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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T1-Suggested_Agenda_for_Meeting_on_Monitoring_Final.docx
October 01, 2016 - Examples of simple measures: (1) the rate of antibiotic use (e.g., the number of fluoroquinolones used … Examples of moderately complex measures: (1) number of antibiotic prescriptions divided by the number … with prescribing criteria; or (2) Examine compliance with antibiogram (e.g., percentage of prescribed antibiotics … Examples: Percentage of antibiotic prescriptions, number of residents receiving antibiotics, number and
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/stewardship-slides.pptx
June 01, 2021 - for Improving Antibiotic Use
AHRQ Pub. … use protocols
Antibiotic stewardship policy
Antibiotic use
Dr. … use protocols
Antibiotic stewardship policy
Antibiotic use
Dr. … Development of minimum criteria for the initiation of antibiotics in residents of long-term-care facilities … Determine whether it is necessary to treat a potential infection with antibiotics. October 2016.
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/improve/sustain-facilitator-guide.pdf
November 01, 2019 - You could consider a pre-authorization
program in which clinicians request approval of
certain antibiotics … post-
prescription review with feedback program in
which you discuss the rationale for continued
antibiotics … clinicians in your facility
understand the importance of a daily time-out for
all patients receiving antibiotics … They
showed that their antibiotic stewardship program
achieved a 46 percent decrease in antibiotic … focused on antibiotic
overuse.
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/changing-system-slides.pptx
June 01, 2021 - No notification system
for when culture results
are available
No pharmacy alerts
for allergies to antibiotics … System
8
Case 1: continued
At the time of transfer, he is written for another 14-day course of oral antibiotics … He already received 3 days of antibiotics in the hospital.
His legs are improved but not better. … Introduce the Four Moments of Antibiotic Decision Making Form. … Guide for the Four Moments of Antibiotic Decision Making Form
Learning From Antibiotic-Associated Adverse
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T3-Sample_Monthly_Summary_Reports_Final.xlsx
October 01, 2016 - Sample Monthly Summary Reports
Month Number of Resident Days Number of Antibiotic Rx Number of Antibiotic … Rx divided by Number of Resident Days Number of Residents Receiving Antibiotics for UTI (incl. … No. 17-0006-2-EF
October 2016
Summary ABX in use
Month [Antibiotic name] [Antibiotic name … ] [Antibiotic name] [Antibiotic name] [Antibiotic name] [Antibiotic name] [Antibiotic name]
Jan In each
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www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/hais/index.html
June 01, 2018 - Antibiotic Prescribing and Use in Hospitals and Long-Term care
Features strategies to help hospitals … and other inpatient facilities implement interventions to improve antibiotic use. … Be Antibiotics Aware
Features information on appropriate antibiotic use. … Society of America (IDSA)
Provides resources on reducing antimicrobial resistance and the need for new antibiotics … Be Antibiotics Aware
Features information on appropriate antibiotic use.
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www.ahrq.gov/hai/cauti-tools/phys-championsgd/section3.html
October 01, 2015 - The patient was started on intravenous antibiotics, then switched to oral antibiotics, and eventually … The patient was readmitted to the hospital and started on intravenous antibiotics again. … The patient cleared his bacteremia with antibiotics and was discharged home to finish his treatment. … She was diagnosed with a CAUTI and associated septicemia and was treated with intravenous antibiotics … The patient was treated with two antibiotics targeting Pseudomonas species, but continued to deteriorate
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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/sites/default/files/wysiwyg/hai/tools/surgery/44-sample-pathway-checklist.docx
June 01, 2023 - · Yes
· No
· N/A
Oral antibiotics completed at home (for procedures with planned bowel resection)? … · Yes
· No
· N/A
Preoperative antibiotics administered within 1 hour of presentation for emergency … thromboembolism
[Procedure] Pathway Checklist: INTRAOPERATIVE AREA
Yes/No
INTRAOPERATIVE AREA
· Yes
· No
Antibiotic … [Fill in prophylactic antibiotics in your pathway]
· Yes
· No
Alcohol-based skin preparation applied … Date:
Time:
If no, note reason:
· Yes
· No
Postoperative antibiotics administered for emergency
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/DESC-technique.pdf
June 01, 2021 - like herself
today, and the last time this happened, someone told you she had a UTI and
gave her antibiotics … I am concerned that the risks of another course of antibiotics outweigh the potential
benefits. … DESC Technique
for Conflict With Residents and Families
I do not want to give her an antibiotic if
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www.ahrq.gov/patient-safety/settings/long-term-care/index.html
September 01, 2021 - Antimicrobial Stewardship Modules are field-tested, evidence-based modules that can help nursing homes develop antibiotic … stewardship programs to help them use and prescribe antibiotics appropriately. … Appropriate antibiotics use can reduce antimicrobial resistance and help retain the effectiveness of … Toolkit To Improve Antibiotic Use in Long-Term Care helps nursing homes improve antibiotic stewardship
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/assess-resident-UTI-slides.pptx
June 01, 2021 - Resident With a Suspected Urinary Tract Infection
Long-Term Care
AHRQ Safety Program for Improving Antibiotic … No. 17(21)-0029
June 2021
AHRQ Safety Program for Improving Antibiotic Use – Long-Term Care
Assessment … Mary Ann is feeling well
Temperature is 98.1oF
She is happy she was not exposed to any unnecessary antibiotics … Start a different antibiotic.
