scholarly journals A Multidisciplinary Hospital-based Antimicrobial Use Program: Impact on Hospital Pharmacy Expenditures and Drug Use

1996 ◽  
Vol 7 (2) ◽  
pp. 104-109 ◽  
Author(s):  
Suzette Salama ◽  
Coleman Rotstein ◽  
Lionel Mandell
Keyword(s):  
Quality Assurance ◽  
Hospital Pharmacy ◽  
Cost Savings ◽  
Antimicrobial Use ◽  
Canadian Hospital ◽  
Drug Budget ◽  
Program Impact ◽  
Use Patterns ◽  
Antimicrobial Prescribing ◽  
Prescribing Behaviour

The authors’ hospital embarked on a three-component, multidisciplinary, hospital-based antimicrobial use program to cut costs and reduce inappropriate antimicrobial use. Initially, antimicrobial use patterns and costs were monitored for 12 months. For the next two years, an antimicrobial use program was implemented consisting of three strategies: automatic therapeutic interchanges; antimicrobial restriction policies; and parenteral to oral conversion. The program resulted in a reduction in the antimicrobial portion of the total pharmacy drug budget from 41.6% to 28.2%. Simultaneously, the average cost per dose per patient day dropped from $11.88 in 1991 to $10.16 in 1994. Overall, mean monthly acquisition cost savings rose from $6,810 in 1992 to $27,590 in 1994. This study demonstrates that a multidisciplinary antimicrobial use program in a Canadian hospital can effect dramatic cost savings and serve as a quality assurance activity of physician antimicrobial prescribing behaviour.

scholarly journals Opportunities and challenges in improving antimicrobial use during the era of telehealth expansion: A narrative review

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Hiroyuki Suzuki ◽  
Stephanie C. Shealy ◽  
Kyle Throneberry ◽  
Edward Stenehjem ◽  
Daniel Livorsi
Keyword(s):  
Antimicrobial Stewardship ◽  
Cost Savings ◽  
Length Of Hospital Stay ◽  
Urgent Care ◽  
Antimicrobial Use ◽  
Antimicrobial Prescribing ◽  
Clostridioides Difficile ◽  
Challenges And Opportunities ◽  
Tract Infections ◽  
Outpatient Settings

Abstract Efforts to improve antimicrobial prescribing are occurring within a changing healthcare landscape, which includes the expanded use of telehealth technology. The wider adoption of telehealth presents both challenges and opportunities for promoting antimicrobial stewardship. Telehealth provides 2 avenues for remote infectious disease (ID) specialists to improve inpatient antimicrobial prescribing: telehealth-supported antimicrobial stewardship and tele-ID consultations. Those 2 activities can work separately or synergistically. Studies on telehealth-supported antimicrobial stewardship have reported a reduction in inpatient antimicrobial prescribing, cost savings related to less antimicrobial use, a decrease in Clostridioides difficile infections, and improved antimicrobial susceptibility patterns for common organisms. Tele-ID consultation is associated with fewer hospital transfers, a shorter length of hospital stay, and decreased mortality. The implementation of these activities can be flexible depending on local needs and available resources, but several barriers may be encountered. Opportunities also exist to improve antimicrobial use in outpatient settings. Telehealth provides a more rapid mechanism for conducting outpatient ID consultations, and increasing use of telehealth for routine and urgent outpatient visits present new challenges for antimicrobial stewardship. In primary care, urgent care, and emergency care settings, unnecessary antimicrobial use for viral acute respiratory tract infections is common during telehealth encounters, as is the case for fact-to-face encounters. For some diagnoses, such as otitis media and pharyngitis, antimicrobials are further overprescribed via telehealth. Evidence is still lacking on the optimal stewardship strategies to improve antimicrobial prescribing during telehealth encounters in ambulatory care, but conventional outpatient stewardship strategies are likely transferable. Further work is warranted to fill this knowledge gap.

scholarly journals Trends and correlates of antimicrobial use in broiler and turkey farms: a poultry company registry-based study in Italy

