Using Antibiograms to Improve Antibiotic Prescribing in Skilled Nursing Facilities

Abstract

BACKGROUND. Antibiograms have effectively improved antibiotic prescribing in acute-care settings; however, their effectiveness in skilled nursing facilities (SNFs) is currently unknown.

Healthcare-associated infections in the elderly: what's new

“…Attempts to institute effective antibiotic stewardship programs in long term care facilities have been made [29, 30, 31, 32*], however the ideal approach remains unclear. A difference in staffing and patient care goals between LTCF and acute care facilities make it difficult to apply the same ASP principles used in acute care to long-term facilities [33].…”

Antimicrobial Stewardship Programs in Long‐Term Care Settings: A Meta‐Analysis and Systematic Review

“…Most of the studies were multifaceted (n = 15), and the number of intervention strategies used per study varied from one to seven, with a median of four (Supplementary Table S2 provides a detailed list of strategies per study). The three most frequently used strategies were educational material (n = 13), educational meetings (n = 12), and guideline implementation (n = 7) . Six studies implemented an intervention to shift organizational culture (eg, creating a new onsite infectious disease consultation service or implementing an ASP).…”

“…The three most frequently used strategies were educational material (n = 13), educational meetings (n = 12), and guideline implementation (n = 7) . Six studies implemented an intervention to shift organizational culture (eg, creating a new onsite infectious disease consultation service or implementing an ASP). Other strategies that have been implemented in LTCFs included audit and feedback (n = 5), reminders (n = 5), local opinion leader (n = 4),patient‐mediated interventions (n = 3), continuous quality improvement (n = 2), educational outreach (n = 2), financial incentives (n = 2), community of practice (n = 1), and tailored interventions (n = 1) .…”

“…Intervention implementation ranged from a one‐time only session to 72 weekly commitments. Of 16 studies, 12 involved ongoing commitment (eg, use of a guideline or a tool), often in addition to the time allocated to participate in the intervention . Interventions also tended to be outside of the routine practice of the daily workflow of the LTCF healthcare providers.…”

Introduction to “Preventing Healthcare-Associated Infections: Results and Lessons Learned from AHRQ's HAI Program”

“…The articles examine epidemiological topics such as regional variation in catheter-associated urinary tract infection and urinary catheter use; 2,3 the spread of multidrug-resistant organisms (MDROs) between nursing homes and acute care hospitals; 4 risk factors and detection of surgical site infections; 5,6 mortality among patients with healthcare-associated pneumonia; 7 age, gender, racial, and ethnic disparities in HAI rates; 8 ' 9 and resistance of Staphylococcus aureus to zinc and cadmium. 10 In addition, the studies included herein report results related to HAI-prevention and quality-improvement efforts, such as effectiveness of and cost savings from universal methicillin-resistant Staphylococcus aureus decolonization versus screening and isolation and targeted decolonization; 1112 development of a tool to assess the Comprehensive Unit-Based Safety Program to Eliminate Ventilator-Associated Pneumonia implementation progress; 13 effectiveness of antibiotic stewardship programs in acute care hospitals, 14 skilled nursing facilities, 15 pediatric primary care practices, 16,17 and assisted living; 18 and the use of microbiology data to notify infection preventionists about admission of patients with MDROs." Collectively, the articles presented in this volume contribute substantially to HAIprevention science, and we trust they will be of interest to readers of this journal.…”