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

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the core of outpatient antibiotic stewardship
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The Core of Outpatient Antibiotic Stewardship August 17, 2017 - - PowerPoint PPT Presentation

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The Core of Outpatient Antibiotic Stewardship August 17, 2017 Objectives Discuss the CDCs Core Elements of Outpatient Antibiotic Stewardship, Identify at least one method, for each Core Element, that can be implemented in your

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August 17, 2017

The Core of Outpatient Antibiotic Stewardship

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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

  • ffice practice toward antibiotic stewardship,
  • Understand how to develop measures to

track success.

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Healthcare-Acquired Infections

MDR MDRO C-Dif Difficile ficile

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Imagine

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Dirty Wounds:

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Immunosuppression

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Prophylaxis

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Prophylaxis

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"The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant

  • rganism."

Alexander Fleming; Nobel Prize 1945

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Antibiotic Stewardship

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CDC Core Elements of Outpatient Antibiotic Stewardship

  • Commitment
  • Action for Policy & Practice
  • Tracking & Reporting
  • Education & Expertise
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Commitment

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Commitment

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  • 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
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  • Single Team Leader

– Awareness – Manager of the implementation – Watches the data – Accountable to Sr. Leaders

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  • Job Descriptions

– Set forth as an expectation of the job

  • Evaluations

– Measure specific expectations

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  • Communicate with staff
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Clinician Checklist

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Take Action!

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Take Action!

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Take Action!

  • Communication Skills Training

– Education – Scripting

  • Justification documentation
  • Clinical Decision support
  • Call centers/web communications

– Reduce unnecessary visits, re: colds

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Examples of things to measure

  • Per physician and
  • verall
  • MACRA measures
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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.

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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.

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MACRA measures

  • Adult sinusitis
  • Children with URI
  • Treatment of MSSA
  • Acute bronchitis
  • Perioperative care: Prophylactic antibiotic
  • Total knee replacement
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Healthcare Professional Education

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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

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Teach Back

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

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Stacie Jenkins, RN, MSN

  • Sr. Director of Quality & Patient Safety

318-227-7206 staciejenkins@lhatrustfunds.com

Questions?