Send her to a urologist.
Examine the resident. … does not work, rather than try “better” antibiotics, consider other reasons for the resident’s signs
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK3_T2c-SBAR_SST_Final.pdf
June 01, 2014 - __________________________________
¨ No ¨ Yes Advance directives for limiting treatment related to antibiotics … The criteria are met to initiate antibiotics if one of situations below are met
No Yes
¨¨ ¨ 1. … The resident may have a skin and soft tissue infection and
need a prescription for an antibiotic agent … The resident does NOT need an immediate
prescription for an antibiotic, but may need additional observation … Antibiotic 1 __________________________________ Dose ________ Route ________ Duration ________
Antibiotic
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www.ahrq.gov/antibiotic-use/ambulatory-care/improve/index.html
October 01, 2022 - to promote antibiotic stewardship is necessary to optimize antibiotic prescribing in ambulatory practices … Practice” and “Sustaining Antibiotic Stewardship Efforts” are more pertinent for the Antibiotic Stewardship … Practice Around Antibiotic Decisions
Sustaining Antibiotic Stewardship Efforts
Tools
The … Accessing and Reporting Antibiotic Prescription Data details how to obtain antibiotic prescribing data … Antibiotic Stewardship in Ambulatory Care (DOCX, 403 KB)
Gap Analysis Tool for Antibiotic Stewardship
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/guides/infection-prevent.html
March 01, 2017 - Return to the Contents
Antibiotic Use and Resistance
Key Messages
Antibiotics are medications … Used incorrectly, antibiotics can lead to antibiotic-resistant infections. … for antibiotics. … overuse of antibiotics can also lead to antibiotic-resistant organisms, which can threaten not only … 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/policymakers/chipra/factsheets/chipra-1416-p007-1-ef.pdf
November 01, 2015 - Timeliness of Confirmatory Testing for Sickle Cell Disease: Timeliness of Antibiotic Prophylaxis for … a
newborn screen
positive for sickle cell
anemia who received
appropriate preventive
antibiotic … Prompt
initiation and consistent use of antibiotics in young children with sickle cell anemia increases … sickle cell
anemia be started on twice-daily penicillin as early as possible and remain on preventive antibiotics … Prophylactic antibiotics for preventing pneumococcal infection in children with sickle cell disease.
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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
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/146-gap-analysis-surgical-services.pdf
April 01, 2025 - Are results available in time to guide decision making about antibiotic prophylaxis? … Does the facility have a protocol for the addition of vancomycin to pre-procedure antibiotic prophylaxis … Yes, Antibiotic Stewardship monitors compliance.
No, compliance is not monitored.
34. … Does the facility have a protocol in place to ensure perioperative antibiotic prophylaxis is stopped … Yes, Antibiotic Stewardship monitors compliance.
No, compliance is not monitored.
40.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/132-gap-analysis-hospital-level.pdf
April 01, 2025 - review
Electronic algorithms to detect patients who may have an SSI (e.g., readmission, receipt of antibiotics … review
Electronic algorithms to detect patients who may have an SSI (e.g., readmission, receipt of antibiotics … review
Electronic algorithms to detect patients who may have an SSI (e.g., readmission, receipt of antibiotics … review
Electronic algorithms to detect patients who may have an SSI (e.g., readmission, receipt of antibiotics … review
Electronic algorithms to detect patients who may have an SSI (e.g., readmission, receipt of antibiotics
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK1_T4-Antibiogram_Formats_and_Instructions_final.pdf
October 01, 2016 - clinicians, the medical director can
review the antibiogram and create a statement regarding which antibiotics … Antibiograms have been shown to improve the appropriate use of antibiotics by providing the
actual susceptibilities … The remaining columns of the
antibiogram are the antibiotics that were tested and the organisms’ susceptibilities … Toolkit 1/Tool 4 5
Sample cautionary statement regarding antibiotic resistance
CAUTION: Antibiotic … We recommend avoiding these antibiotics for empiric usage.