Validation of National Healthcare Safety Network–reported core elements of antimicrobial stewardship in Tennessee

2019 ◽  
Vol 40 (7) ◽  
pp. 817-818
Author(s):  
Christopher D. Evans ◽  
Katie A. Thure ◽  
Honour M. McDaniel ◽  
Cullen J. Adre ◽  
Vicky P. Reed ◽  
...  
Keyword(s):  
Patient Safety ◽  
Antimicrobial Stewardship ◽  
Core Element ◽  
Achievement Data ◽  
National Healthcare ◽  
Annual Survey ◽  
National Healthcare Safety Network ◽  
Core Elements

AbstractA survey of hospital antimicrobial stewardship programs was performed to validate core element achievement data from the National Healthcare Safety Network’s (NHSN) Patient Safety Component Annual Survey. In total, 89% of hospitals met all 7 core elements, compared to only 68% according to the NHSN survey.

scholarly journals Antimicrobial Stewardship Practices Reported by California Hospitals Following New Legislative Requirements: Analysis of National Healthcare Safety Network Annual Survey Data, 2014-2015

2017 ◽  
Vol 38 (12) ◽  
pp. 1503-1505 ◽  
Author(s):  
Kyle Rizzo ◽  
Melissa Kealey ◽  
Erin Epson
Keyword(s):  
Survey Data ◽  
Antimicrobial Stewardship ◽  
Requirements Analysis ◽  
Antimicrobial Stewardship Program ◽  
National Healthcare ◽  
Annual Survey ◽  
National Healthcare Safety Network ◽  
Stewardship Program ◽  
Core Elements ◽  
Implementation Progress

We analyzed California hospitals’ National Healthcare Safety Network Annual Surveys to describe antimicrobial stewardship program (ASP) implementation progress following new state ASP legislation. The proportion of hospitals with all 7 Core Elements of Hospital ASP rose from 59.3% in 2014 to 69.2% in 2015 (P<.001).Infect Control Hosp Epidemiol 2017;38:1503–1505

scholarly journals Antimicrobial stewardship programs; a two-part narrative review of step-wise design and issues of controversy. Part II: Ten questions reflecting knowledge gaps and issues of controversy in the field of antimicrobial stewardship

2020 ◽  
Vol 7 ◽  
pp. 204993612094508
Author(s):  
Fredrik Resman
Keyword(s):  
Antimicrobial Stewardship ◽  
Scientific Evidence ◽  
Unmet Need ◽  
Narrative Review ◽  
Systems Science ◽  
Antimicrobial Use ◽  
Core Element ◽  
Core Elements ◽  
Number Of Publications ◽  
Tailored Design

Regardless of one’s opinion on antimicrobial stewardship programs (ASPs), it is hardly possible to work in hospital care and not be exposed to the term or its practical effects. Despite the term being relatively new, the number of publications in the field is vast, including several excellent reviews of general and specific aspects. Work in antimicrobial stewardship is complex, and include aspects not only of infectious disease and microbiology, but also of epidemiology, genetics, behavioural psychology, systems science, economics and ethics, to name but a few. This review aims to take several of these aspects and the scientific evidence from antimicrobial stewardship studies and merge them into two questions: How should we design ASPs based on what we know today? and Which are the most essential unanswered questions regarding antimicrobial stewardship on a broader scale? This narrative review is written in two separate parts aiming to provide answers to the two questions. The first part, published separately, is written as a step-wise approach to designing a stewardship intervention based on the pillars of unmet need, feasibility, scientific evidence and necessary core elements. It is written mainly as a guide to someone new to the field. It is sorted into five distinct steps; (a) focusing on designing aims; (b) assessing performance and local barriers to rational antimicrobial use; (c) deciding on intervention technique; (d) practical, tailored design including core element inclusion; and (e) evaluation and sustainability. This second part formulates 10 critical questions on controversies in the field of antimicrobial stewardship. It is aimed at clinicians and researchers with stewardship experience and strives to promote discussion, not to provide answers.

Inappropriate intravenous antimicrobial starts: An antimicrobial stewardship metric for hemodialysis facilities

2019 ◽  
Vol 40 (10) ◽  
pp. 1178-1180 ◽  
Author(s):  
Phillip D. Hahn ◽  
Mary Figgatt ◽  
Tiina Peritz ◽  
Susan E. Coffin
Keyword(s):  
Antimicrobial Stewardship ◽  
Network Data ◽  
National Healthcare ◽  
National Healthcare Safety Network

AbstractWe assessed the appropriateness of intravenous antimicrobial starts (IVASs) in Philadelphia County hemodialysis facilities using only National Healthcare Safety Network data. We classified 57.5% of IVASs as inappropriate. These findings warrant further investigation into the determinants of inappropriate IVASs in hemodialysis facilities to enhance antimicrobial stewardship.

