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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK3_T4-Letter_to_Prescribing_Clinicians.pdf
October 01, 2016 - Nursing Home
Antimicrobial Stewardship Guide
Determine Whether To Treat
Toolkit 3. Minimum Criteria for Common Infections Toolkit
Tool 4. Letter to Prescribing Clinicians on the Protocol for Three Common
Infections
PRINTED ON NURSING HOME OR MEDICAL DIRECTOR’S STATIONERY
[DATE]
[PRESCRIBING CLINICIAN…
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK3_T2b-SBAR_LRI_Final.pdf
June 01, 2014 - Advancing Excellence in Health Care www.ahrq.gov
Agency for Healthcare Research and Quality
HAIs
Healthcare-
Associated
Infections
PREVENT
Advancing Excellence in Health Care www.ahrq.gov
Agency for Healthcare Research and Quality
HAIs
Healthcare-
Associated
Infections
PREVENT
¨ No ¨ Yes Other active diagno…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK3_T2c-SBAR_SST_Final.pdf
June 01, 2014 - Advancing Excellence in Health Care www.ahrq.gov
Agency for Healthcare Research and Quality
HAIs
Healthcare-
Associated
Infections
PREVENT
Advancing Excellence in Health Care www.ahrq.gov
Agency for Healthcare Research and Quality
HAIs
Healthcare-
Associated
Infections
PREVENT
Date/Time _____________…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK1_T5-Sample_Policy_Letter_final.pdf
October 01, 2016 - Nursing Home
Antimicrobial Stewardship Guide
Help Clinicians Choose the Right Antibiotic
Toolkit 1. Working With a Lab To Improve Antibiotic Prescribing
[DATE]
Tool 5. Sample Policy Letter
[NAME OF NURSING HOME]
RE: Antibiogram Policy
[DATE]
Antibiotics are among the most commonly prescribed pharmaceuti…
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_T6-Using_Nursing_Home_Antibiograms_to_Choose_the_Right_Antibiotic_Data_Entry_Form.pdf
May 01, 2014 - Nursing Home Antimicrobial Stewardship Guide
Using Nursing Home Antibiograms To Choose the Right Antibiotic
Toolkit 2: Concise Antibiogram Toolkit
Tool 6: Excel Data Entry Form—Helpful Hints
Some Helpful Hints for using the spreadsheet template:
Add or delete antibiotics
If your laboratory does not test ag…
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P1T2-Prescribing_clinician_survey_Phase_1_final.pdf
May 01, 2014 - Nursing Home Readiness and Resource Assessment
Advancing Excellence in Health Care www.ahrq.gov
Agency for Healthcare Research and Quality
HAIs
Healthcare-
Associated
Infections
PREVENT
Comprehensive Antibiogram Toolkit: Phase 1
Prescribing Clinician Survey
[NURSING HOME NAME] is considering implementing an …
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T2-Antibiotic_Use_Tracking_Sheet_Final.pdf
October 01, 2016 - Nursing Home Antimicrobial Stewardship Guide
Toolkit 2. Monitor and Sustain Stewardship
Tool 2. Antibiotic Use Tracking Sheet [11x17 format]
Month:
Resident Name/Identifier
Room
#
Admit
Date
Admit
From
Onset
Date U
rin
ar
y
Tr
ac
t I
nf
ec
tio
n
R
es
pi
ra
to
ry
Sk
in
/S
of
t T
is
su…
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T2-Antibiotic_Use_Tracking_Sheet_Final.doc
October 01, 2016 - Nursing Home Antimicrobial Stewardship Guide
Toolkit 2. Monitor and Sustain Stewardship
Tool 2. Antibiotic Use Tracking Sheet [11x17 format]
Month:
Resident Name/Identifier
Room #
Admit Date
Admit From
Onset Date
Urinary Tract Infection
Respiratory
Skin/Soft Tissue
Gastrointestinal
Other Infection (Specify)…
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK2_T4-Common_Suspected_Infections_Tools_to_Improve_Communication_and_Decision_Making.ppt
May 01, 2014 - PowerPoint Presentation
Nursing Home Antimicrobial
Stewardship Guide
Determine Whether To Treat
Toolkit 2. Common Suspected Infections: Communication and Decision Making for
Four Infections
Tool 4. Tools To Improve Communication and Decision Making
www.ahrq.gov/NH-ASPGuide ● May 2014
AHRQ Pub. No. AHR…
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK1_T3-Sample_Letter_of_Agreement_final.docx
October 01, 2016 - Tool 3. Sample Letter of Agreement With a Laboratory
[DATE]
[NAME OF LABORATORY]
[ADDRESS OF LABORATORY]
RE: Preparing an Annual Antibiogram for [NURSING HOME NAME]
Dear [INSERT NAME]:
The [NURSING HOME NAME] is planning to use an annual antibiogram report as part of a quality initiative to improve the appropriate pre…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK1_T3-Sample_Letter_of_Agreement_final.pdf
October 01, 2016 - Nursing Home
Antimicrobial Stewardship Guide
Help Clinicians Choose the Right Antibiotic
Toolkit 1. Working With a Lab To Improve Antibiotic Prescribing
Tool 3. Sample Letter of Agreement With a Laboratory
[DATE]
[NAME OF LABORATORY]
[ADDRESS OF LABORATORY]
RE: Preparing an Annual Antibiogram for […
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK1_T6-Sample_Distribution_Plan_for_an_Antibiogram_final.docx
October 01, 2016 - Tool 6. Distribution Planning for an Antibiogram
A written plan for how the nursing home will distribute the antibiogram is very helpful. As staff members change, the written plan ensures that the antibiogram can still be properly prepared and distributed.
