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Antibiotic Stewardship: Get Smart 10/7/16

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

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Antibiotic Stewardship: Get Smart 10/7/16

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  1. Antibiotic Stewardship:Get Smart10/7/16 Tina Feaster, Antibiotic Resistance Epidemiologist

  2. 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

  3. States with CP-CRE in 2009 https://www.ihaconnect.org/Quality-Patient-Safety/Documents/Webinars/CfC-cre-webinar-presentation-2014-09-25-final.pdf

  4. Current States with CP-CRE 2015 http://www.cdc.gov/hai/organisms/cre/TrackingCRE.html

  5. Antibiotic Stewardship • Antibiotic Stewardship programs help ensure that patients get the right antibiotics at the right time for the right duration.

  6. http://www.cdc.gov/getsmart/healthcare/pdfs/core-elements.pdfhttp://www.cdc.gov/getsmart/healthcare/pdfs/core-elements.pdf

  7. 7 Core Elements: • Leadership commitment • Accountability • Drug expertise • Act on at least one prescribing improvement • Track • Report • Educate

  8. 1 - Leadership Commitment • Human • Financial • Information technology

  9. 2 – Accountability and 3 – Drug Expertise • Stewardship program leader • Pharmacy Leader

  10. Accountability Key Support • Clinicians and department heads • Infection preventionists and hospital epidemiologists • Quality improvement staff • Laboratory Staff • Information technology staff • Nurses

  11. 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

  12. Policies and Interventions • Interventions to improve antibiotic use • Broad Interventions • Antibiotic “Time outs” • Prior authorization • Prospective audit and feedback

  13. 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 antibiotic-related drug-drug interactions

  14. 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

  15. 5 – Track and 6 – Report Use and Outcomes • Monitoring antibiotic prescribing • Antibiotic use process measures • Antibiotic use measures • Outcome measures

  16. 7 - Education • Provide updates on prescribing, antibiotic resistance and infectious disease management • Share facility specific information on antibiotic use • Use web-based materials

  17. Does your facility have all the seven core elements?

  18. What can you do as infection preventionists? What is the ISDH going to do?

  19. Questions?

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