scholarly journals Survey of Infection Prevention Informatics Use and Practitioner Satisfaction in US Hospitals

2014 ◽  
Vol 35 (7) ◽  
pp. 891-893 ◽  
Author(s):  
Max Masnick ◽  
Daniel J. Morgan ◽  
Marc-Oliver Wright ◽  
Michael Y. Lin ◽  
Lisa Pineles ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
Infect Control Hosp ◽  
Infection Preventionists

We surveyed hospital epidemiologists and infection preventionists on their usage of and satisfaction with infection prevention–specific software supplementing their institution’s electronic medical record. Respondents with supplemental software were more satisfied with their software’s infection prevention and antimicrobial stewardship capabilities than those without. Infection preventionists were more satisfied than hospital epidemiologists.Infect Control Hosp Epidemiol 2014;35(7):891–893

Types of Interventions

2021 ◽  
pp. 24-39
Author(s):  
Jennifer Meddings ◽  
Vineet Chopra ◽  
Sanjay Saint
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Infection Prevention ◽  
Indwelling Catheters ◽  
Inappropriate Use ◽  
Day Hospitals ◽  
Healthcare Associated

Infection prevention programs were slow to develop—they were a rarity as recently as the 1950s—but they have become a staple of modern-day hospitals. Great strides have been made in identifying clinician activities that can control or prevent various healthcare-associated infections. This chapter describes the contents of an infection prevention bundle for catheter-associated urinary tract infection (CAUTI). In the case of CAUTI, the so-called bladder bundle sets forth appropriate and inappropriate use of indwelling catheters. A nursing checklist, on paper or as a template in the electronic medical record, is used to track patients’ daily urinary catheter status. Doctors and nurses are asked to rethink when a Foley is called for, what alternatives should be considered, what catheter equipment should be used, and how long the Foley should remain in place.

scholarly journals Customizing an Electronic Medical Record to Automate the Workflow and Tracking of an Antimicrobial Stewardship Program

2019 ◽  
Vol 6 (8) ◽  
Author(s):  
Michael Katzman ◽  
Jihye Kim ◽  
Mark D Lesher ◽  
Cory M Hale ◽  
George D McSherry ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Stewardship Program ◽  
Documentation System ◽  
Clostridioides Difficile ◽  
Hospital Leadership ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Recorded Data

Abstract Background Documenting the actions and effects of an antimicrobial stewardship program (ASP) is essential for quality improvement and support by hospital leadership. Thus, our ASP tallies the number of charts reviewed, types of recommendations, how and to whom they were communicated, whether they were followed, and any effects on antimicrobial days of therapy. Here we describe how we customized the electronic medical record at our institution to facilitate our workflow and data analysis, while highlighting principles that should be adaptable to other ASPs. Methods The documentation system involves the creation of a novel and intuitive ASP form in each chart reviewed and 2 mutually exclusive tracking systems: 1 for active forms to facilitate the daily ASP workflow and 1 for finalized forms to generate cumulative reports. The ASP form is created by the ASP pharmacist, edited by the ASP physician, reopened by the pharmacist to assess whether the recommendation was followed and to quantify any antimicrobial days avoided or added, then reviewed and finalized by the ASP physician. Active forms are visible on a real-time “MPage,” whereas all finalized forms are compiled nightly into 65 informative tables and associated graphs. Results and Conclusions This system and its underlying principles have automated much of the documentation, facilitated follow-up of interventions, improved the completeness and validity of recorded data and analysis, enabled our ASP to expand its activities, and been associated with decreased antimicrobial usage, drug resistance, and Clostridioides difficile infections.

scholarly journals Use of an electronic medical record system to improve antimicrobial stewardship

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P109
Author(s):  
P Allan ◽  
M Newman ◽  
J Collinson ◽  
L Bond ◽  
W English
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Electronic Medical Record System ◽  
Record System ◽  
Medical Record System

Antimicrobial Stewardship in Rhode Island Long-Term Care Facilities: Current Standings and Future Opportunities

