LeadingAge Florida 53rd Annual Convention & Exposition 7/26/2016. Objectives. From the White House
|
|
- Stephen Whitehead
- 5 years ago
- Views:
Transcription
1 Antibiotic Stewardship in the Long Term Care Setting Presented By Shelley Bhola RN BC, BSN, PHN, MSN RAC CT Nurse Consultant Senior Providers Resource, LLC Objectives Upon completion of this session, the attendee will be able to: 1. Review regulatory expectations in F Describe the role and need for an Infection Prevention and Control Officer 3. Demonstrate examples of Antibiotic Stewardship and how to incorporate them into every day practice From the White House Vision: The United States will work domestically and internationally to prevent, detect, and control illness and death related to infections caused by antibiotic resistant bacteria by implementing measures to mitigate the emergence and spread of antibiotic resistance and ensuring the continued availability of therapeutics for the treatment of bacterial infections. (National Strategy for Combating Antibiotic Resistant Bacteria, 2014) 1
2 History of Antibiotics The first U.S. civilian saved by antibiotics was in 1942 She was 33 years old and suffered with a life threatening streptococcal infection She was hospitalized for more than a month Treatments such as sulfa drugs, blood transfusions and surgery had no effect Her fever reached 107 F as a last resort, her doctors injected her with a tiny amount of an experimental drug That drug was penicillin (MMWR Weekly, 1999) The result? Not only did her temperature drop overnight, by the next day the delirium was gone She survived to marry, raise a family, & to meet Sir Alexander Fleming, the scientist who discovered penicillin She not only survived, she lived to be 90 years of age (MMRW Weekly, 1999) The Pre Antibiotic Era 1942 ended the pre antibiotic era Pneumonia, which was the leading cause of death, was treatable Life expectancy increased What has changed in the past 64 years? 2
3 Antibiotic Resistance Antibiotic Resistance According to the CDC Antibiotic/antimicrobial resistance is the ability of microbes to resist the effects of drugs the germs are not killed and their growth is not stopped. Antibiotic resistance has become one of the most important public health threats we face locally and globally spawning the vision set forth by the White House. Bacteria and Microbes Microbes are organisms too small for the eye to see and are found everywhere. Types of microbes include bacteria, viruses, fungi, and parasites. While most microbes are harmless and even beneficial some can cause disease among humans, other animals, and plants. Disease causing microbes are called pathogens or "bugs" or "germs". All types of microbes have the ability to develop resistance to the drugs created to destroy them, becoming drug resistant organisms. (CDC, 2016) 3
4 The Cause The World Health Organization (WHO) considers misuse and overuse of antimicrobials as one of the top three threats to human health. (Moody, 2012) Once antibiotic resistant organisms are present in an individual or a healthcare facility, they can spread easily via inadequate infection prevention and control measures primarily poor hand hygiene. Antibiotic IQ Question #1 True or False: Antibiotics do not help a chest cold, but if you have bronchitis, you will need them. Answer: False Acute bronchitis and chest cold are two different names for the same illness. The illness is almost always caused by a virus, so in general, antibiotics won t help. Rest, fluids and a cough expectorant will be more beneficial. The Reality in Long Term Care 4.1 million Americans are admitted to or live in a long term care setting during a year As many as 70% of these residents received antibiotics during a year Up to 75% of antibiotics are prescribed incorrectly 4
5 2015 The year of Change In March 2015 the 2014 National Action Plan for Combating Antimicrobial Resistance was released by the White House. In June 2015, the White House held a forum on Antibiotic Stewardship, which included many nursing home partner organizations. In July 2015, CMS proposed new Federal Regulations for Long Term Care facilities including new infection prevention and antibiotic stewardship activities. (Dow, 2016) It is time to act Antibiotic Stewardship has to be a focus. Challenges in Long Term Care Prescribers are often prescribing antibiotics over the phone Documentation is often missing key details regarding actual infection, and the patient symptoms that led to the call and request for antibiotics Laboratory and diagnostic data can be difficult to obtain, or results are not received timely (Dow, 2016) 5
