A Team Approach at MRMCKimberly E. Knox, RN, MHA, CIC

Focus of Presentation

Describing the efforts that one medical center made in establishing an antimicrobial stewardship program.

 

The Multidisciplinary TeamSue Otocki, Director of Pharmacy

Paula Flynn, Staff Pharmacist

Jen Schelin, Staff Pharmacist

Pharmacy studentsMaureen Harris, Microbiology Supervisor

Michael Newstein, MD, PhD, Infectious Disease Specialist

Erin Grenier, IPKim Knox, IP

The Team Implemented:Front end restrictionBack end restriction Retrospective review of drug orders

Formulary restrictionsAutomatic stop orders

The Team Implemented:ID consult requiredVerbal approvalIV to PO switchMonthly review of the following antimicrobials

per 1000 patient days at P&T and IP&C Committees:CiproInvanzLevaquinZosyn

Infectious Disease Specialist Attends Department of Medicine and

Surgery meetings to share information about:Antimicrobial stewardshipProton pump inhibitor use

Posts on the MRMC Intranet:Common Infectious Diseases and

Empiric Antibiotic Recommendations for Adult ER and Inpatients

Antibiogram

Proton Pump Inhibitor (PPI) Reduction

Recent FDA black box warning indicates that the use of PPI can increase an individual’s risk of acquiring CDI

What we are doing:Recommendations for discontinuing therapy

before or at the time of dischargeWorking with partnering SNFs to foster

appropriate PPI use for their residentsRecent review shows a reduction in patients

being discharged from MRMC on PPIsInformation was highlighted in the April 2012

Pharmacy Newsletter

C DIFF Reduction Partnership CollaborativeInformation is shared with our

community SNF by partners at monthly meetings including:Appropriate use of medicationCleaning techniquesNew technology or productsEducation for EOC staff

SCIPMRMC follows recommendations for SCIP antimicrobial prophylaxis for surgical procedures

IS, Nursing Informatics, Surgeons, Infectious Disease and IP&C worked together in developing CPOE to be compatible with our goals

May 2012MRMC Antibiotic Stewardship

pharmacists wonAmerinet Healthcare

Achievement Award for Financial and Operational

Improvement

Amerinet Healthcare Achievement Award

Amerinet Healthcare Achievement Award

The program that was implemented to decrease Zosyn usage

In one year, the program decreased our costs and usage

approximately sixty percent!

To highlight the importance of:•Implementing a multidisciplinary team in establishing an antimicrobial stewardship program•Developing multipronged communication efforts for distributing information