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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/008-antibiotic-stewardship-slides.pptx
October 01, 2022 - About Antibiotic Use
Although antibiotics have saved countless lives, their use is not benign or risk … Antibiotics
Fluoroquinolones9
Other commonly prescribed antibiotics (e.g., ceftriaxone, cefepime, piperacillin … requires antibiotics? … Have I ordered appropriate cultures before starting antibiotics? … Can I stop antibiotics? Can I narrow therapy or change from IV to oral therapy?
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/safety/changes-slides.pptx
November 01, 2019 - Decision Making
Does my patient have an infection that requires antibiotics? … Have I ordered appropriate cultures before starting antibiotics? … Can I stop antibiotics? Can I narrow therapy or change from IV to oral therapy? … Decision Making
Defect Issue Moment
Patient remained on IV antibiotics for duration of hospitalization … Antibiotics could have been changed from IV to PO once clinical improvement and ability to tolerate
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www.ahrq.gov/nhguide/toolkits/implement-monitor-sustain-program/toolkit2-monitor-sustain-program.html
October 01, 2016 - Doctors in the experimental group received an antibiotic guide and a copy of their antibiotic prescribing … Monitoring antibiotic use helps a nursing home assess progress in utilizing the right antibiotics and … avoiding unnecessary antibiotics. … For example, each team will need to consider how to report on residents who receive antibiotics more … Is there decreased use of particular antibiotics that may be of concern (e.g., fluoroquinolones)?
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/sepsis-slides.pptx
November 01, 2019 - infection that requires antibiotics? … for Improving Antibiotic Use – Acute Care
Sepsis
Sepsis: Antibiotic Timing
Antibiotics should be … infection that requires antibiotics? … .
21
AHRQ Safety Program for Improving Antibiotic Use – Acute Care
Sepsis
Narrowing Antibiotics … have an infection that requires antibiotics?
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/gastro-slides.pptx
November 01, 2019 - 4
The Four Moments of Antibiotic Decision Making
Does my patient have an infection that requires antibiotics … antibiotics? … 18
The Four Moments of Antibiotic Decision Making
Does my patient have an infection that requires antibiotics … courses into
practice
Order sets with preset antibiotic durations
Evaluation of need for oral antibiotics … cultures are obtained and source control followed by a short course of antibiotics
Avoid prolonged antibiotic
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/improve/behavior-change-slides.pptx
November 01, 2019 - Around Antibiotic Prescribing
Acute Care
AHRQ Safety Program for Improving
Antibiotic Use
AHRQ Pub. … antibiotics. … – Antibiotic Prescribing
7
Drivers of Suboptimal Antibiotic Prescribing
Fear of inadequate antibiotic … Behavior Changes – Antibiotic Prescribing
11
Antibiotics Are Our Parrot
St. … broad empiric coverage
Are worried about stopping MRSA or Pseudomonas coverage
Want to keep antibiotics
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/allergies-slides.pptx
September 01, 2022 - antibiotics
Recognize types of reactions to antibiotics commonly prescribed in the outpatient setting … reports an allergy to penicillin
95% of people who report a penicillin allergy can tolerate beta-lactam antibiotics … antibiotics are more likely to receive an alternative, broader spectrum antibiotic that:
Is less effective … Palpable purpura
Joint pain
Urticaria
Lymphadenopathy
Fevers
Most commonly occur after several days of antibiotics … DRESS syndrome
Nonsevere reactions
Maculopapular/morbilliform rash
Generally occur days to weeks after antibiotics
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/improve/program-part2-slides.pptx
November 01, 2019 - antibiotics
Optimizes empiric antibiotic choices
Gives opportunity to advise about sending appropriate … antibiotics
Optimizes empiric antibiotic choices
Gives opportunity to advise about sending appropriate … antibiotics
Optimizes empiric antibiotic choices
Gives opportunity to advise about sending appropriate … Con
Providers or clinical teams review their patients who are receiving antibiotics to determine if … the antibiotics are truly needed or if they could be modified Engages frontline clinicians/teams to
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www.ahrq.gov/antibiotic-use/long-term-care/improve/communicate-prescribers.html
June 01, 2021 - Communicating Infectious Concerns With Antibiotic Prescribers
After viewing or presenting this … Recognize that SBAR can support the role of nurses as advocates for antibiotic stewardship. … Communicating Infectious Concerns With Antibiotic Prescribers – Slides (PPTX, 11 MB)
Communicating … Infectious Concerns With Antibiotic Prescribers – Facilitator Guide (DOCX, 3 MB)
Communicating … Infectious Concerns With Antibiotic Prescribers – Video (21 minutes)
The link below is intended
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/sustainability-plan.pdf
June 01, 2021 - for all residents receiving antibiotics to ensure that a
discussion happens for the ongoing need for … antibiotics. … antibiotics should become familiar with the educational toolkit. … The
Antibiotic Stewardship Team should monitor the use of antibiotics and Clostridioides difficile rates … readmission rates or the number of residents given antibiotics for asymptomatic bacteriuria.
