Download Antibiotic Stewardship: Get Smart

Antibiotic Stewardship:
Get Smart
10/7/16
Tina Feaster,
Antibiotic Resistance Epidemiologist
Objectives
• Define what is Antibiotic Stewardship
• Categorize where Indiana falls
nationally in Antibiotic Stewardship
• Discuss the Seven Core Elements of
Antibiotic Stewardship
• Recognize ways to improve antibiotic
prescribing
States with CP-CRE in 2009
https://www.ihaconnect.org/Quality-Patient-Safety/Documents/Webinars/CfC-crewebinar-presentation-2014-09-25-final.pdf
6
Current States with CP-CRE
2015
http://www.cdc.gov/hai/organisms/cre/TrackingCRE.html
7
Antibiotic Stewardship
• Antibiotic Stewardship programs
help ensure that patients get the
right antibiotics at the right time for
the right duration.
http://www.cdc.gov/getsmart/healthcare/pdfs/core-elements.pdf
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7 Core Elements:
Leadership commitment
Accountability
Drug expertise
Act on at least one prescribing
improvement
• Track
• Report
• Educate
1 - Leadership Commitment
• Human
• Financial
• Information technology
2 – Accountability and
3 – Drug Expertise
• Stewardship program leader
• Pharmacy Leader
Accountability Key Support
• Clinicians and department heads
• Infection preventionists and hospital
epidemiologists
• Quality improvement staff
• Laboratory Staff
• Information technology staff
• Nurses
4 - Act on at least one
prescribing improvement
• Implement policies:
– Document dose, duration, and indication
– Develop and implement facility specific
treatment recommendations
– Avoid implementing too many policies and
interventions simultaneously
Policies and Interventions
• Interventions to improve antibiotic use
• Broad Interventions
– Antibiotic “Time outs”
– Prior authorization
– Prospective audit and feedback
Policies and Interventions
cont.
• Pharmacy –driven Interventions
– Automatic changes from intravenous to
oral antibiotic therapy
– Dose adjustments
– Dose optimization
– Automatic alerts in situations where
therapy might be unnecessarily duplicative
– Time-sensitive automatic stop orders
– Detection and prevention of antibioticrelated drug-drug interactions
Policies and Interventions
cont.
• Infection and syndrome specific
interventions
– Community-acquired pneumonia
– Urinary tract infections
– Skin and soft tissue infections
– Empiric coverage of MRSA infections
– Clostridium difficile infections
– Treatment of culture proven invasive
infections
5 – Track and 6 – Report
Use and Outcomes
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Monitoring antibiotic prescribing
Antibiotic use process measures
Antibiotic use measures
Outcome measures
7 - Education
• Provide updates on
prescribing, antibiotic
resistance and
infectious disease
management
• Share facility specific
information on antibiotic
use
• Use web-based
materials
Does your facility have all
the seven core elements?
What can you do as
infection preventionists?
What is the ISDH going to
do?
Questions?