2016 ◽  
Vol 37 (8) ◽  
pp. 979-982 ◽  
Author(s):  
Haley J. Morrill ◽  
Leonard A. Mermel ◽  
Rosa R. Baier ◽  
Nicole Alexander-Scott ◽  
David Dosa ◽  
...  
Keyword(s):  
Rhode Island ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Antibiotic Use ◽  
Infect Control Hosp ◽  
Term Care ◽  
Care Facilities ◽  
Infection Preventionists

Our survey of antimicrobial stewardship practices among Rhode Island long-term care facilities demonstrated opportunities to develop formal programs. Results suggest infection preventionists are largely responsible for ensuring appropriate antibiotic use in long-term care facilities and there is a need for increased interdisciplinary access to individuals with antimicrobial stewardship expertise.Infect Control Hosp Epidemiol 2016;37:979–982

Common Problems, Realistic Solutions

2021 ◽  
pp. 87-117
Author(s):  
Jennifer Meddings ◽  
Vineet Chopra ◽  
Sanjay Saint
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Infection Prevention ◽  
Implementation Process ◽  
Team Leadership ◽  
Project Team ◽  
Short Term ◽  
Common Problems ◽  
Special Circumstances

A hospital-wide intervention is rolled out. There are changes in the team leadership and many operational adjustments: supplies ordered, procedures redesigned, nursing assignments altered. Three major types of troublemakers are described: the active resisters, the organizational constipators, and the time-servers. Motivations range from opposition to any kind of change to a personal animus toward the project champions to a determination to do as little extra work as possible. Requests by patients and their families may be used to try to get around bladder bundle items or a member of the project team may approach nurses with a patronizing attitude. The team cheers short-term progress to encourage staff compliance, solicits concrete criticism as a path to improvement, and adjusts the implementation process to allow for special circumstances. Efforts to use the electronic medical record to game the system must be squelched. Unfortunately, these challenges are all too common when implementing an infection prevention initiative—but there are solutions.

scholarly journals Repurposing antimicrobial stewardship tools in the electronic medical record for the management of COVID-19 patients

2020 ◽  
Vol 41 (11) ◽  
pp. 1335-1337 ◽  
Author(s):  
Matthew W. Davis ◽  
Dayna McManus ◽  
Alan Koff ◽  
Gregory R. Jaszczur ◽  
Maricar Malinis ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship

AbstractDuring the COVID-19 pandemic, the antimicrobial stewardship module in our electronic medical record was reconfigured for the management of COVID-19 patients. This change allowed our subspecialist providers to review charts quickly to optimize potential therapy and management during the patient surge.

Utilizing Information Technology and the Electronic Medical Record to Assist Infection Preventionists in Identifying Ventilator-associated Events (VAE's)

2013 ◽  
Vol 41 (6) ◽  
pp. S126-S127
Author(s):  
Paulette M. Sebastian ◽  
Lisa M. Esolen ◽  
Tamara F. Persing ◽  
Amanda Bengier ◽  
Paulette Sebastian ◽  
...  
Keyword(s):  
Information Technology ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Infection Preventionists

The Use of Best Practice Alerts with the Development of an Antimicrobial Stewardship Navigator to Promote Antibiotic De-escalation in the Electronic Medical Record

2013 ◽  
Vol 34 (12) ◽  
pp. 1259-1265 ◽  
Author(s):  
Lucas Schulz ◽  
Kurt Osterby ◽  
Barry Fox
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Best Practice ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Antibiotic Use ◽  
Evidence Based ◽  
Support Tool ◽  
Clinical Decision Support Tool