2019 ◽  
Vol 74 (9) ◽  
pp. 2784-2787 ◽  
Author(s):  
Claudia Caucci ◽  
Guido Di Martino ◽  
Alessandro Dalla Costa ◽  
Manuel Santagiuliana ◽  
Monica Lorenzetto ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Antimicrobial Resistance ◽  
Geographical Area ◽  
Antimicrobial Use ◽  
Poultry Production ◽  
Structural Interventions ◽  
Antimicrobial Prescribing ◽  
Prescribing Behaviour ◽  
Antimicrobial Treatments

Abstract Background Antimicrobial usage (AMU) in livestock plays a key role in the emergence and spread of antimicrobial resistance. Analysis of AMU data in livestock is therefore relevant for both animal and public health. Objectives To assess AMU in 470 broiler and 252 turkey farms of one of Italy’s largest poultry companies, accounting for around 30% of national poultry production, to identify trends and risk factors for AMU. Methods Antimicrobial treatments administered to 5827 broiler and 1264 turkey grow-out cycles in 2015–17 were expressed as DDDs for animals per population correction unit (DDDvet/PCU). A retrospective analysis was conducted to examine the effect of geographical area, season and prescribing veterinarian on AMU. Management and structural interventions implemented by the company were also assessed. Results AMU showed a 71% reduction in broilers (from 14 to 4 DDDvet/PCU) and a 56% reduction in turkeys (from 41 to 18 DDDvet/PCU) during the study period. Quinolones, macrolides and polymyxins decreased from 33% to 6% of total AMU in broilers, and from 56% to 32% in turkeys. Broiler cycles during spring and winter showed significantly higher AMU, as well as those in densely populated poultry areas. Different antimicrobial prescribing behaviour was identified among veterinarians. Conclusions This study evidenced a decreasing trend in AMU and identified several correlates of AMU in broilers and turkeys. These factors will inform the design of interventions to further reduce AMU and therefore counteract antimicrobial resistance in these poultry sectors.

scholarly journals Bargain Hunting for Buffered Lidocaine: A Collaborative Discovery of Cost-saving Strategies That Can Improve Patient Care

2020 ◽  
Author(s):  
Curtis L Simmons ◽  
Laura K Harper ◽  
Kathryn J Holst ◽  
Nathan J Brinkman ◽  
Christine U Lee
Keyword(s):  
Sodium Bicarbonate ◽  
Hospital Pharmacy ◽  
Cost Savings ◽  
Improve Patient Care ◽  
Medical Waste ◽  
Radiology Department ◽  
Access Pricing ◽  
Bundled Payments ◽  
Improve Patient ◽  
Procedure Room

Abstract Buffered lidocaine is a local anesthetic option during percutaneous needle-directed procedures in the breast. At our institution, sodium bicarbonate (the buffer) is dispensed in volumes that frequently lead to medical waste and shortages. In this study, we describe how moving the buffering of lidocaine from the procedure room to our clinical hospital pharmacy results in a reduction in costs and improves satisfaction across the breast radiology department. While cost savings are difficult to tease out in practices that opt for bundled payments, we were able to access pricing and supply data and coordinate with our pharmacy to change our practice. Making these changes saves our practice $26 000 a year and allows us to continue to offer buffered lidocaine even during sodium bicarbonate shortages. This manuscript describes how these changes came about and their economic impact.

scholarly journals Association between antimicrobial usage and resistance in Salmonella from poultry farms in Nigeria

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Abdurrahman Hassan Jibril ◽  
Iruka N. Okeke ◽  
Anders Dalsgaard ◽  
John Elmerdahl Olsen
Keyword(s):  
Treatment Outcome ◽  
Antimicrobial Resistance ◽  
Global Health ◽  
Human Medicine ◽  
Antimicrobial Use ◽  
Resistance Development ◽  
Use Patterns ◽  
Antimicrobial Usage ◽  
Poultry Farms ◽  
Reduction Strategies

