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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/checkpoint-tool.docx
June 01, 2021 - Directions: This tool is intended to help facilities with formulate and execute local antibiotic stewardship … Checkpoint Tool – Long-Term Care
AHRQ Safety Program for Improving Antibiotic Use
Name of Intervention
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/poster-8x11-UTI.pdf
June 01, 2021 - noncatheterized residents)
� Send a urinalysis (UA) & urine culture (UCx)
� Increase hydration
� Start antibiotics … resident appears ill
� If UA & UCx are positive and the resident has ongoing UTI symptoms,
modify antibiotics … or start antibiotics (if not receiving active antibiotics)
Signs & Symptoms of a UTI
Suspected … Development of minimum criteria for the
initiation of antibiotics in residents of long-term-care facilities
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/educational-bundles/urine-culturing/whento-order/urine-cultures.pptx
March 01, 2017 - , sediments
Inappropriate use of urine culture
Overinflated CAUTI rates
Inappropriate treatment and antibiotic … Urinalysis
Urine culture
Urinalysis and antibiotics
Culture and antibiotics
Nothing
Urine Culturing ׀ … At least, don’t send urine for urinalysis or culture
Definitely don’t start antibiotics! … Possible side effects of antibiotic use
Promote shared decision making
Urine Culturing ׀ 12
AHRQ SAFETY … familiar with SBAR, it can be a helpful tool to outline your conversation about urine cultures and antibiotic
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/implementation/imp_ssibundle.pptx
December 01, 2017 - for the antibiotic. … Why aren’t patients receiving appropriate redosing of antibiotics? … ASK:
Do providers understand that antibiotic A needs to be redosed every 4 hours or that antibiotic B … • Have antibiotics been given, if indicated? … · Have antibiotics been given, if indicated?
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P3T9-Sample_email_for_distribution_of_the_antibiogram_Phase_3.pdf
May 01, 2014 - This antibiogram
contains relevant antibiotic sensitivities aggregated across all residents from mm … Please
refer to this antibiogram when considering an antibiotic order for a [NURSING HOME NAME] resident
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4j_combo_psi13-sepsis-bestpractices.pdf
May 20, 2016 - Obtain blood cultures, administer antibiotics, measure serum
lactate, and manage fluid status for hypotension … Evaluate compliance by using process measures such as door-
to-antibiotic time; share reports regularly … Collect blood cultures before administration of the initial antibiotic. … Administer broad-spectrum antibiotics. … • Appropriate medications, including antibiotics and vasopressors.
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www.ahrq.gov/patient-safety/reports/engage/appe.html
March 01, 2017 - Antibiotic, opioid, and other medication overuse
Definition: The overuse of antibiotics and opioids … can pose long-term safety consequences for the individual as well as the community in terms of antibiotic
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/poster-4x6-UTI.pdf
June 01, 2021 - delirium is identified
� Send a urinalysis (UA) & urine culture (UCx)
� Increase hydration
� Start antibiotics … resident appears ill
� If UA & UCx are positive and the resident has ongoing UTI symptoms, modify
antibiotics … or start antibiotics (if not receiving active antibiotics)
Do NOT Send a Urinalysis and Urine … Development of minimum criteria for the initiation
of antibiotics in residents of long-term-care facilities
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/resources/guides/guide-infection-prevention.pdf
March 01, 2017 - Antibiotic Use and Resistance
KEY MESSAGES
▪ Antibiotics are medications that can save lives when … ▪ Used incorrectly, antibiotics can lead to antibiotic-resistant infections. … for antibiotics. … and overuse of antibiotics can also lead to antibiotic-resistant
organisms, which can threaten not … An antibiotic stewardship program is a coordinated program that promotes the appropriate
use of antibiotics
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/implementation/imp_ssibundle_facnotes.docx
December 01, 2017 - for the antibiotic. … Why aren’t patients receiving appropriate redosing of antibiotics? … No care provider is intentionally ignoring evidence about antibiotics and surgical site infections. … ASK:
Do providers understand that antibiotic A needs to be redosed every 4 hours or that antibiotic B … If antibiotics redosing is required, is the medication readily available?
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/onboarding/onboarding_ssi_investigation.pptx
December 01, 2017 - For example, one process measure is antibiotic redosing. … Onboarding
SAY:
One intervention involved appropriate and adequate skin preparation.