6 Regulatory Guidance Currently the following exists to promote appropriate use of antibiotics: F 441 Infection Control F 329 Unnecessary Drugs F 332 & F 333 Medication Errors F 428 Drug Regimen Review (Dow, 2016) Proposed Rule of 2015 Addresses concerns about antibiotics, including expanding pharmacy medication reviews to include antibiotic use, improved antibiotic protocols, and integration of an Antibiotic Stewardship Program into existing QAPI activities. (Dow, 2016) Antibiotic IQ Question #2 True or False: Antibiotics are good for treating strep throat? Answer: True Most sore throats are caused by viruses, but strep throat is caused by a bacteria. If your doctor does a test, and you have strep, you will need to be on an antibiotic. 6
7 Antibiotic Stewardship Antibiotic Stewardship Programs (ASPs) promote the appropriate use of antibiotics by selecting the appropriate dose, duration and route of administration. The appropriate use of antibiotics has the potential to: Improve efficacy, Reduce treatment related costs, Minimize drug related adverse events, and Limit the potential for emergence of antibiotic resistance. (Drew, 2009) CDC Program for Long Term Care The CDC defines antibiotic stewardship as A set of commitments and activities designed to optimize the treatment of infections while reducing the adverse events associated with antibiotic use. Core Elements for Antibiotic Stewardship in Nursing Homes 1. Leadership commitment 2. Accountability 3. Drug expertise 4. Action 5. Tracking 6. Reporting 7. Education 7
8 Leadership Commitment Write statements in support of improving antibiotic use Include stewardship related duties in position descriptions for the medical director, clinical nurse leads, and consultant pharmacists Communicate with the nursing staff and prescribing clinicians about the facility expectations regarding the use of antibiotics, the monitoring and enforcement of stewardship policies Create a culture, through messaging, education, and celebrating improvement, which promotes antibiotic stewardship Accountability Medical Director sets standards for antibiotic prescribing practices that are followed by all clinical providers. Director of Nursing set the practice standards for assessing, monitoring and communicating changes in resident s condition by the front line staff. The knowledge, perceptions and attitudes among the nursing staff will influence how information is communicated to the clinicians who decide on use of antibiotics. Consultant Pharmacist quality assurance activities such as medication regimen review and reporting of antibiotic use data. Accountability Infection Prevention and Control Preventionalist must have expertise to improve antibiotic use. This includes tracking, monitoring adherence to evidence based published criteria and evaluation and management of treated infections to review patterns or trends. Consultant Laboratory develop a process for alerting the facility if certain antibiotic resistant organisms are identified, providing education for nursing staff on the differences in diagnostic tests available, etc. 8
9 Drug Expertise Work with a consultant pharmacist who has received specialized infectious disease or antibiotic stewardship training. Partner with antibiotic stewardship program leads a the hospitals in your referral network. Develop relationships with infectious disease consultants in your community interested in supporting your facility s stewardship goals. Antibiotic IQ Question #3 True or False: It does no harm to take an antibiotic even if you have a virus it will make you feel better sooner Answer: False By misusing antibiotics, you could also be helping to create superbugs resistant bacteria that are not killed by antibiotics. Antibiotics are one of our most important weapons in the fight against disease. We can t afford to misuse them. Action Provide policies that support optimal antibiotic use Broad interventions to improve antibiotic use (will discuss later) Pharmacy interventions that improve antibiotic use Infection and syndrome specific interventions looking at those on prophylaxis antibiotics for history of UTI s 9
10 Tracking and Reporting Usually are done simultaneously. Track how and why antibiotics are prescribed. Track how often and how many antibiotics are prescribed. Antibiotic use data from nursing homes to improve antibiotic stewardship efforts is important for individual facility improvements and for public health action. Antibiotic outcome measures: Tracking the adverse outcomes and costs of antibiotics New QA data Antibiotic days of Therapy (DOT) An antibiotic day each day the resident receives a single antibiotic If a resident is prescribed a 7 day course of amoxicillin, that course equals 7 antibiotic days. However, if a resident is prescribed a 7 day course of amoxicillin plus azithromycin, then the course equals 14 antibiotic days. Antibiotic DOT the sum of all antibiotic days for all residents in the facility during a given time frame (a month or a quarter) Rate of antibiotic DOT (per 1,000 resident days): (Total monthly DOT/total monthly resident days x 1000) Antibiotic utilization ratio: Total monthly DOT/total monthly resident days Example A facility has 10 residents that received a 7 day course of single antibiotics. The facility has an average of 50 residents in the facility with a total resident days for a 30 day month being x 1000 = 46%