Abstract Background Antimicrobial resistance (AMR) is a global health threat affecting treatment outcome in animals and humans. A pre-requisite for development of AMR reduction strategies is knowledge of antimicrobial use patterns, and how these affect resistance development. The aim of this study was to determine antimicrobial usage (AMU) and whether such usage was associated with AMR in Salmonella from poultry farms in Northwest Nigeria. Results Fifteen (37%) of antimicrobial products observed contained compounds that are of highest priority and critically important for human medicine. Broilers chicken consumed higher (28 ± 14 mg/kg active ingredients) amounts of antimicrobials compared to layers (13 ± 8 mg/kg) per week (p = 0.0009). Surprisingly, chickens raised under backyard system consumed higher amounts of antimicrobials (34 ± 7 mg/kg) than poultry in other systems (p = 0.02). High levels of resistance to tetracycline (58%), sulphonamides (65%), ciprofloxacin (46%) and gentamicin (42%) correlated with high farm level usage of these antimicrobials, and there was a strong correlation (r = 0.9) between farm usage and resistance of isolates to the same antimicrobials (p = 0.03). Conclusion High AMU, including use of highest priority critically important antimicrobials was observed at poultry farms in Northwest Nigeria. AMU correlated with high levels of resistance. Communication of prudent use of antimicrobials to farmers and regulation to obtain reduction in AMU should be a priority.

Influences on antimicrobial prescribing behaviour of veterinary practitioners in cattle practice in Ireland

2012 ◽  
Vol 172 (1) ◽  
pp. 14-14 ◽  
Author(s):  
J. F. Gibbons ◽  
F. Boland ◽  
J. F. Buckley ◽  
F. Butler ◽  
J. Egan ◽  
...  
Keyword(s):  
Antimicrobial Prescribing ◽  
Prescribing Behaviour

scholarly journals Evaluation of the Master of curriculum and science instruction  in Taibah University in the light of (CAEP) Standards: تقويم برنامج ماجستير مناهج وطرق تدريس العلوم بجامعة طيبة في ضوء معايير (CAEP)

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Rashdan Humaid Almatrafi, Sawsan Nasser Alahmadi
Keyword(s):  
Quality Assurance ◽  
Continuous Improvement ◽  
Science Instruction ◽  
Pedagogical Knowledge ◽  
Faculty Members ◽  
Master Program ◽  
Program Impact ◽  
Provider Quality ◽  
Research Population ◽  
Candidate Quality

This study aimed to evaluate the master program of curriculum and science instruction in Taibah University in the light of the standards of council for the accreditation of educator preparation (CAEP). To achieve that, the study applied a questionnaire on the research population that consisted of all the faculty members (7) in the curriculum and science instruction specialty. And all the students (7) in the curriculum and science instruction specialty. The questioner consisted of (32) items distributed on the (CAEP) five standards: Content and Pedagogical Knowledge, Clinical Partnerships and Practice, Candidate Quality and Selectivity, Program Impact, Provider Quality Assurance and Continuous Improvement. The results showed that (CAEP) standards are highly available in the program with an average of (3.46) where: Content and Pedagogical Knowledge comes first with an average of (3.67) then Candidate Quality and Selectivity (3.51), Program Impact (3.45), Clinical Partnerships and Practice (3.41), and they all were highly available. And in the last place Provider Quality Assurance and Continuous Improvement (3.08) with a medium availability in the program. And the results showed that There were no significant differences at the level of significance(α≤0.05) between the faculty members and students responds of (CAEP) standards availability in the program. The study recommended prepare the curriculum and science instruction specialty to import (CAEP) standards. and perform more studies about (CAEP) standards.

