The Centers for Disease Control and Prevention have identified a set of core elements necessary for the successful implementation of an antibiotic stewardship program in nursing homes. See the CDC's complete reference, download a printer-friendly version of Qualis Health's checklist, and use the suggestions for further assistance.
Nursing Home Antibiotic Stewardship Checklist |
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Corresponding Suggestions |
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Leadership Support |
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Our facility leadership: ✔
Documented their commitment to improve antibiotic use ✔
Monitors compliance with antibiotic stewardship policies ✔
Reviews antibiotic use and resistance data in quality assurance meetings Antibiotic stewardship duties are included in the position description of our: ✔
Medical director ✔
Director of nursing |
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Qualis Health See resources related to tracking and reporting data in the sections below. Other ways to demonstrate leadership commitment:
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Accountability |
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The following staff have been assigned as leads for antibiotic stewardship activities: |
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Consider creating an antibiotic stewardship accountability grid (see sample) to ensure clarity and complete coverage of the antibiotic activities. |
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The following antibiotic stewardship experts contribute to facility activities: |
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Consider asking your consulting pharmacist or stewardship consultant if s/he has earned certificates or educational units related to antibiotic or antimicrobial stewardship, such as those offered from: MAD-ID Society of Infectious Diseases Pharmacists
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Our facility: ✔
Requires prescribers to document a dose, duration, and indication for all antibiotics ✔
Monitors compliance with stewardship policies ✔
Reviews antibiotic agents listed on the medication formulary ✔
Utilizes a standard assessment and communication tool for residents suspected of having an infection ✔
Shares antibiotic use information with, or gathers information from, the other healthcare facility when a resident is transferred ✔
Conducts an antibiotic review process / “antibiotic time out” ✔
Implemented an infection-specific intervention to improve antibiotic use for these conditions:
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Developed reports summarizing the antibiotic susceptibility patterns (e.g., facility antibiogram) ✔
Other:
We have developed facility-specific: ✔
Algorithms for assessing suspected infections ✔
Algorithms for appropriate diagnostic testing (e.g., obtaining cultures) for specific infections ✔
Treatment recommendations for infections ✔
Other:
Our consultant pharmacist: ✔
Reviews antibiotic courses for appropriateness of administration and/or indication ✔
Establishes standards for clinical/laboratory monitoring for adverse drug events from antibiotic use ✔
Reviews microbiology culture data to assess and guide antibiotic selection ✔
Other:
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Qualis Health AHRQ AHRQ AHRQ CDC AHRQ AHRQ AHRQ AHRQ AHRQ AHRQ
AHRQ AHRQ |
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Tracking |
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Our facility monitors the following measures of antibiotic use: ✔
Adherence to clinical assessment documentation (signs/symptoms, vital signs, physical exam findings) ✔
Adherence to prescribing documentation (dose, duration, indication) ✔
Adherence to facility-specific treatment recommendations ✔
Point prevalence surveys of antibiotic use ✔
New antibiotic starts/1,000 resident-days ✔
Antibiotic days of therapy/1,000 resident-days ✔
Other:
Our facility monitors the following outcomes of antibiotic use: ✔
Rates of C. difficile infection ✔
Rates of antibiotic-resistant organisms ✔
Rates of adverse drug events due to antibiotics ✔
Other:
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AHRQ AHRQ National Nursing Home Quality Improvement Campaign West Virginia Department of Health and Human Resources Signs and symptoms of possible adverse drug event related to antibiotics (especially in residents with history of renal disease, concurrent course of medications that raise PT/INR or PTT, concurrent course of phenytoin, or concurrent course of other antibiotics):
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We give providers written feedback regarding their antibiotic prescribing We provide staff with reports that include the following facility-specific measures: ✔
Antibiotic use ✔
Outcomes related to antibiotic use (i.e., C. difficile rates) ✔
Antibiotic susceptibility patterns (within last 18 months) |
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AHRQ |
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Education |
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Our facility provides educational resources about antibiotic resistance and improved use to: ✔
Clinical providers (e.g., MDs, NPs, PAs, PharmDs) ✔
Nursing staff (e.g., RNs, LPNs, CNAs) ✔
Residents and families ✔
Other:
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AHRQ AHRQ CMS' QIO Program AHRQ EQuIP for LTC |
Download a printer-friendly version of this checklist.
Return to resource listing for our NHQCC Learning Session #2.