Presenter Pranita Tamma Pranita Tamma MD MHS Assistant Professor of Pediatrics Director of Pediatric Antimicrobial Stewardship Johns Hopkins Hospital Program email address antibioticsafetynorcorg ID: 751198
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The AHRQ Safety Program for Improving Antibiotic UseSlide2
Presenter — Pranita Tamma
Pranita Tamma, M.D., M.H.S.
Assistant Professor of Pediatrics
Director of Pediatric Antimicrobial Stewardship, Johns Hopkins HospitalProgram email address: antibioticsafety@norc.org
2Slide3
What is the AHRQ Safety Program?
Collaborative intervention
AHRQ
Johns Hopkins MedicineNORC
Overarching goal:To improve antibiotic prescribing practices and assist facilities with implementing effective antibiotic stewardship programs. The goals of antibiotic stewardship:
To ensure that all patients requiring antibiotics receive the right drug at the right dose and for the right duration.
3Slide4
What is the AHRQ Safety Program?
Addresses both:
Technical aspects e.g., best practice in antibiotic prescribing for common infectious diseases syndromes
Adaptive aspects e.g., safety culture, behavior change, teamwork and communication
4Slide5
What is the AHRQ Safety Program?
One year program begins in December 2017
Three month baseline period
Nine month intervention periodNo fee to participateEntire hospitals are invited to participate but individual units within hospitals can also still participate
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Benefits of Participating
Access to Antibiotic Stewardship experts for coaching and
troubleshooting
Monthly interactive webinars 30-60 minutes longRecorded and posted to the project website for 24/7
accessSlides and facilitator guides available for local use
6Slide7
Benefits of Participating
Access to:
F
ast
fact sheets and learning modules Tools to improve antibiotic prescribing
practices
Educational
material for
patients and familiesMaterials to assist with compliance with The Joint Commission Stewardship Standard
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Expected Outcomes of Participation
Improve safety culture around antibiotic prescribing
Enhance
teamwork and communication among health care workers and between health care workers and patients/familiesReduce unnecessary antibiotic useImprove antibiotic decision-making by frontline staffReduce
Clostridium difficile infection rates
Improve
compliance with
The Joint Commission Antimicrobial Stewardship Standard
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The Four Moments of Antibiotic Decision-Making
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1. Does my patient have an infection that requires antibiotics?
2. Have I ordered appropriate cultures before starting antibiotics? What empiric therapy should I initiate?
3. A day or more has passed. Can I stop antibiotics? Can I narrow therapy or change from IV to oral therapy?
4. What duration of antibiotic therapy is needed for my patient's diagnosis?Slide10
Acute Care Facilities Webinars: Adaptive Topics
Behavior change theory for antibiotic stewardship leaders
Improving
antibiotic
u
se
is a
patient
s
afety
i
ssue
Improving communication and teamwork around antibiotic prescribing
Identifying
defects to improve
a
ntibiotic
u
se
Improving antibiotic use by learning from defects
Sustaining
antibiotic stewardship
e
fforts
10Slide11
Acute Care Facilities Webinars: Technical Topics
Antibiotic stewardship program development
Stewardship of asymptomatic bacteriuria and urinary tract infections
Stewardship of c
ommunity-acquired lower respiratory tract conditions
Stewardship
of h
ealthcare-associated and ventilator-associated pneumonia
Stewardship of skin and soft tissue infections
Stewardship
of intra-abdominal infections
Stewardship
of
C. difficile
infections
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Compliments CMS HIIN Initiative
One of the goals
of
the CMS’s Partnership
for Patient’s
Hospital Improvement Innovation Network (HIIN)
initiative is reduction in
C. difficile
rates reported to the CDC
A
doption of antibiotic stewardship is one approach suggested to achieve this
The AHRQ Safety Program can help your site develop or improve your stewardship activities and places specific emphasis on approaches to reduce
C. difficile
LabID
events and
C. difficile
infection
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Data Required From Participating Hospitals
Monthly data on days of antibiotic therapy per 1,000 days present
← AUR
measure
Using NHSN AUR definitions
https://www.cdc.gov/nhsn/pdfs/pscmanual/11pscaurcurrent.pdf
Quarterly
C.
difficile
laboratory events per 10,000 patient-days
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Data Required From Participating Hospitals
Completion of:
10
antibiotic review forms per month
per unit to
identify targets for and track improvement in antibiotic
prescribing
Completed
by:
ASP and front-line
prescribers together
Completion guide available
About 5 minutes per form
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Team Antibiotic Review Form
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Data Required From Participating Hospitals
Completion of a survey regarding current antibiotic stewardship practice
Basic information about the facility and current activities in patient safety and antibiotic stewardship
Completion of the Hospital Survey on Patient Safety
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What Do Participating Hospitals Need to Do?
Identify the antibiotic stewardship team
Identify and engage front-line staff on participating units and services
Participate in monthly webinars with expertsBetween webinars, identify antibiotic-related defects and identify solutions, incorporate relevant tools into practiceSubmit requested data to the program website
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Timeline for Participation
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Action
Due Date
Complete the Hospital Letter of Commitment
October 15, 2017
Assemble ASP and front-line teams within your hospital
October 15, 2017
Complete the Data Use Agreement
(Optional)
October 31,
2017
Register your team members to use the project data portal
October 31,
2017
At least one team
member attends an online informational webinar
November 2017
Participate
in monthly webinars
Beginning December
2017
Regularly meet as a team to implement interventions and monitor
performance
December
2017 until the end of project
Complete survey assessments and submit hospital data according to the data collection schedule
Starting
December 2017 until end of projectSlide19
To Learn More and Enroll
Visit our website at
https://safetyprogram4antibioticstewardship.org/
Complete the online application on the website
Email
antibioticsafety@norc.org
with any questions
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Questions
20
Type in your questions using “Chat” or
Speak up on conference line
THANK YOU FOR PARTICIPATING!Slide21
Joint Commission Antimicrobial Stewardship Standard
AS established as an organizational priority
Education of staff and licensed independent practitioners on antibiotic use and stewardship
Education of patients and families
AS program in place consisting of
an ID physician, pharmacist(s),
Infection
Preventionist
(s), and Practitioner (depending on availability)
AS program includes CDC core elementsAS program uses organization-approved multidisciplinary protocols
Hospital collects, analyzes, and reports data on its ASP
Hospital takes action on improvement opportunities identified by its ASP
8 Required Components
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