-acquired Clostridium difficile infection in patients at risk Christine Ibarra
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 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 informationOverview of C. difficile infections. Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases
Overview of C. difficile infections Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases Conflicts of Interest I have no financial conflicts of interest related to this topic and presentation.
More informationThis survey was sent only to EIN members with a pediatric infectious diseases practice.
Infectious Diseases Society of America Emerging Infections Network Report for Query: Pediatric Outpatient Parenteral Antibiotic Therapy (OPAT) Overall response rate: 188/281 (66.9%) physicians responded
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 informationInappropriate Use of Antibiotics and Clostridium difficile Infection. Jocelyn Srigley, MD, FRCPC November 1, 2012
Inappropriate Use of Antibiotics and Clostridium difficile Infection Jocelyn Srigley, MD, FRCPC November 1, 2012 Financial Disclosures } No conflicts of interest } The study was supported by a Hamilton
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 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 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 informationWhy Antimicrobial Stewardship?
Antimicrobial Stewardship: Why and How CAPT Arjun Srinivasan, MD Associate Director for Healthcare Associated Infection Prevention Programs Division of Healthcare Quality Promotion Why Antimicrobial Stewardship?
More informationSt. Joseph s General Hospital Vegreville. and. Mary Immaculate Care Centre. Antimicrobial Stewardship Report
St. Joseph s General Hospital Vegreville and Mary Immaculate Care Centre Antimicrobial Stewardship Report January to June 217 Introduction Antibiotics are among the most commonly prescribed medications
More informationOPAT discharge navigator and laboratory monitoring Select OPAT button for ALL patients that discharge on intravenous antimicrobials
Clinical Monitoring of Outpatient Parenteral Antimicrobial Therapy (OPAT) and Selected Oral Antimicrobial Agents Adult Inpatient/Ambulatory Clinical Practice Guideline Appendix A. Coordinating an OPAT
More information4/3/2017 CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA DISCLOSURE LEARNING OBJECTIVES
CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA BILLIE BARTEL, PHARMD, BCCCP APRIL 7 TH, 2017 DISCLOSURE I have had no financial relationship over the past 12 months with any commercial
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 informationCefazolin vs. Antistaphyloccal Penicillins: The Great Debate
Cefazolin vs. Antistaphyloccal Penicillins: The Great Debate Annie Heble, PharmD PGY2 Pediatric Pharmacy Resident Children s Hospital Colorado Microbiology Rounds March 22, 2017 Image Source: Buck cartoons
More informationAntimicrobial stewardship in managing septic patients
Antimicrobial stewardship in managing septic patients November 11, 2017 Samuel L. Aitken, PharmD, BCPS (AQ-ID) Clinical Pharmacy Specialist, Infectious Diseases slaitken@mdanderson.org Conflict of interest
More informationMAGNITUDE OF ANTIMICROBIAL USE. Antimicrobial Stewardship in Acute and Long Term Healthcare Facilities: Design, Implementation and Challenges
Antimicrobial Stewardship in Acute and Long Term Healthcare Facilities: Design, Implementation and Challenges John A. Jernigan, MD, MS Division of Healthcare Quality Promotion Centers for Disease Control
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 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 informationLinda Taggart MD FRCPC Infectious Diseases Physician Lead Physician, Antimicrobial Stewardship Program St. Michael s Hospital
Linda Taggart MD FRCPC Infectious Diseases Physician Lead Physician, Antimicrobial Stewardship Program St. Michael s Hospital no industry conflicts of interest salary support to lead Antimicrobial Stewardship
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 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 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 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 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 informationDisclosures. Principles of Antimicrobial Therapy. Obtaining an Accurate Diagnosis Obtain specimens PRIOR to initiating antimicrobials
Disclosures Principles of Antimicrobial Therapy None Lori A. Cox MSN, ACNP-BC, ACNPC, FCCM Penn State Hershey Medical Center Neuroscience Critical Care Unit Obtaining an Accurate Diagnosis Determine site
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 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 informationCurricular Components for Infectious Diseases EPA
Curricular Components for Infectious Diseases EPA 1. EPA Title Promoting antimicrobial stewardship based on microbiological principles 2. Description of the A key role for subspecialists is to utilize
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 informationAntimicrobial utilization: Capital Health Region, Alberta
ANTIMICROBIAL STEWARDSHIP Antimicrobial utilization: Capital Health Region, Alberta Regionalization of health care services in Alberta began in 1994. In the Capital Health region, restructuring of seven
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 informationMisericordia Community Hospital (MCH) Antimicrobial Stewardship Report
Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report July December 216 Table of Contents I. Introduction... 3 II. Executive Summary... 5 III. MCH Antimicrobial Utilization Reports...
