scholarly journals Association of Inpatient Antimicrobial Utilization Measures with Antimicrobial Stewardship Activities and Facility Characteristics of Veterans Affairs Medical Centers

2017 ◽  
Vol 12 (5) ◽  
pp. 301-309 ◽  
Author(s):  
Christopher J Graber ◽  
Makoto M Jones ◽  
Ann F Chou ◽  
Yue Zhang ◽  
Matthew Bidwell Goetz ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Veterans Affairs ◽  
Medical Centers ◽  
Antimicrobial Utilization ◽  
Veterans Affairs Medical Centers

scholarly journals Inpatient Management of Uncomplicated Skin and Soft Tissue Infections in 34 Veterans Affairs Medical Centers: A Medication Use Evaluation

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Jesse D Sutton ◽  
Ronald Carico ◽  
Muriel Burk ◽  
Makoto M Jones ◽  
XiangMing Wei ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Medication Use ◽  
Antibiotic Use ◽  
Veterans Affairs ◽  
Soft Tissue Infections ◽  
Gram Negative ◽  
Medical Centers ◽  
Veterans Affairs Medical Centers

Abstract Background Skin and soft tissue infections (SSTIs) are a key antimicrobial stewardship target because they are a common infection in hospitalized patients, and non-guideline-concordant antibiotic use is frequent. To inform antimicrobial stewardship interventions, we evaluated the proportion of veterans hospitalized with SSTIs who received guideline-concordant empiric antibiotics or an appropriate total duration of antibiotics. Methods A retrospective medication use evaluation was performed in 34 Veterans Affairs Medical Centers between 2016 and 2017. Hospitalized patients who received antibiotics for uncomplicated SSTI were included. Exclusion criteria were complicated SSTI, severe immunosuppression, and antibiotics for any non-SSTI indication. Data were collected by manual chart review. The primary outcome was the proportion of patients receiving both guideline-concordant empiric antibiotics and appropriate treatment duration, defined as 5–10 days of antibiotics. Data were analyzed and reported using descriptive statistics. Results Of the 3890 patients manually evaluated for inclusion, 1828 patients met inclusion criteria. There were 1299 nonpurulent (71%) and 529 purulent SSTIs (29%). Overall, 250 patients (14%) received guideline-concordant empiric therapy and an appropriate duration. The most common reason for non-guideline-concordance was receipt of antibiotics targeting methicillin-resistant Staphylococcus aureus (MRSA) in 906 patients (70%) with a nonpurulent SSTI. Additionally, 819 patients (45%) received broad-spectrum Gram-negative coverage, and 860 patients (48%) received an antibiotic duration >10 days. Conclusions We identified 3 common opportunities to improve antibiotic use for patients hospitalized with uncomplicated SSTIs: use of anti-MRSA antibiotics in patients with nonpurulent SSTIs, use of broad-spectrum Gram-negative antibiotics, and prolonged durations of therapy.

A pilot study using telehealth to implement antimicrobial stewardship at two rural Veterans Affairs medical centers

2018 ◽  
Vol 39 (10) ◽  
pp. 1163-1169 ◽  
Author(s):  
Lauren D. Stevenson ◽  
Richard E. Banks ◽  
Krysttel C. Stryczek ◽  
Christopher J. Crnich ◽  
Emma M. Ide ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Pilot Study ◽  
Acute Care ◽  
Antimicrobial Stewardship ◽  
Veterans Affairs ◽  
Acceptance Rate ◽  
Term Care ◽  
Limited Access ◽  
Medical Centers ◽  
Veterans Affairs Medical Centers

AbstractObjectiveTo test the feasibility of using telehealth to support antimicrobial stewardship at Veterans Affairs medical centers (VAMCs) that have limited access to infectious disease-trained specialists.DesignA prospective quasi-experimental pilot study.SettingTwo rural VAMCs with acute-care and long-term care units.InterventionAt each intervention site, medical providers, pharmacists, infection preventionists, staff nurses, and off-site infectious disease physicians formed a videoconference antimicrobial stewardship team (VAST) that met weekly to discuss cases and antimicrobial stewardship-related education.MethodsDescriptive measures included fidelity of implementation, number of cases discussed, infectious syndromes, types of recommendations, and acceptance rate of recommendations made by the VAST. Qualitative results stemmed from semi-structured interviews with VAST participants at the intervention sites.ResultsEach site adapted the VAST to suit their local needs. On average, sites A and B discussed 3.5 and 3.1 cases per session, respectively. At site A, 98 of 140 cases (70%) were from the acute-care units; at site B, 59 of 119 cases (50%) were from the acute-care units. The most common clinical syndrome discussed was pneumonia or respiratory syndrome (41% and 35% for sites A and B, respectively). Providers implemented most VAST recommendations, with an acceptance rate of 73% (186 of 256 recommendations) and 65% (99 of 153 recommendations) at sites A and B, respectively. Qualitative results based on 24 interviews revealed that participants valued the multidisciplinary aspects of the VAST sessions and felt that it improved their antimicrobial stewardship efforts and patient care.ConclusionsThis pilot study has successfully demonstrated the feasibility of using telehealth to support antimicrobial stewardship at rural VAMCs with limited access to local infectious disease expertise.

Association of Hospital Employee Satisfaction with Patient Safety and Satisfaction within Veterans Affairs Medical Centers

2019 ◽  
Vol 132 (4) ◽  
pp. 530-534.e1 ◽  
Author(s):  
Ravinder Kang ◽  
Samuel T. Kunkel ◽  
Jesse A. Columbo ◽  
Philip P. Goodney ◽  
Sandra L. Wong
Keyword(s):  
Patient Safety ◽  
Employee Satisfaction ◽  
Veterans Affairs ◽  
Hospital Employee ◽  
Medical Centers ◽  
Veterans Affairs Medical Centers

GEOGRAPHIC VARIATION ACROSS VETERANS AFFAIRS MEDICAL CENTERS IN THE TREATMENT OF EARLY STAGE PROSTATE CANCER

2004 ◽  
Vol 172 (6 Part 1) ◽  
pp. 2362-2365 ◽  
Author(s):  
BENJAMIN A. SPENCER ◽  
CONSTANCE H. FUNG ◽  
MINGMING WANG ◽  
LISA V. RUBENSTEIN ◽  
MARK S. LITWIN
Keyword(s):  
Prostate Cancer ◽  
Geographic Variation ◽  
Early Stage ◽  
Veterans Affairs ◽  
Medical Centers ◽  
Veterans Affairs Medical Centers
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