Implementation of core elements of antibiotic stewardship in nursing homes—National Healthcare Safety Network, 2016–2018

2021 ◽  
pp. 1-5
Author(s):  
Katryna A. Gouin ◽  
Sarah Kabbani ◽  
Angela Anttila ◽  
Josephine Mak ◽  
Elisabeth Mungai ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Infection Prevention And Control ◽  
Term Care ◽  
National Healthcare ◽  
The Core ◽  
National Healthcare Safety Network ◽  
Core Elements

Abstract Objective: To assess the national uptake of the Centers for Disease Control and Prevention’s (CDC) core elements of antibiotic stewardship in nursing homes from 2016 to 2018 and the effect of infection prevention and control (IPC) hours on the implementation of the core elements. Design: Retrospective, repeated cross-sectional analysis. Setting: US nursing homes. Methods: We used the National Healthcare Safety Network (NHSN) Long-Term Care Facility Component annual surveys from 2016 to 2018 to assess nursing home characteristics and percent implementation of the core elements. We used log-binomial regression models to estimate the association between weekly IPC hours and the implementation of all 7 core elements while controlling for confounding by facility characteristics. Results: We included 7,506 surveys from 2016 to 2018. In 2018, 71% of nursing homes reported implementation of all 7 core elements, a 28% increase from 2016. The greatest increases in implementation from 2016 to 2018 were in education (19%), reporting (18%), and drug expertise (15%). In 2018, 71% of nursing homes reported pharmacist involvement in improving antibiotic use, an increase of 27% since 2016. Nursing homes that reported at least 20 hours of IPC activity per week were 14% (95% confidence interval, 7%–20%) more likely to implement all 7 core elements when controlling for facility ownership and affiliation. Conclusions: Nursing homes reported substantial progress in antibiotic stewardship implementation from 2016 to 2018. Improvements in access to drug expertise, education, and reporting antibiotic use may reflect increased stewardship awareness and resource use among nursing home providers under new regulatory requirements. Nursing home stewardship programs may benefit from increased IPC staff hours.

scholarly journals Hospital microbiology laboratory practices for Enterobacteriaceae: Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN) annual survey, 2015 and 2016

2018 ◽  
Vol 39 (9) ◽  
pp. 1115-1117 ◽  
Author(s):  
Alicia Shugart ◽  
Maroya Spalding Walters ◽  
Lindsey M. Weiner ◽  
David Lonsway ◽  
Alexander J. Kallen
Keyword(s):  
Susceptibility Testing ◽  
Multidrug Resistant ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
National Healthcare ◽  
Annual Survey ◽  
National Healthcare Safety Network ◽  
Control And Prevention ◽  
Using Data ◽  
Facility Survey

AbstractWe analyzed clinical microbiology laboratory practices for detection of multidrug-resistant Enterobacteriaceae in US short-stay acute-care hospitals using data from the National Healthcare Safety Network (NHSN) Annual Facility Survey. Half of hospitals reported testing for carbapenemases, and 1% performed routine polymyxin susceptibility testing using reference broth microdilution.

scholarly journals Implementation of the Core Elements of Antibiotic Stewardship in Nursing Homes Enrolled in the National Healthcare Safety Network

2019 ◽  
Vol 69 (7) ◽  
pp. 1235-1238 ◽  
Author(s):  
Danielle L Palms ◽  
Sarah Kabbani ◽  
Jeneita M Bell ◽  
Angela Anttila ◽  
Lauri A Hicks ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Disease Control ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Ownership Type ◽  
National Healthcare ◽  
The Core ◽  
National Healthcare Safety Network ◽  
Core Elements ◽  
Centers For Disease Control

Abstract In 2016, 42% of nursing homes enrolled in the National Healthcare Safety Network reported meeting all 7 of the Centers for Disease Control and Prevention’s Core Elements of Antibiotic Stewardship. Bivariate analyses suggested that implementation of all core elements differed by ownership type and amount of infection prevention staff hours.

scholarly journals Antimicrobial stewardship programs; a two-part narrative review of step-wise design and issues of controversy Part I: step-wise design of an antimicrobial stewardship program

