Core Elements for Antibiotic Stewardship in Nursing Homes

Transcription

1 Core Elements for Antibiotic Stewardship in Nursing Homes 1

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3 Antibiotic Stewardship A set of commitments and activities designed to optimize the treatment of infections while reducing the adverse events associated with antibiotic use. 3

4 Antibiotics are Frequently Prescribed in Nursing Homes 4

5 Summary of Core Elements for Antibiotic Stewardship in Nursing Homes 5

6 Leadership Commitment Nursing home leaders commit to improving antibiotic use. Leaders demonstrate support and commitment to safe and appropriate antibiotic use in your facility. How? Write statements in support of improved antibiotic use to share with staff, residents and families Include stewardship-related duties in job descriptions of medical director/nurse leads/pharmacists Communicate with staff and physicians about antibiotic use Create a culture which promotes stewardship 6

7 Accountability Identify physician, nursing and pharmacy leads responsible for promoting and overseeing antibiotic stewardship activities in your facility. How? Medical Director: sets standards for antibiotic prescribing Director of Nursing: leads communications on resident conditions and how information is relayed to clinicians Pharmacist: provides oversight through medication review Work with infection prevention program coordinator, consultant laboratory, state and local health departments 7

8 Drug Expertise Establish access to individuals with antibiotic stewardship expertise to implement stewardship activities How? Work with a consultant pharmacist who has specialized infectious diseases or antibiotic stewardship training Partner with stewardship program leads at hospitals within your referral network Develop relationships with infectious disease consultants in your community 8

9 Take Action through Policy and Practice Change to Improve Antibiotic Use Implement prescribing policies and change practices to improve antibiotic use. How? Medication safety policies that support optimal antibiotic use Broad interventions to improve antibiotic use, standardize practices during care of any resident suspected of an infection or started on an antibiotic Pharmacy interventions to improve antibiotic use Infection and syndrome specific interventions to improve antibiotic use 9

10 Tracking and Reporting Antibiotic Use and Outcomes Monitor antibiotic use practices and outcomes related to antibiotics to guide practice change and track the impact of new interventions. How? Process measures: tracking how and why antibiotics are prescribed Antibiotic use measure: tracking how often and how many antibiotics are prescribed Antibiotic outcome measures: tracking the adverse outcomes and costs from antibiotics 10

11 Education Provide antibiotic stewardship education to clinicians, nursing staff, residents and families. How? Provide information on the goal of an antibiotic stewardship intervention and the responsibility of each group for ensuring the implementation Use a variety of mechanisms for disseminating antibiotic education Sustain improvements by incorporating both education and feedback to providers Engage residents and their family members in antibiotic use and stewardship education 11

12 Next Steps Select one or two activities to start with and over time, as improvements are implemented, expand efforts to add new strategies to continue improving antibiotic use Commit now to ensure antibiotic stewardship policies and practices are in placed to protect residents and improve clinical care in nursing homes This material was prepared by Telligen, the Quality Innovation Network National Coordinating Center, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-QINNCC /13/16 12