11
Prophylactic Antibiotics … Did the patient receive appropriate antibiotic selection, dosing, timing, and redosing? … measures Johns Hopkins Hospital focused on, because of frontline staff observations.
12
Prophylactic Antibiotics … Did the patient receive appropriate antibiotic selection, dosing, timing, and redosing?
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cap-toolkit/ed-workflowdiagrams.pdf
January 01, 2018 - No
ED Process for Patient with
Suspected CAP (Pre-
Implementation)
Prescription for
outpatient antibiotic … Patient with
Suspected CAP (Pre-Implementation)
with Data Elements
Prescription for
outpatient antibiotic … ED Process for Patient with
Suspected CAP (Post-
Implementation)
Prescription for
outpatient antibiotic
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www.ahrq.gov/research/findings/final-reports/stpra/stpraapa2.html
April 01, 2018 - arthroscopic surgery, the systematic administration of antibiotics before arthroscopy of the knee does … initial procedure was performed for a follow-up; superficial infections can be treated empirically with antibiotics … Treatment with 2 weeks of intravenous antibiotics was successful in all but one patient. … Intraarticular infection requiring drainage and antibiotics was reported in 95 cases (10.2% of all complications … in <90° of motion in 18 of the 95 cases
Once an infection is suspected, immediate drainage and IV antibiotics
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P3T8-Sample_Pocket_Card_Long_Version_Phase_3.doc
May 01, 2014 - cultures
· Enterococcus species: xx%
· Klebsiella pneumoniae: xx%
· Proteus mirabilis: xx%
· Not all antibiotics … are tested—one antibiotic from each class is usually tested. … It is reasonable to consider that similar antibiotics
have similar resistance patterns; for example … · Several commonly used antibiotics have significant resistance patterns to the gram-negative organisms
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/guide.html
March 01, 2017 - Appropriate antibiotic treatment of urinary tract infections is a key element of antibiotic stewardship … Treatment of ASB with antibiotics is one of the leading causes for antibiotic overuse in long-term care … . 12 , 13 Moreover, antibiotics can lead to resident harm, such as nausea, diarrhea, allergic reactions … , and antibiotic-related infections. 14 Antibiotics can also wipe out healthy bacteria that can lead … urine testing (urine cultures) is one strategy that can be used to decrease the inappropriate use of antibiotics
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/education-bundles/urine-culturing/when-to-order/cultures-slides.html
April 01, 2017 - Similarly, inappropriate ordering of urine cultures can lead to improper use of antibiotics. … Urinalysis
Urine culture
Urinalysis and antibiotics
Culture and antibiotics
Nothing
Slide … Definitely don't start antibiotics! … Alternatives to ordering cultures and using antibiotics. … Possible side effects of antibiotic use.
Promote shared decision making.
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0230-sepsis-antibiotics-technical-specs.pdf
August 01, 2014 - Sepesis or Septic Shock Technical Specifications
Q-METRIC Sepsis Measure 4, Timely Administration of Antibiotics … Sepsis and Septic Shock
U18HS020516 Page 50
Submitted August 2014
Sepsis
Measure 4: Timely Antibiotics … Parenteral
antibiotics
Administration of antibiotics via the intravenous, intramuscular or intraosseous … Antibiotics must be in one of the classes listed in Table 4-C. … OR
• Antibiotics administered OR
• Orders for urine, blood or spinal culture OR
• Urine, blood or
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/poster-commitment.docx
June 01, 2021 - the individuals you believe are important to indicate your institution’s commitment to prescribing antibiotics
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www.ahrq.gov/research/findings/final-reports/stpra/stpraexh9.html
April 01, 2018 - BMI <40)
Event 642 (0.2)
Fail to protect patient effectively (failure related to skin prep, antibiotics … Event 182 (0.2)
Fail to administer indicated antibiotics
Event 543 (0.0325)
SSI risk for … BMI <40)
Event 642 (0.2)
Fail to protect patient effectively (failure related to skin prep, antibiotics … Event 182 (0.2)
Fail to administer indicated antibiotics
Event 659 (0.18)
Glove puncture … Event 182 (0.2)
Fail to administer indicated antibiotics
Event 138 (0.15)
Fail to remove
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/commitment-poster-spanish.docx
September 01, 2022 - the individuals you believe are important to indicate your institution’s commitment to prescribing antibiotics