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Gary Evans writes Hospital Infection Control & Prevention (HIC), Hospital Employee Health (HEH) and contributes to IRB Advisor (IRB). As senior writer at AHC, Evans has written numerous articles on infectious disease threats to both patients and health care workers, including pandemic influenza, MERS and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.
The American Hospital Association (AHA) has created an antimicrobial stewardship toolkit and is joining with public health officials in making the issue a high priority as drugs continue to lose efficacy against a host of resistant pathogens.
“The toolkit is a collection of resources available for health care organizations, patients, and physicians to develop and maintain an antimicrobial stewardship program,” says John Combes, MD, senior vice president of AHA and president and chief operating officer of the Center for Healthcare Governance in Chicago, IL.
The toolkit is based on three basic antimicrobial stewardship principals, Combes says, including:.
1. Do not give antimicrobials when they’re not needed.
2. Give the appropriate amount at an appropriate time.
3. Give the right antimicrobials.
The toolkit’s main sections include a user guide that introduces the toolkit; a Centers for Disease Control & Prevention readiness checklist; a resource section for hospitals and health systems; clinician implementation guides and tools, and patient resource.
The eight-page toolkit is intended to be viewed electronically and contains links to additional tools and information. For example, the Checklist for Core Elements of Hospital Antibiotic Stewardship Programs, a four-page tool is available as a link.
“The toolkit has various components to help implement an antimicrobial stewardship program,” Combes says. “All organizations need to take the readiness assessment as a first step.”
The readiness assessment checklist includes questions such as these two:
* Does your facility have a formal, written statement of support from leadership that supports efforts to improve antibiotic use (antibiotic stewardship)?
* Does your facility receive any budgeted financial support for antibiotic stewardship activities (e.g., support for salary, training, or IT support)?
A next step is to follow the CDC’s implementation piece, a link to the 25-page “Core Elements of Hospital Antibiotic Stewardship Programs” piece. This summarizes the core elements of hospital antibiotic stewardship programs as containing these seven components:
1. Leadership commitment: including human, financial, and information technology;
2. Accountability: appointing one physician leader who is responsible for outcomes;
3. Drug expertise: appointing a pharmacist leader to work toward improving antibiotic use;
4. Action: implementing recommended actions;
5. Tracking: monitoring prescribing and resistance patterns;
6. Reporting: giving doctors and staff regular information on antibiotic use and resistance;
7. Education: discussing resistance and optimal prescribing with clinicians.