8/17/2016 ABOUT US REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM
|
|
- Domenic York
- 6 years ago
- Views:
Transcription
1 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 US Great River Health Systems is located in the southeastern part of the state, serving Iowa, Illinois and Missouri. It is comprised of a 240-bed regional hospital, a new 165-bed long term care center, a 5-bed hospice house, home health care and hospice services and numerous outpatient clinics. Our Mission: Great River Health Systems is dedicated to improving the region s health by providing high-quality care, world-class customer service, and uncompromising value to our patients and their families. Our Vision: Great People, Great Care, Great River 1
2 DEFINING THE PROBLEM Antibiotic Resistance In India, 58,000 babies died in one year from super-resistant bacterial infections, which are usually passed on from their mothers In the EU, antibiotic resistance causes 25,000 deaths/year and 3.2M hospital days In Thailand, antibiotic resistance causes 38,000 deaths/year In the US, antibiotic resistance causes 23,000 deaths/year and more than 2M illnesses CAUSES OF ANTIBIOTIC RESISTANCE POOR ANTIBIOTIC PRESCRIBING PATTERNS Although antibiotics save lives, they put patients at risk for Clostridium difficile (C diff) infections (250,000 infections and 14,000 deaths/year in hospitalized patients) Decreasing use of antibiotics could lead to 26% fever cases of C. diff Patients getting powerful antibiotics, that treat a broad range of infections, are up to 3 times more likely to get another infection from an even more resistant bacteria - CDC 2
3 BACTERIAL VS. VIRAL INFECTIONS IMPROVING ANTIBIOTIC PRESCRIBING EVERY TIME ANTIBIOTICS ARE PRESCRIBED Order cultures before antibiotics are given and start drugs promptly Make sure indication, dose, expected duration are specified Reassess within 48 hours and adjust prescription if necessary or stop antibiotics 3
4 SPECIFIC RECOMMENDATIONS FOR COMMON PRESCRIBING SITUATIONS Urinary Tract Infections True infection, not colonization Recommended length, post-discharge treatment accounts for antibiotics given in hospital as well Pneumonia Same as above MRSA infections Need to grow from relevant culture Don t use vancomycin to treat methicillin sensitive Staph aureus (MSSA) ANTIMICROBIAL STEWARDSHIP PROGRAM Leadership commitment Dedicate necessary staff, financial, IT resources Accountability Single leader responsible of program outcome Drug expertise Single ID trained pharmacist Act At least one prescribing improvement action Track Report Educate Work with other health care facilities to prevent infections, transmission and resistance - CDC STEWARDSHIP TEAM AT GRHS Infectious Disease Physician Pathologist Family Practice Physician ARNP LTC Hospitalist Director of Pharmacy Clinical Pharmacy Coordinator Clinical Informatics Pharmacist LTC Pharmacy Coordinator Microbiology Technical Specialist Infection Preventionist 4
5 COMMUNITY HEALTH PERSPECTIVE Representation Inpatient Long term care Outpatient clinics SITUATION AT GRHS In 2012, a steady increase in the rate of hospital-acquired C diff was identified Surveillance efforts correlated the occurrence of these infections to antimicrobial use, especially the use of the fluoroquinolones for urinary tract infections RISK FACTORS FOR C DIFF ASSOCIATED DISEASE (CDAD) Antimicrobial use, especially clindamycin, fluoroquinolones and cephalosporins Advanced age Recent and repeated hospitalizations Use of proton pump inhibitors (PPIs) Co-morbid conditions, especially chronic renal failure 5
6 BACKGROUND Long hospital stays 12.4% of patients with C diff infections stayed in the ICU for a mean length of stay of 12 days* Need for multiple consultations Increased costs Average total cost $35,621* *Palli S et al, Cost drivers associated with Clostridium difficile infection in a hospital setting, ASHP 2012;Abstract ASSESSMENT Johnston BC, Ma SS, Goldenberg JZ, et al. Probiotics for the Prevention of Clostridium difficile-associated diarrhea: A Systematic Review and Meta-Analysis. Annals of Internal Medicine, 13 November Guide to the Elimination of Clostridium difficile in Healthcare Settings, APIC, Pakyz AL, et al. The utility of hospital antibiograms as tools for guiding empiric therapy and tracking resistance: Insights from the Society of Infectious Diseases Pharmacists, Pharmacotherapy, 2007 Sep 27(9): ASSESSMENT Raineri Enrico, Pan Angelo, Mondello Placido et al. Role of the Infectious Diseases Specialist Consultant on the Appropriateness of Antimicrobial Therapy Prescription in an Intensive Care Unit, The American Journal of Infection Control, May Yahya Shehabi and Ian Seppelt, Is procalcitonin useful for guiding antibiotic decision making, in critically ill patients, Critical Care, 2008; 12(3):211. 6