11 Education, Education, Education It s more than simply staff antibiotic stewardship education needs to go out to the clinicians, residents and their families/rp s. Flyers, pocket guides, newsletters, s whatever way works best for your facility you need to get your goals out there. The strongest evidence for improving medication prescribing practices is to have everyone looking at the same goal. Infection Preventionalist & Control Officer (IPCO) The proposed changes to F 441 require a RN staff member who is employed by the facility at least ½ time. This RN needs to receive education above and beyond the education received in nursing school. The primary focus of the IPCO is that of infection prevention. Surveillance As discussed, tracking and reporting will be imperative to this position. However, surveillance requires that the information tracked is analyzed and appropriate measures are then taken. The regulation currently defines surveillance as the ongoing, systematic collection, analysis, interpretation, and dissemination of data to identify infections and infection risks, to try to reduce morbidity and mortality, and to improve resident health status. (SOM, 2015) 11
12 What is expected Currently, these are items that the surveyor can ask for: 1. Monitoring and documenting of infections this includes tracking and analyzing outbreaks of infection, as well as implementing and documenting actions to resolve related problems. 2. Surveillance, including process and outcome surveillance, monitoring, data analysis, documentation and communicable disease reporting. 3. Documented data analysis to help detect unusual or unexpected outcomes that will determine the effectiveness of infection prevention and control practices 4. Use of records to improve infection control processes and outcomes by taking corrective actions (SOM, 2016) Current expectations 5. Perform surveillance and investigation to prevent the onset and spread of infection. 6. Facilities may use various approaches to gathering, documenting, and listing surveillance data; but it needs to describe the types of infections and needs to be able to identify trends and patterns. (SOM, 2016) Current Expectations There needs to be statistical analysis of the data that is found and then there needs to be feedback of results to the primary caregivers so that they can assess the residents for signs of infection and use the correct precautions. 12
13 What's to come? The IPCO will need to coordinate all efforts in the facility to assure timeliness of surveillance. Month end reports will do nothing to stop the immediate spread of an infection. Real time prevention will be required. Real time data analysis with prevention strategies firmly in place. Antibiotic usage will need to be stopped the day an infection is found not to meet criteria. Education, Education, Education Antibiotic IQ Question #4 True or False: Clostridium Difficile is the most common MDRO we currently have. Answer: False C Diff is one of our most pressing adverse reactions to the use of antibiotics, but it is not considered to be a MDRO. It is however, a major threat to our residents and is caused by; overprescribing of antibiotics, improper cleaning of surrounding environment, and improper infection prevention precautions of staff. What to do? Infections are a common problem among residents in a long term care facility. They are at risk due to: 1. Resident factors including chronic illness, age, functional impairment 2. Close living conditions 3. Low influenza vaccination rates among healthcare staff 4. Transfer between acute and long term care settings 5. High rates of antibiotic usage 13
14 What is seen The most common infections seen in long term care residents are: 1. Urinary tract infections (UTI) 2. Lower respiratory tract infections such as influenza or pneumonia 3. Skin and soft tissue infections 4. Gastroenteritis Where to start? An example given on a recent MLN Connects webinar Performance Improvement Project Subject Urinary Tract Infections Root Cause Analysis: Criteria for utilization of antibiotics has changed Family insistence Adequate hydration Physicians/Nurses/Families require education on new criteria Objectives Reduce urinalysis obtained by 25% Reduce culture and sensitivity of those by 25% Reduce antibiotic usage for asymptomatic bacteria by 25% 14