More informationMisericordia Community Hospital (MCH) Antimicrobial Stewardship Report. July December 2013 Second and Third Quarters 2014
H e a l i n g t h e B o d y E n r i c h i n g t h e M i n d N u r t u r i n g t h e S o u l Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report July December 213 Second and Third Quarters
More informationGrey Nuns Community Hospital (GNCH) Antimicrobial Stewardship Report
H e a l i n g t h e B o d y E n r i c h i n g t h e M i n d N u r t u r i n g t h e S o u l Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship Report to 214 Table of Contents I. Introduction..
More informationNorthwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16
Northwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16 These criteria are based on national and local susceptibility data as well as Infectious Disease Society of America
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 informationSPARK. Southern Illinois University Edwardsville. Punit J. Shah HSHS St. John's Hospital,
Southern Illinois University Edwardsville SPARK SIUE Faculty Research, Scholarship, and Creative Activity 10-2015 Monitoring of outpatient parenteral antimicrobial therapy (OPAT) and implementation of
More informationANTIBIOTIC STEWARDSHIP. Brian Mayhue, Pharm D, CGP Director of Pharmacy Palm Beach Gardens Medical Center
ANTIBIOTIC STEWARDSHIP Brian Mayhue, Pharm D, CGP Director of Pharmacy Palm Beach Gardens Medical Center Antibiotic Resistance It is not difficult to make microbes resistant to penicillin in the laboratory
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 informationImplementing Antibiotic Stewardship in Rural and Critical Access Hospitals
National Center for Emerging and Zoonotic Infectious Diseases Implementing Antibiotic Stewardship in Rural and Critical Access Hospitals Denise Cardo, MD Director, Division of Healthcare Quality Promotion,
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 informationAntimicrobial Stewardship Strategy:
Antimicrobial Stewardship Strategy: Prospective audit with intervention and feedback Formal assessment of antimicrobial therapy by trained individuals, who make recommendations to the prescribing service
More informationGrey Nuns Community Hospital (GNCH) Antimicrobial Stewardship July December 2017
Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship July December 217 Table of Contents Table of Contents... 2 I. Executive Summary... 3 II. GNCH Total Antimicrobial Utilization... 4 III. GNCH
More informationRole of IV Therapy in Bone and Joint Infection
Role of IV Therapy in Bone and Joint Infection Andrew Seaton ID Consultant, Queen Elizabeth University Hospital Lead Doctor Antimicrobial Management Team, NHS GGC @raseaton66 OPAT The IVnOAT Perspective
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 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 informationDisclosure. Objectives. Transitions in Care: Inpatient to Outpatient Parenteral Antibiotic Therapy 2/16/2017
Transitions in Care: Inpatient to Outpatient Parenteral Antibiotic Therapy Juan E. Villanueva, PharmD, BCPS PGY2 Infectious Diseases University of Arizona Banner University Medical Center Tucson Disclosure
More informationExecutive Summary: A Point Prevalence Survey of Antimicrobial Use: Benchmarking and Patterns of Use to Support Antimicrobial Stewardship Efforts
Executive Summary: A Point Prevalence Survey of Antimicrobial Use: Benchmarking and Patterns of Use to Support Antimicrobial Stewardship Efforts Investigational Team: Diane Brideau-Laughlin BSc(Pharm),
More informationCARBAPENEM RESISTANT ENTEROBACTERIACEAE (KPC CRE)
CARBAPENEM RESISTANT ENTEROBACTERIACEAE (KPC CRE) Bartsch SM et al. Potential economic burden of carbapenem-resistent Enterobacteriaceae (CRE) in the United States. Clin Microbiol Infect 2017;23(1):48e9-e16.