7 RECOMMENDATIONS/ACTION PLAN Antibiogram Probiotics Procalcitonin Infectious Diseases Physician C diff Bundle Outcome Measures Culture Change USE OF THE ANTIBIOGRAM Definition - a collection of data, usually in the form of a table, summarizing the percent of individual bacterial pathogens susceptible to different antimicrobial agents An antibiogram is generated after bacteria are isolated (as from a patient's tissues or body fluids) and subjected to laboratory testing. Hospitals offer more directed help to their physicians by creating antibiograms, or tables, that chart the resistance patterns within a specific facility Our 2012 antibiogram showed a 77% susceptibility of E coli to levofloxacin (a fluoroquinolone) Demonstrates a 23% treatment failure Fluoroquinolones associated with an increase in the incidence of C diff Physician education Table tents at medical staff meeting EXAMPLE OF ANTIBIOGRAM 7
8 EXAMPLE OF ANTIBIOGRAM PROBIOTICS Probiotics were added to the formulary based on the Johnston study 3,000 patients Moderate quality evidence supports a large protective effect of probiotics in the prevention of C diff Given the low cost of probiotics and the moderate quality evidence suggesting the absence of important adverse effects, there seems little reason not to encourage use of probiotics in patients receiving antibiotics who are at risk for C diff. ADVERSE EFFECTS OF PROBIOTICS Consider eliminating the following high risk groups when using probiotics Patients with central venous catheters Yeast detected on hands of HCW and was isolated on the catheter hub of one of the patients Munoz, et.al. Saccharomyces cerevisiae Fungemia: An Emerging Infectious Disease, Clinical Infectious Diseases 2005:40: Patients in the ICU Immunosuppressed patients 8
9 PROCALCITONIN Biomarker that is used to diagnose and monitor severe bacterial infections and sepsis Detects bacterial infections over viral infections Drives clinical decision making Shehabi and Seppelt- This simple strategy can result in a reduction of up to 30% in the cost of antibiotics. INTERPRETATION OF PROCALCITONIN Most useful in determining bacterial sepsis Test results μg/l=normal μg/l=possible sepsis 2-10 μg/l=likely sepsis >10μg/L=Severe sepsis or septic shock INFECTIOUS DISEASES PHYSICIAN Administrative Support Raineri, Pan, Mondello, et al- introduction of an ID specialist improves the appropriateness of antimicrobial therapy in the ICU Arrival in June 2013 Interventions began in June
10 C DIFF BUNDLE 10% bleach solution Contact precautions Entire length of stay Spores are shed for up to 6 weeks after treatment Signage Brown signage CNA pericare education Community Health Education C diff pamphlet for patients Nurse-driven protocol Automatic order for C diff test if patient notes at least 3 episodes of diarrhea within 24 hours of admission Began October 2015 CULTURE CHANGE Education Return demonstrations, fliers, newsletters, medical staff and staff meetings, Q & A s and huddles Staff Involvement Piloting of C diff pamphlet, infection prevention committee involvement Communication Information sent to leaders to be communicated to staff during meetings, huddles, etc. Administrative Support Consistent with mission, vision and values OUTCOME MEASURES 10
11 OUTCOME MEASURES OUTCOME MEASURES ADDITIONAL INTERVENTIONS-REDUCING USE OF VANCOMYCIN Penicillin Binding Protein 2 Test(PbP2) Detects protein coded by meca gene in methicillin resistant staph aureus (MRSA) isolates Latex test performed by microbiologist Test has 100% sensitivity and 99% specificity Results are complete one day prior to susceptibility testing Reduces vancomycin use by one day for methicillin susceptible staph aureus (MSSA) isolates Requires physician education 11
12 ADDITIONAL INTERVENTIONS-HOSPITAL ACQUIRED PNEUMONIA PROTOCOL NEXT STEPS 48 hour reminders for antibiotics (whether to continue or stop depending on cultures), automatic vs. pharmacy calls Stop date on antibiotics Restriction of antibiotics More sophisticated testing in microbiology CRE genetic testing for screening and culture Protocols for most common infections Skin and soft tissue infections Pneumonias (VAP) QUESTIONS? 12
UPDATE 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 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 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 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 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 informationPreventing Multi-Drug Resistant Organism (MDRO) Infections. For National Patient Safety Goal
Preventing Multi-Drug Resistant Organism (MDRO) Infections For National Patient Safety Goal 07.03.01 2009 Methicillin Resistant Staphlococcus aureus (MRSA) About 3-8% of the population at large is a carrier
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 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 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 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 informationANTIMICROBIAL STEWARDSHIP IN LONG TERM CARE FACILITIES
ANTIMICROBIAL STEWARDSHIP IN LONG TERM CARE FACILITIES ANTIMICROBIAL STEWARDSHIP COLLABORATIVE COLORADO HOSPITAL ASSOCIATION MARCH 23, 2016 Bridget Olson, RPh Infectious Disease Pharmacist, Sharp Coronado
