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www.ahrq.gov/news/toolkit-improve-antibiotic-prescribing.html
July 01, 2021 - New Toolkit To Help Long-Term Care Facilities Improve Antibiotic Prescribing
AHRQ's new Toolkit … To Improve Antibiotic Use in Long-Term Care offers a step-by-step approach to help facilities start … or revitalize an antibiotic stewardship program. … to help prescribers make decisions about antibiotic therapy. … stewardship teams to ensure antibiotics are used judiciously to prevent harm and keep residents safe
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www.ahrq.gov/nhguide/index.html
Home Antimicrobial Stewardship Guide provides toolkits to help nursing homes optimize their use of antibiotics … Choose the Right Antibiotic
Three toolkits describe how to work with a lab and use an antibiogram. … Toolkits
The toolkits cover a variety of interventions that nursing homes can use to improve antibiotic … Antimicrobial Stewardship Program
Determine Whether It Is Necessary To Treat a Potential Infection With Antibiotics … Help Prescribing Clinicians Choose the Right Antibiotic
Educate and Engage Residents and
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/CDI-facilitator-guide.pdf
November 01, 2019 - Moment 2: Have I ordered appropriate cultures before
starting antibiotics? … Can I stop
antibiotics? Can I narrow therapy or change from
intravenous to oral therapy? … “Does my patient have
an infection that requires antibiotics?” … It may not occur
immediately after discontinuing antibiotics. … Slide 21
Clostridioides difficile and Antibiotics
SAY:
Virtually all antibiotics can increase
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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/long-term-care/one-pager-COPD.pdf
June 02, 2021 - associated with COPD exacerbations and are usually limited to residents with COPD who
have had extensive antibiotic … to prescribing antibiotics to residents with mild COPD
exacerbations.2
• Empiric treatment1,2
− … Exacerbations
AHRQ Safety Program for Improving Antibiotic … Antibiotic
prescribing choices and their comparative C. difficile
infection risks: a longitudinal case-cohort … Prophylactic
antibiotic therapy for chronic obstructive pulmonary
disease (COPD).
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www.ahrq.gov/research/findings/final-reports/ssi/ssiexh7.html
April 01, 2018 - Surgery
Description
CABG
Presence of both postoperative culture and postoperative antibiotics … 67.3
Absence of a postoperative culture and one of the following criteria:
Postoperative antibiotics … given and any postoperative leukocyte count test drawn
Postoperative antibiotics not given, but the … count is not less than 9.45
THA
Presence of a postoperative culture and postoperative antibiotics
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www.ahrq.gov/sites/default/files/publications/files/cdifftoolkit.pdf
September 01, 2012 - The goal of this focused case-
control study is to identify the antibiotics or antibiotic classes most … The strengths and weaknesses of the four
main types of antibiotic data (purchasing, orders, antibiotics … If the
shift is to a more narrow antibiotic, an oral antibiotic regimen, or no antibiotics, the patient … /Class
(strength of
association)
Review of Aggregate
Antibiotic Use for
Each Class of
Antibiotics … patients where antibiotic order form
was used, e.g., to continue or stop
antibiotics
Total number
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/assess-resident-RTI-slides.pptx
June 01, 2021 - Resident With a Suspected Respiratory Tract Infection
Long-Term Care
AHRQ Safety Program for Improving Antibiotic … Bordetella is the only one of these that requires antibiotic treatment.3
‹#›
Assessment of RTI
12 … His daughter asks you for some antibiotics to make her dad’s cough go away. … Antibiotics are great at making coughs go away. … He has bacterial pneumonia and needs antibiotics.
Case 3: Peter, Diagnosis?
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www.ahrq.gov/antibiotic-use/long-term-care/improve/discuss-concerns.html
June 01, 2021 - About Residents
Effective communication may help residents and family members requesting antibiotics … understand that there are potential risks associated with antibiotic use. … Poster – Talking With Residents and Family Members About Antibiotics (PDF, 216.3 KB)
Poster – Talking
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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/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/mindfulness-061014.pptx
March 07, 2014 - Yes
No
Why We Have to Improve Antibiotic Use
Antibiotics are unlike any other drug, in that the use … We are running out of antibiotics.
We won’t get new ones soon. … departments for adverse events attributed to antibiotics.