15 Action Plan Educational topics needing to be presented: McGeer criteria Colonization Reading and understanding culture and sensitivity reports Asymptomatic bacteriuria Appropriate peri care Risk for C Diff and adverse events Action Plan Education presented to: Nurses Therapists Senior leaders Nursing assistants Residents/Families Ancillary staff Antibiotic IQ Question #5 True or False Being colonized with a bacteria does not make a person feel sick, however, they should receive treatment for the colonization so that the bacteria does not remain in their system. Answer: False Colonization is when bacteria is present in your body or on your skin, but does not cause infection. Caring for colonized residents can result in contamination of healthcare workers hands, however, that resident does not need to be treated unless it turns into an infection. 15
16 Challenges with Residents with Dementia Residents with dementia are not able to voice their signs and symptoms so you will hear: "They are acting funny, let's get a UA to be safe" Families will say, "I know when Mom gets a UTI, you need to get a UA" Educate, Educate, Educate Have staff watch for changes in behavior, including: 1. Increase in agitation/anxiety 2. Decrease in ADL ability, mood, and/or lethargy Share information on multi drug resistant organisms and antibiotic stewardship Non pharmacological interventions specific to each resident Always, always start pushing fluids and cranberry juice (unless on a fluid restriction) The Results??? 16
17 Amazing January June the prior year 79 UA's were obtained, 60 C&S, 42 were treated with antibiotics January June during the PIP 47 UA's were obtained, 39 with C&S, 21 treated with antibiotics July December the prior year 71 UA's obtained, 57 C&S, 37 treated with antibiotics July December during the PIP 13 UA's obtained, 10 C&S, 12 were treated with antibiotics The reality is "I did then what I knew then, when I knew better, I did better." (Maya Angelou) Incorporation Remembering the CDC's Core Elements for Antibiotic Stewardship, incorporating each step should occur in a systematic fashion that will guarantee continued adherence and success. Start small begin with the education for all staff, residents, clinicians and families. Don't expect immediate "buy in" but don't settle for less. 17
18 Incorporation It takes 30 days to create a habit. Monitor infections on a daily basis. Meet with the laboratory to assure timeliness of information. Assure nursing staff understand how to read the results and report to the clinicians. Incorporation Have the pharmacist do an antibiotic review on a weekly basis in the beginning Standardize practices that should be applied during the care of any resident suspected of having the start of an infection e.g. push fluids, cranberry juice with each meal. Identify clinical situations that could be driving inappropriate antibiotics e.g. knowledge deficit dealing with difficult behaviors or not understanding lab results when returned. Top 10 Questions to Ask a Nursing Home Leader 1. What infections commonly occur among the residents in this facility? 2. When was the last outbreak in this facility? What was the cause? 3. How does the facility communicate with residents, family and visitors when an outbreak occurs? 4. Is the flu vaccine mandatory for all staffing working in this facility? If a staff member is sick, is he/she allowed to stay home without losing pay or time off? 18
19 Top 10 Questions 6. How are facility staff trained to respond to questions about hand hygiene from residents and family? 7. Are residents with new diarrhea given separate toilet facilities until the cause of their diarrhea is determined or resolved? 8. How is shared equipment managed to prevent the spread of germs? (think common areas and therapy as well) 9. Does the facility have private rooms for those who develop signs or symptoms of potentially contagious infection? 10. Does the facility provide educational materials for residents and families on infection control issues? As a leader what can you do? Share formal statements in support of improving antibiotic use with staff, residents, and families. Commit resources for monitoring antibiotic use and providing feedback to staff. Identify and empower the medical director, director of nursing, and/or consultant pharmacist to lead stewardship activities. As a leader Have clear policies for staff to assure antibiotics are not started unless needed: Establish minimum criteria for prescribing antibiotics Develop facility specific standards for empiric antibiotic use Review antibiotic appropriateness and resistance patterns Meet monthly with IPCO to assure processes are in place Provide access to individuals with antibiotic expertise for staff support, e.g. infectious disease clinicians Partner with the ABS leaders in referral hospitals 19