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 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 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 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 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 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 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: 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 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 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 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 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 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 2 nd Quarter
Antimicrobial Stewardship Program 2 nd Quarter May 19, 2016 Jill Hanson, WHA DeAnn Richards, MetaStar Objectives for Today Hospital Highlight UnityPoint Health - Meriter Status of the state Update on pilot
More informationAntimicrobial Stewardship Strategy: Antibiograms
Antimicrobial Stewardship Strategy: Antibiograms A summary of the cumulative susceptibility of bacterial isolates to formulary antibiotics in a given institution or region. Its main functions are to guide
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 information9/30/2016. Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS
Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS 1 2 Untoward Effects of Antibiotics Antibiotic resistance Adverse drug events (ADEs) Hypersensitivity/allergy Drug side effects
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 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 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 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 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 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 informationDATA COLLECTION SECTION BY FRONTLINE TEAM. Patient Identifier/ Medical Record number (for facility use only)
Assessment of Appropriateness of ICU Antibiotics (Patient Level Sheet) **Note this is intended for internal purposes only. Please do not return to PQC.** For this assessment, inappropriate antibiotic use
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 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 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 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 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 informationAntibiotic Stewardship at MetroWest Medical Center. Colleen Grocer, RPh, BCOP Co-Chair, Antibiotic Stewardship Committee
Antibiotic Stewardship at MetroWest Medical Center Colleen Grocer, RPh, BCOP Co-Chair, Antibiotic Stewardship Committee Antibiotic Stewardship Committee Subcommittee of Pharmacy and Therapeutics. Also
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 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 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 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 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 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 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 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 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 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 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 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 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 informationInfectious Disease 101: Helping the Consultant Pharmacist with Stewardship Principles
Infectious Disease 101: Helping the Consultant Pharmacist with Stewardship Principles Conflicts of Interest None at this time May be discussing off-label indications KALIN M. CLIFFORD, PHARM.D., BCPS,
More informationMulti-Drug Resistant Organisms (MDRO)
Multi-Drug Resistant Organisms (MDRO) 2016 What are MDROs? Multi-drug resistant organisms, or MDROs, are bacteria resistant to current antibiotic therapy and therefore difficult to treat. MDROs can cause
More informationHospital - Leaders establish antimicrobial stewardship as an
Below please find the IDSA response to the Joint Commission s Proposed Standard for Antimicrobial Stewardship in various types of facilities, (AHC, CAH,HAP, NCC, and OBS). Comments are broken out by the
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 informationSafe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times
Safe Patient Care Keeping our Residents Safe 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Do bugs need drugs? Dr Deirdre O Brien Consultant Microbiologist Mercy University
More information03/09/2014. Infection Prevention and Control A Foundation Course. Talk outline
Infection Prevention and Control A Foundation Course 2014 What is healthcare-associated infection (HCAI), antimicrobial resistance (AMR) and multi-drug resistant organisms (MDROs)? Why we should be worried?
