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ce.effectivehealthcare.ahrq.gov/research/findings/final-reports/ptflow/executive-summary.html
July 01, 2018 - Staff resistance
Staff education. … Staff resistance
Post-implementation adjustments reflecting user recommendations. … Staff resistance, culture change, and lack of staffing resources
Use of Lean quality improvement methods … Lack of staffing resources
Staff resistance
Robust data collection.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/pharyngitis-one-pager.pdf
September 01, 2022 - ‒ Penicillin resistance has not been documented in group A strep. … ‒ GAS resistance to both of these agents has been observed.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/ASB-UTI-facilitator-guide.pdf
November 01, 2019 - It is
important to know local resistance patterns for both of
these agents before using them, given … increasing
resistance particularly with trim/sulfa. … However, local E. coli resistance data must be
considered as these agents cannot be recommended
for … empiric therapy if resistance is seen in a large
proportion of isolates—some have proposed a cutoff … If trim/sulfa or
fluoroquinolones cannot be used because of resistance,
then consider converting to
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ce.effectivehealthcare.ahrq.gov/news/newsroom/press-releases/reduced-ltc-antibiotic-use.html
February 01, 2022 - evidence-based steps long-term care facilities can take to improve antibiotic use and reduce the risk of resistance … promoting the appropriate use of antibiotic medications to improve patient outcomes, reduce antibiotic resistance … medications is a significant public health challenge because overuse can enable organisms to develop a resistance
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ce.effectivehealthcare.ahrq.gov/teamstepps-program/curriculum/implement/activity/change.html
June 01, 2023 - Accept and plan for resistance. Resisters help to clarify the problem. … Exploring the reasons for resistance might surface a belief that current debriefs are relatively long … Use the following actions to overcome resistance to change:
Acknowledge change as a process. … Think about how to handle resistance. … How can you leverage your Change Team to strategize, plan, and control the impact of resistance?
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/shareddecisionmaking/success-stories/share_approach_success_story2_jmu.pdf
June 01, 2016 - “Antibiotic Resistance Questions and Answers.” http://www.cdc.gov/getsmart/community/about/
antibiotic-resistance-faqs.html … getsmart/week/downloads/gsw-factsheet-providers.pdf
http://www.cdc.gov/getsmart/community/about/antibiotic-resistance-faqs.html … http://www.cdc.gov/getsmart/community/about/antibiotic-resistance-faqs.html
3
AHRQ’s SHARE Approach
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P2T8-Sample_Antibiogram_Phase_2.doc
May 01, 2014 - 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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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P2T8-Sample_Antibiogram_Phase_2.pdf
May 01, 2014 - 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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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/mindfulness-061014.pptx
March 07, 2014 - Clinical Infectious Diseases 2008; 15:735-43
Antibiotic exposure increases the risks of resistance … Cipro Standard
Antibiotic duration 3 days 10 days
LOS ICU 9 days 15 days
Antibiotic resistance … antimicrobial stewardship programs
Optimize Patient Safety
Decrease or Control Costs
Reduce Resistance … for outcomes
Single pharmacy leader
Antibiotic use tracking
Regular reporting on antibiotic use and resistance … Educating providers on use and resistance
Specific improvement interventions
Interventions to Improve
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0230-section-5-table-4.pdf
January 01, 2014 - Furthermore, restricting use of antibiotics
to limit development of resistance or reduce cost
is not … Pathogen resistance patterns in the
hospital and community, along with hospital
protocols to limit … antibiotic resistance, also
should be taken into account. … However, to minimize the promotion of
antimicrobial resistance and cost and to maximize
efficacy, detailed
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK1_T6-Sample_Distribution_Plan_for_an_Antibiogram_final.pdf
October 01, 2016 - provide the clinician with a copy of the antibiogram and/or the
cautionary statement about antibiotic resistance … provide the clinician with a copy of the antibiogram and/or the cautionary statement about antibiotic resistance