2020 ◽  
Vol 7 ◽  
pp. 204993612093318 ◽  
Author(s):  
Fredrik Resman
Keyword(s):  
Antimicrobial Stewardship ◽  
Scientific Evidence ◽  
Unmet Need ◽  
Narrative Review ◽  
Systems Science ◽  
Core Element ◽  
Stewardship Program ◽  
Core Elements ◽  
Number Of Publications ◽  
Tailored Design

Regardless of one’s opinion of antimicrobial stewardship programs (ASPs), it is hardly possible to work in hospital care and not be exposed to the term or its practical effects. Despite the term being relatively new, the number of publications in the field is vast, including several excellent reviews of general and specific aspects. Work in antimicrobial stewardship is complex, and includes not only aspects of infectious disease and microbiology, but also of epidemiology, genetics, behavioural psychology, systems science, economics and ethics, to name a few. This review aims to take several of these aspects and the scientific evidence of antimicrobial stewardship studies and merge them into two questions: How should we design ASPs based on what we know today? And which are the most essential unanswered questions regarding antimicrobial stewardship on a broader scale? This narrative review is written in two separate parts aiming to provide answers to the two questions. This first part is written as a step-wise approach to designing a stewardship intervention based on the pillars of unmet need, feasibility, scientific evidence and necessary core elements. It is written mainly as a guide to someone new to the field. It is sorted into five distinct steps: (a) focusing on designing aims; (b) assessing performance and local barriers to rational antimicrobial use; (c) deciding on intervention technique; (d) practical, tailored design including core element inclusion; and (e) evaluation and sustainability. The second part, published separately, formulates ten critical questions on controversies in the field of antimicrobial stewardship. It is aimed at clinicians and researchers with stewardship experience and strives to promote discussion, not to provide answers.

scholarly journals Determining Core Element Achievement in Long-Term Care Facilities Across Tennessee

2020 ◽  
Vol 41 (S1) ◽  
pp. s89-s89
Author(s):  
Cullen Adre ◽  
Youssoufou Ouedraogo ◽  
Christopher David Evans ◽  
Amelia Keaton ◽  
Marion Kainer
Keyword(s):  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Core Element ◽  
Term Care ◽  
Current State ◽  
Stewardship Program ◽  
National Quality ◽  
Care Facilities ◽  
Core Elements

Background: In 2017, a new antimicrobial stewardship standard was established by the Joint Commission that requires long-term care facilities (LTCFs) to have an antimicrobial stewardship program (ASP) based on current scientific literature. The Tennessee Department of Health (TDH) team sought to ascertain the current state of ASPs across Tennessee and to assist programs with implementation strategies. Utilizing a Centers for Medicaid and Medicare Services’ Civil Monetary Penalties grant, the TDH purchased copies of the National Quality Partners Playbook for Antibiotic Stewardship in Post-Acute and Long-Term Care to provide to LTCFs as incentive to complete a survey that would evaluate their current adoption of core elements. Methods: A self-administered questionnaire on ASP practices was developed and distributed to LCTFs. This survey expanded upon questions from the NHSN 2018 LTCF annual survey. These questions pertained to actionable items facilities are taking to achieve core elements. Achievement of the CDC’s 7 core elements of ASPs was determined based upon a combination of 1 or more responses to the survey questions. The percentage of LTCFs achieving each ASP core element at the regional and statewide level was determined. We also calculated the percentage of LTCFs that achieved all 7 elements versus 5 or more core elements. The analyses and visualizations were performed using SAS 9.4 and Tableau software. Results: Currently, 88 of 316 licensed LTCF facilities in Tennessee have participated in the survey. All regions were represented by EMS region. Based on the results of our survey, 100% of participating facilities have achieved at least 5 core elements, and 78% of participating facilities have achieved all 7 core elements. The core element with the lowest achievement was Accountability at 89%, and reporting and action had the highest achievement (100%). Conclusions: Early results suggest that LTCFs across Tennessee have active ASPs with strong core element achievement. However, we received responses from only 27% of licensed LTCFs. Minimal data are available regarding the current state of LTCF ASPs in Tennessee, and data will continue to be collected and analyzed. Participation may be limited to those already actively engaged in public health efforts, including antimicrobial stewardship. LTCFs that have participated in the initial evaluation will be surveyed at 6 months and 12 months after receipt of playbooks to evaluate their ASP progression and NQP Playbook utilization.Funding: NoneDisclosures: None

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