More informationAntimicrobial Stewardship. October 2012
Antimicrobial Stewardship October 2012 Rising Antimicrobial Resistance Methicillin resistant staphylococcus aureus (MRSA) Vancomycin resistant enterococci (VRE) MDR and extremely drug resistant (XDR TB)
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 informationInfection Prevention Highlights for the Medical Staff. Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention
Highlights for the Medical Staff Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention Standard Precautions every patient every time a. Hand Hygiene b. Use of Personal Protective Equipment (PPE)
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 informationGUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS
Version 3.1 GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Date ratified June 2008 Updated March 2009 Review date June 2010 Ratified by Authors Consultation Evidence base Changes
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 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 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 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 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. 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 informationThe Use of Procalcitonin to Improve Antibiotic Stewardship
The Use of Procalcitonin to Improve Antibiotic Stewardship Disclosures I have no actual or potential conflict of interest in relation to this presentation. Patrick A. Laird, DNP, RN, ACNP-BC Objectives
More informationAntibiotic Prophylaxis in Spinal Surgery Antibiotic Guidelines. Contents
Antibiotic Prophylaxis in Spinal Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine Unique
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 informationPreserve the Power of Antibiotics
PROVIDERInsight News for providers in Northeast Nebraska April 2016 Preserve the Power of Antibiotics Antimicrobial stewardship interventions have been proven to improve individual patient outcomes, reduce
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 informationAntimicrobial Stewardship the State Health Department Perspective
Antimicrobial Stewardship the State Health Department Perspective Marion A. Kainer MD, MPH, FRACP, FSHEA Healthcare Associated Infections and Antimicrobial Resistance Program NIAA Antibiotic Stewardship:
More informationHealthcare-associated Infections Annual Report December 2018
December 2018 Healthcare-associated Infections Annual Report 2011-2017 TABLE OF CONTENTS INTRODUCTION... 1 METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTIONS... 2 MRSA SURVEILLANCE... 3 CLOSTRIDIUM
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 informationAntimicrobial Stewardship: Stopping the Spread of Antibiotic Resistance
Antimicrobial Stewardship: Stopping the Spread of Antibiotic Resistance Natalie Weber, PharmD PGY2 Critical Care Pharmacy Resident September 22, 2016 The speaker has no actual or potential conflicts of
More informationDr Eleri Davies. Consultant Microbiologist and Infection Control Doctor, Public Health Wales NHS Trust
Dr Eleri Davies Consultant Microbiologist and Infection Control Doctor, Public Health Wales NHS Trust Antimicrobial stewardship What is it? Why is it important? Treatment and management of catheter-associated
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 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 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 informationStewardship tools. Dilip Nathwani Ninewells Hospital and Medical School Dundee, UK
Stewardship tools Dilip Nathwani Ninewells Hospital and Medical School Dundee, UK What is Antimicrobial Stewardship (AMS)? Antimicrobial stewardship has been defined as the optimal selection, dosage, and
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 informationSurveillance of Multi-Drug Resistant Organisms
Surveillance of Multi-Drug Resistant Organisms Karen Hoffmann, RN, MS, CIC Associate Director Statewide Program for Infection Control and Epidemiology (SPICE) University of North Carolina School of Medicine
More informationInfectious Disease in PA/LTC an Update. Karyn P. Leible, MD, CMD, FACP October 2015
Infectious Disease in PA/LTC an Update Karyn P. Leible, MD, CMD, FACP October 2015 Disclosures Dr. Leible has no financial disclosures relevant to this presentation. Introduction Objectives The participant
More informationIDENTIFICATION: PROCESS: Waging the War against C. difficile Radical Multidisciplinary Approaches From a Community Hospital
Waging the War against C. difficile Radical Multidisciplinary Approaches From a Community Hospital Organization Name: St. Joseph Medical Center Type: Acute Care Hospital Contact Person: Leigh Chapman RN,
More informationNew Drugs for Bad Bugs- Statewide Antibiogram
New Drugs for Bad Bugs- Statewide Antibiogram Felicia Matthews, Pharm.D., BCPS Senior Consultant, Pharmacy Specialty BE MedMined Services Disclosures Employee of BD Corporation MedMined Services Agenda
More informationAntibiotic Stewardship in the Neonatal Intensive Care Unit. Objectives. Background 4/20/2017. Natasha Nakra, MD April 28, 2017
Antibiotic Stewardship in the Neonatal Intensive Care Unit Natasha Nakra, MD April 28, 2017 Objectives 1. Describe antibiotic use in the NICU 2. Explain the role of antibiotic stewardship in the NICU 3.
More informationTwo (II) Upon signature
Page 1/5 SCREENING FOR ANTIBIOTIC RESISTANT ORGANISMS (AROS) IN ACUTE CARE AND LONG TERM CARE Infection Prevention and Control IPC 050 Issuing Authority (sign & date) Office of Administrative Responsibility
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 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 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 informationUsing Web-Based Instruction Modules to Improve Practitioner Knowledge at Yale New Haven Hospital on the Prevention of Antimicrobial Resistance and
Using Web-Based Instruction Modules to Improve Practitioner Knowledge at Yale New Haven Hospital on the Prevention of Antimicrobial Resistance and Health-Care Associated Infections Overall Goals & Objectives:
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Antimicrobial Stewardship Studies have estimated that 30 50% of antibiotics prescribed in acutecare hospitals are unnecessary or inappropriate 1 Antimicrobial stewardship definition:
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 informationAntimicrobial Stewardship in Continuing Care. Urinary Tract Infections Clinical Checklist
Antimicrobial Stewardship in Continuing Care Urinary Tract Infections Clinical Checklist December 2014 What is Antimicrobial Stewardship? Using the: right antimicrobial agent for a given diagnosis at the
More information