1. Establish procedures to provide the antibiogram as needed an…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_T1-Concise_Antibiogram_Toolkit_Background.pdf
May 01, 2014 - www.ahrq.gov/NH-ASPGuide ● May 2014 AHRQ Pub. No. 14-0012-1-EF
Concise Antibiogram Toolkit
Background
This toolkit is designed to guide nursing homes in creating their own antibiograms, an important
tool for guiding empiric antimicrobial therapy. Information about antibiograms and instructions
on how to…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_T6-Using_Nursing_Home_Antibiograms_to_Choose_the_Right_Antibiotic_Data_Entry_Form.xlsx
May 01, 2014 - Antibiotic_Susceptibilities
Resident ID Birthdate Sex Floor Room Bed Laboratory Used Culture ID Collection Date Source Organism Amikacin (AMK) Amoxicillin-Clavulanate (AMC) Ampicillin (AMP) Ampicillin-Sulbactam (SAM) Aztreonam (ATM) Cefazolin (CZO) Cefepime (FEP) Cefoxitin (FOX) Ceftazidime (CAZ) Ceftriaxone (CRO) Chl…
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_T6-Using_Nursing_Home_Antibiograms_to_Choose_the_Right_Antibiotic_Data_Entry_Form.docx
May 01, 2014 - Nursing Home Antimicrobial Stewardship Guide
Using Nursing Home Antibiograms To Choose the Right Antibiotic
Toolkit 2: Concise Antibiogram Toolkit
Tool 6: Excel Data Entry Form—Helpful Hints
Some Helpful Hints for using the spreadsheet template:
Add or delete antibiotics
If your laboratory does not test against a cer…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P4O-Comprehensive_Antibiogram_Toolkit_Phase_4_Monitoring.pdf
May 01, 2014 - Phase 4 Monitoring
Advancing Excellence in Health Care www.ahrq.gov
Agency for Healthcare Research and Quality HAIs
Healthcare-
Associated
Infections
PREVENT
Comprehensive Antibiogram Toolkit
Phase 4 Monitoring
It will be important to monitor the antibiogram program by (1) soliciting feedback from prescribin…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T3-Sample_Monthly_Summary_Reports_Final.pdf
October 01, 2016 - Nursing Home
Antimicrobial Stewardship Guide
Implement, Monitor, & Sustain a Program
Toolkit 2. Monitor and Sustain Stewardship
Tool 3. Sample Monthly Summary Reports
The monthly summary report can provide an overview of prescription rates as well as
information regarding a specific infection. The example…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T2-Antibiotic_Use_Tracking_Sheet_Final.xlsx
October 01, 2016 - Sheet1
Nursing Home Antimicrobial Stewardship Guide
Toolkit 2. Monitor and Sustain Stewardship
Tool 2. Antibiotic Use Tracking Sheet
Month:
Resident Name/Identifier Room # Admit Date Admit From Onset Date Urinary Tract Infection Respiratory Skin/Soft Tissue Gastrointestinal Other Infection (Specify) Signs & Sympt…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK2_T3-QI_Meetings_Tip_Sheet_final.docx
October 01, 2016 - Tool 3. QI Meetings Tip Sheet
Having a Quality Improvement (QI) Team and QI team meetings is important to successfully implement and oversee progress being made in relation to antibiotic use, infection control, and care practices related to communication with medical care providers (using the Medical Care Referral Form…
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK2_T3-QI_Meetings_Tip_Sheet_final.pdf
October 01, 2016 - Nursing Home
Antimicrobial Stewardship Guide
Determine Whether To Treat
Toolkit 2. Common Suspected Infections: Communication and
Decisionmaking for Four Infections
Tool 3. QI Meetings Tip Sheet
Having a Quality Improvement (QI) Team and QI team meetings is important to successfully implement
and oversee…