The impact of digital interventions on antimicrobial stewardship in hospitals: A qualitative synthesis of systematic reviews (Preprint)

2021 ◽  
Author(s):  
Bethany A Van Dort ◽  
Jonathan Penm ◽  
Angus Ritchie ◽  
Melissa T Baysari
Keyword(s):  
Systematic Reviews ◽  
Antimicrobial Stewardship ◽  
Digital Health ◽  
Hospital Setting ◽  
Antimicrobial Use ◽  
Qualitative Synthesis ◽  
Large Variability ◽  
Antimicrobial Prescribing ◽  
Digital Interventions ◽  
The Impact

BACKGROUND Antimicrobial stewardship (AMS) programs aim to optimize antimicrobial use by utilizing a suite of coordinated strategies. With the increased use of health information technology in hospitals, AMS processes that were traditionally paper-based are becoming computerized and streamlined. A number of reviews on digital interventions supporting AMS have been performed, so we performed a review of reviews to consolidate findings OBJECTIVE To provide a systematic overview and synthesis of evidence on the effectiveness of digital interventions to improve antimicrobial prescribing and monitoring in hospitals. METHODS Databases: Medline, Embase, Scopus, CINAHL and the Cochrane Database of Systematic Reviews were searched from 2010 onwards. Papers were eligible if they included studies that examined the effectiveness of digital health interventions related to antimicrobial prescribing and monitoring, in an inpatient hospital setting. Papers were excluded if they did not include a clearly defined search strategy, if they were limited to a pediatric setting, or they were not in English. RESULTS Seven systematic reviews were included for data extraction. Five reviews were of moderate quality and two of low quality. A large number of digital interventions were evaluated, with a strong focus on clinical decision support. There was a large variability in outcome measures used. Six reviews reported that digital interventions reduced antimicrobial use and improved antimicrobial appropriateness. The impact of digital interventions on clinical outcomes was inconsistent. CONCLUSIONS The results of this review indicate digital interventions, regardless of type, reduce antimicrobial use and improve antimicrobial appropriateness in hospitals. We recommend hospitals consider implementing one or more digital interventions to facilitate AMS programs.

scholarly journals Establishing a baseline for a national paediatric antimicrobial stewardship programme

2019 ◽  
Vol 74 (10) ◽  
pp. 3104-3110
Author(s):  
C L Gibbons ◽  
W Malcolm ◽  
J Sneddon ◽  
C Doherty ◽  
S Cairns ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Antimicrobial Use ◽  
Local Policy ◽  
Prevalence Survey ◽  
Antimicrobial Prescribing ◽  
Common Diagnosis ◽  
Acute Hospitals ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
National Prevalence

Abstract Background The majority of antimicrobial stewardship programmes focus on prescribing in adult populations; however, there is a recognized need for targeted paediatric antimicrobial stewardship to improve the quality and safety of prescribing amongst this patient group. Objectives To describe the current epidemiology of antimicrobial prescribing in paediatric inpatient populations in Scotland to establish a baseline of evidence and identify priority areas for quality improvement to support a national paediatric antimicrobial stewardship programme. Methods A total of 559 paediatric inpatients were surveyed during the Scottish national point prevalence survey of healthcare-associated infections and antimicrobial prescribing, 2016. The prevalence of antimicrobial prescribing was calculated and characteristics of antimicrobial prescribing were described as proportions and compared between specialist hospitals and paediatric wards in acute hospitals. Results Prevalence of antimicrobial use in paediatric inpatients was 35.4% (95% CI = 31.6%–39.4%). Treatment of community- and hospital-acquired infections accounted for 47.1% and 20.7% of antimicrobial use, respectively, with clinical sepsis being the most common diagnosis and gentamicin the most frequently prescribed antimicrobial for the treatment of infection. The reason for prescribing was documented in the notes for 86.5% of all prescriptions and, of those assessed for compliance against local policy, 92.9% were considered compliant. Conclusions Data from national prevalence surveys are advantageous when developing antimicrobial stewardship programmes. Results have highlighted differences in the prescribing landscape between paediatric inpatient populations in specialist hospitals and acute hospitals, and have informed priorities for the national antimicrobial stewardship programme, which reinforces the need for a targeted paediatric antimicrobial stewardship programme.

Home bowel preparation for elective colonic procedures in children: Cost savings with quality assurance and improvement

2000 ◽  
Vol 35 (2) ◽  
pp. 232-234 ◽  
Author(s):  
S.A. Engum ◽  
M.E. Carter ◽  
D. Murphy ◽  
F.M. Breckler ◽  
G. Schoonveld ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Bowel Preparation ◽  
Cost Savings
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