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www.ahrq.gov/antibiotic-use/long-term-care/four-moments/review-form.html
June 01, 2021 - The Four Moments of Antibiotic Decision Making Form
A facility's antibiotic stewardship team … is encouraged to use Four Moments of Antibiotic Decision Making Form to review 5–10 residents each month … The Four Moments of Antibiotic Decision Making Form (PDF, 319 KB)
Completion Guide for the Four Moments … of Antibiotic Decision Making Form (PDF, 265.3 KB)
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/tracking-measuring-data-facilitator-guide.docx
June 01, 2021 - AHRQ Safety Program for Improving Antibiotic Use
Tracking and Measuring Antibiotic Use Data
Long-Term … It is useful to look at individual antibiotics as well as the combined total of all antibiotics. … This is the number of new prescriptions for each antibiotic and for all antibiotics. … Note that new admissions already on antibiotics should be counted as an antibiotic start. … If a resident receives two different antibiotics, count each as a start.
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/VAP-slides.pptx
November 01, 2019 - Does my patient have an infection that requires antibiotics?
2. … Have I ordered appropriate cultures before starting antibiotics? … Does my patient have an infection that requires antibiotics? … Does my patient have an infection that requires antibiotics?
2. … Have I ordered appropriate cultures before starting antibiotics?
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/four-moments-questions.pdf
June 01, 2021 - Four Moments of Antibiotic Decision Making in Long Term Care_Questions
The Four Moments of
Antibiotic … Have we collected appropriate
cultures before starting
antibiotics? … Moment 3
Length of Therapy
What duration of antibiotic
therapy is needed for the
resident’s diagnosis … Most bacterial infections need 7 days or less
of antibiotics:
• Urinary tract infection (3 to 7 days … •Can we stop antibiotics?
•Can we narrow therapy?
•Can we change from intravenous to oral
therapy?
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/program-dev-facilitator-guide.docx
June 01, 2021 - The use of antibiotics is not without consequences. … This is one of the most distressing features of antibiotics. … You meet with your antibiotic stewardship team to brainstorm problems related to antibiotics in your … At this point, she has been on antibiotics for 8 days. … · Length of therapy
· Cost of antibiotics
· Use of guideline-concordant antibiotics
· Clostridioides
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www.ahrq.gov/antibiotic-use/long-term-care/safety/teamwork.html
June 01, 2021 - viewers will be able to—
Recognize the importance of seeking input from all team members when making antibiotic … change; A ssessment or appearance; and R equest for action), to improve communication related to antibiotic … Describe how to effectively communicate the potential harms of antibiotics to other health care practitioners … Communication – Facilitator Guide (DOCX, 2.2 MB)
Poster – Talking With Residents and Family Members About Antibiotics
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/respiratory-facilitator-guide.pdf
November 01, 2019 - As I have
more clinical and microbiologic data available can I stop
antibiotics, can I narrow antibiotics … , or can I change
from intravenous to oral antibiotics? … have an infection that requires antibiotics?” … for
the continued need for antibiotics is needed. … can be treated for a 5-day course of
antibiotics.
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/HAP-slides.pptx
November 01, 2019 - of Antibiotic Decision Making
Does my patient have an infection that requires antibiotics? … Have I ordered appropriate cultures before starting antibiotics? … that requires antibiotics? … that requires antibiotics? … that requires antibiotics?
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/intervention-worksheet.pdf
June 01, 2021 - stewardship interventions can occur before antibiotics are prescribed (pre-prescription
interventions … ) and after antibiotics have been started (post-prescription interventions) … started AND to reassess the need for continued antibiotics
after they are started … of antibiotic therapy
Use of guideline-concordant antibiotics
Clostridioides difficile LabID events … • Pocket cards distributed to staff indicating
minimum criteria for starting antibiotics.
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/penicillin-allergy.pdf
June 01, 2021 - Consider a different beta-lactam
antibiotic or medication to help with symptoms if the same antibiotic … require hospitalization should be
evaluated by an allergy specialist before considering beta-lactam antibiotics … High risk These residents should NOT receive penicillin or other beta-lactam antibiotics in the absence … diarrhea)
� Headache
� Itching without rash
� Yeast infection
Laboratory abnormality
related to antibiotics … evidence supporting
the American Academy of Pediatrics
recommendation for prescribing cephalosporin
antibiotics