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P3T8-Sample_Pocket_Card_Long_Version_Phase_3.doc
May 01, 2014 - 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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ce.effectivehealthcare.ahrq.gov/hai/cauti-tools/archived-webinars/mindfulness-slides.html
December 01, 2017 - Slide 9
Antibiotic Exposure Increases the Risks of Resistance
Pathogen and Antibiotic Exposure … Slide 16
Stewardship Optimizes Patient Safety: Decreased Patient-level Resistance
Image on left … Cipro
Standard
Antibiotic duration
3 days
10 days
LOS ICU
9 days
15 days
Antibiotic resistance … right duration
Slide 19
Goals of Antimicrobial Stewardship
Optimize Patient Safety
Reduce Resistance … Educating providers on use and resistance
Specific improvement interventions
Slide 25
Interventions
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ce.effectivehealthcare.ahrq.gov/hai/cauti-tools/archived-webinars/preventing-cauti-engaging-leadership-slides.html
December 01, 2017 - there are the most number of catheters
Slide 25
Start with a Plan
Anticipate barriers – nurse resistance … , physician resistance, patient/family requests for a catheter
Track performance (both processes and … where to begin, usually where there are the most number of catheters
Anticipate barriers – nurse resistance … , physician resistance, patient/family requests for a catheter
Track performance (both processes and … Substantial physician resistance?
Patient and family requests for a Foley?
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/sustainability/training-tools/training-tools-material-guide.docx
May 01, 2017 - Discuss team resistance to change and identify solutions to reduce resistance and help the project sustain
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/resources/tools/reduce/antibiotic-faqs.docx
March 01, 2017 - [endnoteRef:3] Overuse of antibiotics can lead to antimicrobial resistance, medication adverse events … Would it be useful for LTC facilities to assess local antibiotic resistance patterns in their facility … The best source for determining local antibiotic resistance patterns in your LTC facility is the laboratory
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/event-summary-details-maximizing-physician-buy-in.pdf
June 16, 2022 - There are multiple approaches that can be used to
address physician resistance to CR. … • Christine Bryant noted that the best way to address resistance is through education and to
expand … • Katelyn King highlighted the importance of leadership support in addressing physician
resistance … misunderstandings about the goals and outcomes, the overall leadership support has
helped to mitigate this resistance
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module8/module8-organizational-learning-sustainability.pptx
August 20, 2015 - Ultimately, the organization should develop a formal sustainability plan that can identify barriers or resistance … Manage skepticism and resistance.
Engage staff with stories.
Celebrate successes. … Manage barriers such as skepticism and resistance.
Engage staff with stories. … transparent feedback systems that continuously monitor performance metrics.
12
Manage Skepticism and Resistance … Leaders can also reinforce positive staff experiences from new processes to help overcome resistance
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/preventing-cauti-engaging-clinicians-051413.ppt
January 01, 2013 - , physician resistance, patient/family requests for a catheter
Track performance (both processes and … processes
Provide support from leadership for the efforts of the physician champion
*
Overcoming Resistance … , physician resistance, patient/family requests for a catheter
Track performance (both processes and … *
CAUTI GPS Questions
Have you experienced any of the following barriers:
Substantial nursing resistance … Substantial physician resistance?
Patient and family requests for a Foley?
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ce.effectivehealthcare.ahrq.gov/hai/tools/ambulatory-surgery/sections/sustainability/training-tools/slides.html
October 01, 2020 - Slide 16: Barrier: Individual Resistance to Change
Image: Using Roger's Diffusion of Innovations … to show individuals at different levels of adoption as the barrier of individual resistance to change … Rogers Diffusion of Innovations 1
Slide 17: Factors That Influence Individual Resistance or Adoption … Manage barriers to sustainability such as skepticism and resistance.
Engage staff with stories. … Manage Skepticism and Resistance
Active involvement of the administrative and clinical champions