Antibiotic Overuse Training Module 4 AHRQ Pub No 1617000321EF March 2017 Learning Objective Upon completion of this session longterm care staff will be able to describe what a kneejerk antibiotic response is ID: 920746
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Slide1
How To Avoid the Harms of Antibiotic Overuse
Training Module 4
AHRQ Pub. No.
16(17)-0003-21-EF
March 2017
Slide2Learning ObjectiveUpon completion of this session, long-term care staff will be able to—
describe what a knee-jerk antibiotic response is;
list two reasons to avoid antibiotic overuse; and
demonstrate communication strategies that address antibiotic alternatives with providers, residents, and family members.
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Slide3Have You Ever Heard This?
Why not just give her an antibiotic? It won’t do any harm.
Probably the urine. Needs an antibiotic.
Turning to antibiotics as a knee-jerk reflex
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Slide4Asymptomatic Bacteriuria (ASB) Versus CAUTI
If you suspect that a resident has a CAUTI, ask yourself two easy questions:
Does the resident have one or more CAUTI signs or symptoms?
Is there another explanation for this resident’s symptoms?
Think before you reach for antibiotics!
ASB
Bacteriuria ≠ CAUTI
Bacteriuria means a positive urine culture
Bacteriuria is not the same as
a catheter-associated urinary tract infection (CAUTI),
and vice versa
CAUTI
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Slide5Why Is Knee-Jerk Antibiotic Use Bad?Reason 1
IT’S BAD FOR THE RESIDENT!
Side effects are common
Nausea, diarrhea
Allergic reactions
Antibiotic-related infections
Clostridium difficile
Candida
(yeast)
Wrong diagnosis will delay treatment
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Slide6Why Is Knee-Jerk Antibiotic Use Bad?Reason 21
Antibiotic resistance is a growing problem
Often forced to use older antibiotics to deal with resistant organisms
Many of these drugs are harmful to older
people
It Leads to Bacterial Resistance!
The White House
Office of the Press Secretary
Fact sheet about
National Action Plan to Combat Antibiotic-Resistant Bacteria
March 27, 2015
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Slide7Bringing the Message Home
How is your role important in reducing antibiotic overuse?
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Slide8Engaging Physicians and Other Providers2
Remind others that antibiotic resistance is a growing problem and that antibiotics can have harsh side effects
CUS
Advocate for individual residents
“I know you don’t want to miss anything with Mrs. Lacy.”
“We learned that cloudy urine is not a symptom of CAUTI. Almost everyone with a catheter gets cloudy urine eventually.”
“Extra urine cultures lead to extra antibiotics—and that’s not good for anyone.”
Please use
CUS
words,
but
only
when appropriate!
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Slide9Consider What Residents and FamiliesAre Actually Saying2-5
S
ituation
Explain the current situation
Background
Brief history with only the important information
A
ssessment
Summarize the facts and what you think is going on
R
ecommendation
Explain what actions you think should take place
Family says: “My Bobby always looks like this when he has a UTI.”
We are going to watch him closely.
Let’s help him drink more fluids. Would you be able to encourage him to drink some extra juice?
Family says: “Let’s just give him antibiotics just in case.”
Antibiotics won’t help if he doesn’t have a UTI.Antibiotics could hurt him (e.g., diarrhea).We don’t want to miss the real cause.
Educate residents and families regarding antibiotic use!
Ensure that residents’ needs for pain relief and other supportive care are met.
Example Family Dialogue
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Slide10Avoid Knee-Jerk AntibioticsRemember, unnecessary antibiotic use can lead
to— Resident harms
An increase in antibiotic resistant organisms
Be aware of overuse if the resident has a positive urine culture;
instead, try other treatment options
Communication can reduce antibiotic overuse
Include the resident and family in discussions
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Slide11ReferencesThe White House, Office of the Press Secretary. National
Action Plan for Combating Antibiotic-Resistant Bacteria.
March
2015.
https://www.whitehouse.gov/the-press-office/2015/03/27/fact-sheet-obama-administration-releases-national-action-plan-combat-ant. Accessed December 23, 2015.
Appendix
. Example of the SBAR and CUS Tools.
In: Taylor SL, Saliba D.
Improving Patient Safety in Long-Term Care Facilities, Student Workbook.
Module 2: Communicating a Change in a Resident’s Condition. Rockville, MD: Agency for Healthcare Research and Quality; June 2012.
http://www.ahrq.gov/professionals/systems/long-term-care/resources/facilities/ptsafety/ltcmod2ap.html
. Accessed on April 26, 2016.
Varonen H, Sainio S
.
Patients’ and physicians’ views on the management of acute maxillary sinusitis.
Scand J Prim Health Care. 2004 Mar;22(1):22-6. PMID: 15119516.Van Driel ML, De Sutter, AD, Deveugele M, et
al. Are sore throat patients who hope for
antibiotics actually asking
for
pain relief
?
Ann Fam Med.
2006 Nov-Dec;4(6):494-9. PMID: 17148626.
Braun BL, Fowles
JB.
Characteristics and
experiences
of
parents
and
adults who want antibiotics
for
cold symptoms
.
Arch Fam Med.
2000 Jul;9(7):589-95. PMID: 10910304.
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