Objective.Develop a clinical decision support tool comprised of an electronic medical record alert and antimicrobial stewardship navigator to facilitate antimicrobial stewardship.Design.We analyzed alerts targeting antimicrobial de-escalation to assess the effectiveness of the navigator as a stewardship tool. The alert provides antimicrobial recommendations, then directs providers to the navigator, which includes order management, relevant patient information, evidence-based clinical information, and bidirectional communication capability.Setting.Academic, tertiary care medical center with an electronic medical record.Intervention.Alerts containing stewardship recommendations and immediate access to the navigator were created.Results.Antibiotic use and response data were collected 1 day before stewardship recommendation via the best practice alert (BPA) tool and 1 day after the BPA tool response. A total of 1,285 stewardship BPAs were created. Two hundred and forty-four (18.9%) of the BPAs were created and acted upon within 72 hours for the purpose of de-escalation: 169 (69%) were accepted, 30 (12%) were accepted with modification, and 45 (18%) were rejected. Statistically significant decreases in total antibiotic use as well as in use of broad-spectrum (anti-methicillin-resistant Staphylococcus aureus and anti-pseudomonal) agents occurred when accepted recommendations were compared with rejected recommendations.Conclusions.We describe the successful development of a clinical decision support tool to perform prospective audit and feedback comprised of an alert and navigator system featuring evidence-based recommendations and clinical and educational information. We demonstrate that this tool improves antibiotic use through our example of de-escalation.Clinical Trials Identifier.This project was registered at ClinicalTrials.gov (NCT01573195).

scholarly journals Has UTI and Clostridioides difficile Testing and Treatment Stewardship Diffused Into Oregon Hospitals? A Survey of the Current State

2020 ◽  
Vol 41 (S1) ◽  
pp. s243-s244
Author(s):  
Angela Villamagna ◽  
Rebecca Pierce ◽  
Dat Tran ◽  
Roza Tammer ◽  
Lisa Iguchi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Acute Care ◽  
Infection Prevention ◽  
Acute Care Hospitals ◽  
Urine Collection ◽  
Treatment Algorithms ◽  
Clostridioides Difficile ◽  
Formed Stool

Background: Urinary tract infection (UTI) and Clostridioides difficile infection (CDI) both pose significant diagnostic challenges. Excess testing has implications for hospital-associated infection surveillance and may also lead to overtreatment and associated patient risk. Accurate diagnosis requires stewardship efforts to ensure that the correct patients are tested appropriately. In coordination with clinicians and microbiology labs, hospital infection prevention departments can aid diagnostic stewardship efforts by creating policies for order indications and proper test collection methods and by developing electronic medical record (EMR) support for diagnostic and treatment algorithms. The prevalence of these practices in Oregon, however, is unknown. Methods: We deployed a web-based survey to infection preventionists at all 61 acute-care hospitals in Oregon in January 2019. Responses were collected through April 2019, and a subset of applicable questions were analyzed. Results: Of 61 acute-care hospitals, 58 (95%) responded. A response from a single long-term acute-care hospital was excluded. For urinary tract infections (UTIs), a minority of hospitals reported having policies requiring annual sterile urine collection training for registered nurses (n = 7, 12%), annual observation of the RN sterile urine collection procedure (n = 1, 2%), or use of boric acid containers for urine collection (n = 10, 17%). UTI testing and treatment algorithms embedded in the electronic medical record (EMR) were more common (Fig. 1). Regarding urine culture reflex policies, 39 facilities (68%) reported reflexing abnormal urinalyses to culture only if ordered, whereas 14 respondents (25%) reported automatically reflexed all abnormal urinalyses to culture. For Clostridioides difficile infection (CDI), respondents reported using a variety of methods to discourage inappropriate testing (Fig. 2). Although almost all facilities (n = 53, 93%) reported having a policy to reject formed stool, less than half (n = 27, 47%) reported having a policy to reject stool in patients receiving laxatives. Furthermore, 74% of respondents (n = 42) had a published testing algorithm, more than twice the 18 (32%) hospitals that reported having a comparable UTI algorithm. Conclusions: Infection prevention departments in Oregon acute-care hospitals utilize a variety of tools to contribute to diagnostic and treatment stewardship for UTI and CDI. Our survey revealed many opportunities for improvement in UTI and C. difficile testing and treatment stewardship in Oregon hospitals. For example, although most hospitals reject formed stool for CDI testing, policies for other diagnosis and treatment stewardship techniques were much less commonly employed. Future work will compare the results of this survey to a set of similar questions on a statewide microbiology laboratory survey, assess best practices, and form consensus recommendations on stewardship practices for the state.Funding: NoneDisclosures: None

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