1. … It’s to ensure that there are systems and support to help every provider use antibiotics optimally. … Overuse
Hospitalized patients are ill
Early, appropriate antibiotics are life saving
“Chagrin” factor
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P2T8-Sample_Antibiogram_Phase_2.pdf
May 01, 2014 - Name/Clinical Laboratory Name
Antibiogram for dd/mm/yyyy to dd/mm/yyyy
Gram Negative Gram Positive
Antibiotic … The antibiograms will be
most applicable when selecting antibiotics to treat urine infections and systemic … One antibiotic from each class is usually tested. … Antibiotics from the same
class are likely to have similar resistance patterns, for example with cephalosporins … • Significant resistance to commonly used antibiotics is seen among the gram-negative organisms that
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P2T8-Sample_Antibiogram_Phase_2.doc
May 01, 2014 - Laboratory Name
Antibiogram for dd/mm/yyyy to dd/mm/yyyy
Gram Negative
Gram Positive
Antibiotic … The antibiograms will be most applicable when selecting antibiotics to treat urine infections and systemic … One antibiotic from each class is usually tested. … Antibiotics from the same class are likely to have similar resistance patterns, for example with cephalosporins … · Significant resistance to commonly used antibiotics is seen among the gram-negative organisms that
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www.ahrq.gov/antibiotic-use/long-term-care/best-practices/posters.html
June 01, 2021 - Minimum Criteria for Initiation of Antibiotics for Suspected UTI, and When To Send a Urinalysis and Urine … Culture (8 x 11, one-sided) (PDF, 202.3 KB)
Minimum Criteria for Initiation of Antibiotics for Suspected
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www.ahrq.gov/downloads/monahrq/xls/MONAHRQ_v3_MeasureList.xls
June 16, 2012 - outpatient surgery Y 3.0
OP-7 Prophylactic Antibiotic Selection for Surgical Patients Patients who … Advice to stop smoking Y 2.0
PN-5C Patients Given Initial Antibiotic(s) within 6 Hours After Arrival … Initial Antibiotic Right antibiotics given Y 2.0
PN-7 Pneumonia Patients Assessed and Given Influenza … lower blood pressure given (if needed) Y 2.0
SCIP-INF-1 Surgery Patients Who Received Preventative Antibiotic … Who Received the Appropriate Preventative Antibiotic(s) for Their Surgery Right antibiotics given Y
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/asp-pneumonitis-one-page.pdf
November 01, 2019 - cultures should be considered when the diagnosis is unclear, if
purulent sputum is being produced, or if antibiotic … Treatment
• Hemodynamically stable patients with aspiration events
o Antibiotics are not warranted … o Prophylactic antibiotics have not been shown to be helpful in preventing the development
of pneumonia … If clincial symptoms resolve, antibiotics can be discontinued. … no improvement or there is clinical worsening within the first 48–72 hours,
consider a course of antibiotic
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www.ahrq.gov/antibiotic-use/acute-care/safety/index.html
June 01, 2021 - the benefits and risks of antibiotic use and be engaged in reducing harm associated with antibiotic … Teamwork Around Antibiotic Decision Making
Identifying Targets for Improvement in Antibiotic Decision … Around Antibiotic Prescribing
Tools
The tools below are designed to be used to assist the Antibiotic … prescribing and takes action when harm related to antibiotics is detected. … Antibiotic Use Commitment Poster (DOCX)
Antibiotic Time Out Tool (DOCX)
Identifying Antibiotic–Associated
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/ASB-UTI-slides.pptx
November 01, 2019 - have an infection that requires antibiotics? … Have I ordered appropriate cultures before starting antibiotics? … Decision Making
Does my patient have an infection that requires antibiotics? … requires antibiotics? … Have I ordered appropriate cultures before starting antibiotics?
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_T4-Concise_Antibiogram_Toolkit_How_to_Enter_Data_Manually_into_an_Antibiogram_Template.doc
May 01, 2014 - (%) susceptibilities based on 20 isolates should still give a general idea of how effective various antibiotics … Only include percent (%) susceptibilities for antibiotics where at least 70 percent of the isolates were … Different isolates of an organism are not always tested for susceptibilities to the exact same antibiotics … Because of this uncertainty, we recommend you only include percent (%) susceptibilities for antibiotics … So, in the example, percent (%) susceptibilities for antibiotics which about 20 or more E. coli isolates
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www.ahrq.gov/es/hai/patient-safety-resources/advances-in-hai/hai-article6.html
June 01, 2014 - The Institute of Medicine has prioritized decreasing the inappropriate use of antibiotics as one of the … use. 4,5 The Institute of Medicine has prioritized decreasing the inappropriate use of antibiotics … is the “safest” strategy; (5) time necessary for the provider to explain why antibiotics are not indicated … Parents' and physicians' views on antibiotics. Pediatrics 1997 Jun;99(6):E6. … Delayed antibiotics for respiratory infections.