20 The Urgency Antibiotics are a precious resource, it takes years for an antibiotic to be developed. Antibiotics have increased life expectancy for all. Modern medical advances such as surgery, transplants, and chemotherapy may no longer be viable due to the threat of infection. (White House, 2014) The Post Antibiotic Era This is an era we have the power to change we need to begin. Questions? 20
21 References CDC. (2015) The Core Elements of Antibiotic Stewardship for Nursing Homes. Atlanta, GA; US Department of Health and Human Services. Retrieved from Dow, B. (2016). Antibiotic Stewardship in America's Nursing Homes. Harmony Healthcare Blog. stewardship in americas nursing homes Drew, R. (2009). Antimicrobial Stewardship Programs: How to Start and Steer a Successful Program. Supplement to Journal of Managed Care Pharmacy, 15(2). S18 S23. References MMRW Weekly. (1999). Achievements in Public Health, : Control of Infectious Diseases. Morbidity and Mortality Weekly Report 48(29) Moody, J. (2012). Infection prevention + antimicrobial stewardship. Prevention strategist. Summer References State Operations Manual Appendix PP Guidance to Surveyors for Long Term Care Facilities. (Rev. 133, ). Centers for Medicare & Medicaid Services. Retrieved from and Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines _ltcf.pdf White House. (2014). National Strategy for Combating Antibiotic Resistant Bacteria in ar/national strategy/index.html. 21
22 Thanks for your participation!!! Shelley Bhola RN BC, BSN, PHN, MSN, RAC CT Nurse Consultant Senior Providers Resource, LLC Cell:
What 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 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 information4/4/2018. Pathway Health 1. Antibiotics - Are they OVERUSED?? Best Practice Approach to Antibiotic Stewardship: Essential Strategies for Compliance
Best Practice Approach to Antibiotic Stewardship: Essential Strategies for Compliance Laura Chambers, RN, MSN, RAC-CT, CIMT Pathway Health Objectives Upon completion of this presentation, attendees should
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 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 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 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 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 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 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 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 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 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 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 informationNursing Home Online Training Sessions Session 2: Exploring Antibiotics and Their Role in Fighting Bacterial Infections
National Nursing Home Quality Care Collaborative Nursing Home Online Training Sessions Session 2: Exploring Antibiotics and Their Role in Fighting Bacterial Infections Health Services Advisory Group (HSAG)
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 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 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 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 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 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 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 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 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
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 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 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 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 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 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 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 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 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 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 informationGhinwa Dumyati, MD Christina Felsen, MPH University of Rochester Medical Center
Ghinwa Dumyati, MD Christina Felsen, MPH University of Rochester Medical Center How do you decide where to start? Start small; core elements recommend you focus on one thing at a time Use data to help
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 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 information: "INFECTION CONTROL: WHAT'S COMING IN 2017?" LISA THOMAS RN-BC STATE TRAINING COORDINATOR OFFICE OF LONG TERM CARE
: "INFECTION CONTROL: WHAT'S COMING IN 2017?" LISA THOMAS RN-BC STATE TRAINING COORDINATOR OFFICE OF LONG TERM CARE OBJECTIVES REVIEW STATISTICS ASSOCIATED WITH OLDER ADULTS AND THEIR RISK OF INFECTIONS
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 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
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 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 informationAntimicrobial Stewardship. Where are we now and where do we need to go?
