The Core of Outpatient Antibiotic Stewardship August 17, 2017 - PowerPoint PPT Presentation

The Core of Outpatient Antibiotic Stewardship August 17, 2017

Objectives • Discuss the CDC’s Core Elements of Outpatient Antibiotic Stewardship, • Identify at least one method, for each Core Element, that can be implemented in your office practice toward antibiotic stewardship, • Understand how to develop measures to track success.

Healthcare-Acquired Infections MDR MDRO C-Dif Difficile ficile

Imagine

Dirty Wounds:

Immunosuppression

Prophylaxis

Prophylaxis

Alexander Fleming; Nobel Prize 1945 "The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism."

Antibiotic Stewardship

CDC Core Elements of Outpatient Antibiotic Stewardship • Commitment • Action for Policy & Practice • Tracking & Reporting • Education & Expertise

Commitment

Commitment

• Public displays – Posters – Social Media Messages – Press release materials – Incorporation into Board and Medical staff meetings – Web-site banners https://www.cdc.gov/getsmart/community/materials -references/index.html

• Single Team Leader – Awareness – Manager of the implementation – Watches the data – Accountable to Sr. Leaders

• Job Descriptions – Set forth as an expectation of the job • Evaluations – Measure specific expectations

• Communicate with staff

Clinician Checklist

Take Action!

Take Action!

Take Action! • Communication Skills Training – Education – Scripting • Justification documentation • Clinical Decision support • Call centers/web communications – Reduce unnecessary visits, re: colds

Examples of things to measure • Per physician and overall • MACRA measures

Examples of overall measures % times an antibiotic is prescribed without a clear indication specified. % times watchful waiting was implemented when a patient presents with URI symptoms.

Examples of per physician measures % times Dr. Z documented a justification for antibiotic prescription % times Dr. X used watchful waiting when a patient presented with URI symptoms.

MACRA measures • Adult sinusitis • Children with URI • Treatment of MSSA • Acute bronchitis • Perioperative care: Prophylactic antibiotic • Total knee replacement

Healthcare Professional Education

Patient Education • Some infections might improve without antibx • Serious potential harm – Allergic reactions, – C. Diff, – N/V, diarrhea – Links to other illness when used in small children

Teach Back https://www.ahrq.gov/professionals/quality-patient-safety/quality- resources/tools/literacy-toolkit/healthlittoolkit2-tool5.html

Questions? Stacie Jenkins, RN, MSN Sr. Director of Quality & Patient Safety 318-227-7206 staciejenkins@lhatrustfunds.com