More informationMisericordia Community Hospital (MCH) Antimicrobial Stewardship Report
Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report January June 215 Table of Contents I. Introduction... 3 II. CHASC Antimicrobial Utilization Reports... 4 III. Executive Summary...
More informationBecker s Hospital Review
Becker s Hospital Review Oct 2, 2014 Top 10 Best Practices for Antimicrobial Stewardship & Hospital Infection Prevention Presented in Cooperation with Today s Panelists: Stacy Pur, RN (Moderator) Vice
More informationGet Smart For Healthcare
Get Smart For Healthcare Know When Antibiotics Work Marry Bardin, Quality Improvement Advisor June 9, 2015 Why We Need to Improve In-patient Antibiotic Use Antibiotics are misused in hospitals Antibiotic
More informationAntibiotic Stewardship for Hospital Acquired Infection Prevention
Antibiotic Stewardship for Hospital Acquired Infection Prevention Emi Minejima, PharmD Assistant Professor of Clinical Pharmacy USC School of Pharmacy minejima@usc.edu Objectives Review the elements of
More informationObjectives 4/26/2017. Co-Investigators Sadie Giuliani, PharmD, BCPS Claude Tonnerre, MD Jayme Hartzell, PharmD, MS, BCPS
IMPLEMENTATION AND ASSESSMENT OF A GUIDELINE-BASED TREATMENT ALGORITHM FOR COMMUNITY-ACQUIRED PNEUMONIA (CAP) Lucas Schonsberg, PharmD PGY-1 Pharmacy Practice Resident Providence St. Patrick Hospital Missoula,
More informationOral antibiotics are not always straight forward
Oral antibiotics are not always straight forward OPAT Regional Workshop 1 st May 2018 Fiona Robb, Antimicrobial Pharmacist NHS Greater Glasgow & Clyde Introduction Describe NHS GGC s Oral vs IV Antibiotics
More informationAntimicrobial stewardship: Quick, don t just do something! Stand there!
Antimicrobial stewardship: Quick, don t just do something! Stand there! Stanley I. Martin, MD, FACP, FIDSA Director, Division of Infectious Diseases Director, Antimicrobial Stewardship Program Geisinger
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 informationCreating an EHR-based Antimicrobial Stewardship Program Session #257, March 8, 2018 David Ratto M.D., Chief Medical Information Officer, Methodist
Creating an EHR-based Antimicrobial Stewardship Program Session #257, March 8, 2018 David Ratto M.D., Chief Medical Information Officer, Methodist Hospital of Southern California 1 Conflict of Interest
More informationAntimicrobial Stewardship Program
Antimicrobial Stewardship Program David R. Woodard, MSc, FSHEA, CIC CDC: Antibiotic Resistance Threats in the United States, 2013 http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ CDC Threat Levels
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 information* gender factor (male=1, female=0.85)
Usual Doses of Antimicrobials Typically Not Requiring Renal Adjustment Azithromycin 250 500 mg Q24 *Amphotericin B 1 3-5 mg/kg Q24 Clindamycin 600 900 mg Q8 Liposomal (Ambisome ) Doxycycline 100 mg Q12
More informationDr. Torsten Hoppe-Tichy, Chief Pharmacist. How to implement Antibiotic Stewardship without having the resources for that?
Dr. Torsten Hoppe-Tichy, Chief Pharmacist How to implement Antibiotic Stewardship without having the resources for that? No conflict of interests Questions to the audience (Yes/No) - Is it promising to
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Annual Report 2015-2016 Prepared by the Fraser Health Antimicrobial Stewardship Program August 2016 Contents Executive Summary... 3 Background... 4 ASP Team Members... 5 Ackowledgements...
More informationConsider the patient, the drug and the device how do you choose?