Safe Patient Care Bugs and Drugs The ongoing challenge of MDROs and AMR 2017 @SPC2016Cork Antimicrobial Stewardship. Where are we now and where do we need to go? Frank O Riordan Antimicrobial pharmacist,
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 informationThe Core Elements of Antibiotic Stewardship for Nursing Homes
The Core Elements of Antibiotic Stewardship for Nursing Homes APPENDIX B: Measures of Antibiotic Prescribing, Use and Outcomes National Center for Emerging and Zoonotic Infectious Diseases Division of
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 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:
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 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 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 informationAntimicrobial Resistance, Everyone s Fight. Charlotte Makanga Consultant Antimicrobial Pharmacist Betsi Cadwaladr University Health Board
Antimicrobial Resistance, Everyone s Fight Charlotte Makanga Consultant Antimicrobial Pharmacist Betsi Cadwaladr University Health Board Antimicrobial Resistance Antimicrobial resistance happens when microorganisms
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 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 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 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 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 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 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 informationAbout Antimicrobial Resistance
Pagina 1 di 10 About Antimicrobial Resistance On This Page Explanation of Bacteria and Other Microbes How Resistance Happens Resistance in the United States 4 Core Actions Brief History of Antibiotics
More informationAHRQ Safety Program for Improving Antibiotic Use
AHRQ Safety Program for Improving Antibiotic Use Long Term Care Presenter Morgan Katz Morgan Katz, M.D., M.H.S. Title: Assistant Professor of Infectious Diseases Place of Work: Johns Hopkins Hospital Project
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 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 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 informationResponsible Use of Antibiotics Saves Lives. 54 th National Pharmacy Week (NPW) th to 21 st November, 2015 Indian Pharmaceutical Association
Responsible Use of Antibiotics Saves Lives 54 th National Pharmacy Week (NPW) - 2015 15 th to 21 st November, 2015 Indian Pharmaceutical Association Antimicrobial resistance is a cause of serious concern
More informationCall-In Number: (888) Access Code:
EDUCATIONAL SERIES: Navigating Infection Control and Antimicrobial Stewardship in Long-Term Care Webinar #2: Introduction to Antimicrobial Stewardship in Long Term Care: What is Antimicrobial Stewardship
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 informationDo Bugs Need Drugs? A community program for wise use of antibiotics
Do Bugs Need Drugs? A community program for wise use of antibiotics June 2012 Antibiotics Most significant discovery of modern medicine Save millions of lives Antibiotic resistance Caused by overuse and
More informationChallenges and opportunities for rapidly advancing reporting and improving inpatient antibiotic use in the U.S.
Challenges and opportunities for rapidly advancing reporting and improving inpatient antibiotic use in the U.S. Overview of benchmarking Antibiotic Use Scott Fridkin, MD, Senior Advisor for Antimicrobial
More informationCore 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 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 informationPRINCIPLES OF ANTIMICROBIAL STEWARDSHIP FOR ASSISTED LIVING. Albert Riddle, MD, CMD Riddle Medical LLC
PRINCIPLES OF ANTIMICROBIAL STEWARDSHIP FOR ASSISTED LIVING Albert Riddle, MD, CMD Riddle Medical LLC 2 CASE STUDY OF A URI Infection Control Issues in Assisted Living Facilities 3 THE CASE OF FLORENCE
More informationRxPress. May/Jun Vol 16 No 3. The White House Releases Plan to Combat Antibiotic-Resistant Bacteria
May/Jun 2015 Vol 16 No 3 RxPress TABLE OF CONTENTS The White House Releases Plan to Combat Antibiotic-Resistant Bacteria 1-2 FDA Requests New Data on Health Care Antiseptics 2-4 Penicillin Allergies and
More informationANTIBIOTIC STEWARDSHIP IN LONG TERM CARE
ANTIBIOTIC STEWARDSHIP IN LONG TERM CARE How consultant pharmacists can help their facilities by Kelli Musick-Hocker, Pharm D. Complete Pharmacy Consulting Kansas City Why is antibiotic stewardship in
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 informationREPORT ON THE ANTIMICROBIAL RESISTANCE (AMR) SUMMIT
1 REPORT ON THE ANTIMICROBIAL RESISTANCE (AMR) SUMMIT The Department of Health organised a summit on Antimicrobial Resistance (AMR) the purpose of which was to bring together all stakeholders involved
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 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 informationrunning head: SUPERBUGS Humphreys 1
running head: SUPERBUGS Humphreys 1 Superbugs GCH 360 Term Paper Assignment Kelly Humphreys April 30, 2014 SUPERBUGS Humphreys 2 Introduction The World Health Organization (WHO) recognizes antibiotic resistance
More informationAntibiotics: Take a Time Out
Antibiotics: Take a Time Out Christine LaRocca, MD Telligen April 27, 2018 This material was prepared by Telligen, the Medicare Quality Innovation Network Quality Improvement Organization, under contract
More informationMaximizing Treatment Outcomes in an Era of Antibiotic Resistance
Friday General Session Maximizing Treatment Outcomes in an Era of Antibiotic Resistance Edward Dominguez, MD Medical Director, Organ Transplant and Infectious Diseases Methodist Dallas Medical Center Dallas,
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 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 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 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 information1/30/ Division of Disease Control and Health Protection. Division of Disease Control and Health Protection
Surveillance, Outbreaks, and Reportable Diseases, Oh My! Assisted Living Facility, Nursing Home and Surveyor Infection Prevention Training February 2015 A.C. Burke, MA, CIC Health Care-Associated Infection
More informationImagine. Multi-Drug Resistant Superbugs- What s the Big Deal? A World. Without Antibiotics. Where Simple Infections can be Life Threatening
Multi-Drug Resistant Superbugs- What s the Big Deal? Toni Biasi, RN MSN MPH CIC Infection Prevention Indiana University Health Imagine A World Without Antibiotics A World Where Simple Infections can be
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 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 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 informationECHO: Management of URIs. Charles Krasner, M.D. Sierra NV Veterans Affairs Hospital University of NV, Reno School of Medicine October 16, 2018
ECHO: Management of URIs Charles Krasner, M.D. Sierra NV Veterans Affairs Hospital University of NV, Reno School of Medicine October 16, 2018 Infectious causes of URIs change over time Most ARIs are viral
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 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 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 informationImproving patient knowledge of antimicrobial resistance and appropriate antibiotic use in a Rutland county acute care center
University of Vermont ScholarWorks @ UVM Family Medicine Clerkship Student Projects College of Medicine 2019 Improving patient knowledge of antimicrobial resistance and appropriate antibiotic use in a
More informationPrescribing Guidelines for Outpatient Antimicrobials in Otherwise Healthy Children
Prescribing Guidelines for Outpatient Antimicrobials in Otherwise Healthy Children Prescribing Antimicrobials for Common Illnesses When treating common illnesses such as ear infections and strep throat,
More informationMonthly Webinar. Tuesday 16th January 2018, 16:00. That Was The Year That Was : Selections from the 2017 Antimicrobial Stewardship Literature
Monthly Webinar Tuesday 16th January 2018, 16:00 That Was The Year That Was : Selections from the 2017 Antimicrobial Stewardship Literature Audio dial-in (phone): 01 526 0058 Instructions Interactive Please
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 informationAppropriate Antimicrobial Use in California: The Path of Least Resistance
Appropriate Antimicrobial Use in California: The Path of Least Resistance BEACON Fall Exchange November 9, 2011 Kavita K. Trivedi, MD Healthcare Associated Infections Program California Department of Public
More informationIFMSA Policy Proposal Antimicrobial Resistance
IFMSA Policy Proposal Antimicrobial Resistance Proposed by Team of Officials Presented to the IFMSA General Assembly March Meeting 2017 in Arusha, Tanzania Policy Statement Introduction Antimicrobial resistance
More information