Consider the patient, the drug and the device how do you choose? Tim Hills Lead Pharmacist Antimicrobials and Infection Control Nottingham University Hospitals NHS Trust OPAT Recommendations Drug Therapy
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 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 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 informationCHAPTER:1 THE RATIONAL USE OF ANTIBIOTICS. BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY
CHAPTER:1 THE RATIONAL USE OF ANTIBIOTICS BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY Antibiotics One of the most commonly used group of drugs In USA 23
More informationIMPLEMENTATION AND ASSESSMENT OF A GUIDELINE-BASED TREATMENT ALGORITHM FOR COMMUNITY-ACQUIRED PNEUMONIA (CAP)
IMPLEMENTATION AND ASSESSMENT OF A GUIDELINE-BASED TREATMENT ALGORITHM FOR COMMUNITY-ACQUIRED PNEUMONIA (CAP) Lucas Schonsberg, PharmD PGY-1 Pharmacy Practice Resident Providence St. Patrick Hospital Missoula,
More informationAntibiotic Stewardship Program (ASP) CHRISTUS SETX
Antibiotic Stewardship Program (ASP) CHRISTUS SETX Program Goals I. Judicious use of antibiotics Decrease use of broad spectrum antibiotics and deescalate use based on clinical symptoms Therapeutic duplication:
More informationThe Impact of meca Gene Testing and Infectious Diseases Pharmacists. Intervention on the Time to Optimal Antimicrobial Therapy for ACCEPTED
JCM Accepts, published online ahead of print on 7 May 2008 J. Clin. Microbiol. doi:10.1128/jcm.00801-08 Copyright 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights
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 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 informationMeasurement of Antimicrobial Drug Use. Elizabeth Dodds Ashley, PharmD, MHS, FCCP, BCPS DASON Liaison Pharmacist
Measurement of Antimicrobial Drug Use Elizabeth Dodds Ashley, PharmD, MHS, FCCP, BCPS DASON Liaison Pharmacist Defined Daily Dose Target Audience: Administrators and Epidemiologists Standardized definition
More informationPharmacist-Driven ASP. Jessica Holt, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Coordinator October 24 th, 2013
Pharmacist-Driven ASP Jessica Holt, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Coordinator October 24 th, 2013 Abbott Northwestern Hospital Largest not-for-profit hospital in the Twin Cities area
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 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 informationAn Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings?
An Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings? Dr. Andrew Morris Antimicrobial Stewardship ProgramMt. Sinai Hospital University Health Network amorris@mtsinai.on.ca andrew.morris@uhn.ca
More informationAntibiotic Updates: Part II
Antibiotic Updates: Part II Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures
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 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 informationOutpatient parenteral antimicrobial treatment. Which antibiotics can be used?
Outpatient parenteral antimicrobial treatment Which antibiotics can be used? Franky Buyle SBIMC-BVIKM March 30th 2017 Brussels Pharmacy Multidisciplinary Infection Team Ghent University Hospital, Belgium
More informationToday s webinar will begin in a few minutes.
Today s webinar will begin in a few minutes. Please press *6 to mute your line or use the mute button on your phone. If you have questions for the presenter or need to contact TCPS staff, type your comments
More informationABSTRACT ORIGINAL RESEARCH. Li Wen Loo. Yi Xin Liew. Winnie Lee. Piotr Chlebicki. Andrea Lay-Hoon Kwa
DOI 10.1007/s40121-015-0085-7 ORIGINAL RESEARCH Impact of Antimicrobial Stewardship Program (ASP) on Outcomes in Patients with Acute Bacterial Skin and Skin Structure Infections (ABSSSIs) in an Acute-
More informationChildrens Hospital Antibiogram for 2012 (Based on data from 2011)
Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Prepared by: Department of Clinical Microbiology, Health Sciences Centre For further information contact: Andrew Walkty, MD, FRCPC Medical
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 informationAntimicrobial Stewardship Strategy: Formulary restriction
Antimicrobial Stewardship Strategy: Formulary restriction Restricted dispensing of targeted antimicrobials on the hospital s formulary, according to approved criteria. The use of restricted antimicrobials
More information