new jersey antimicrobial stewardship learning action
TRANSCRIPT
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NewJerseyAntimicrobialStewardshipLearning
ActionCollaborativeUpdate
May10,2017
AntimicrobialStewardshipEffortsinNewJersey
AcuteCareHospitals
LongTermCareFacilities
OutpatientSettings(ED,physicianpractices)
Source:PfPpacingevent,Sept,2016
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ReduceHarmAcrosstheBoard• Supporthospitalstoworkonall11coreareasofharm
– Adversedrugevents(ADE),tofocusonatleastthefollowingthreemedicationcategories:opioids,anticoagulantsandhypoglycemicagent
– Centralline-associatedbloodstreaminfections(CLABSI)
– Catheter-associatedurinarytractinfections(CAUTI)
– Clostridiumdifficile(C.diff)bacterialinfection,includingantibioticstewardship
– Injuryfromfallsandimmobility
– PressureUlcers
– SepsisandSepticShock
– SurgicalSiteInfections(SSI)
– Venousthromboembolism(VTE)
– Ventilator-AssociatedEvents(VAE)
– Readmissions
CollaborativeLeadership
AdministrativeLeadership:NJHAInstituteforQualityandPatientSafety• AlineHolmes,DNP,MSN,RN• ShannonDavila,MSN,RN,CIC,CPHQ
• LaurenRava,MPP
ClinicalLeadership:KennedyHealthcare• CindyHou,DO,MBA,FACOI• MarianneKraemer,RN,MPA,ED.M.,CCRN
• DavidCondoluci,DO,MSc.,andMACOI
Partners• NewJerseyDepartmentofHealth
• QIO- HealthcareQualityStrategiesInc.
• CDC• ErnestMarioSchoolofPharmacy• RonaldGNahass,MD,MHCM–PresidentIDCare
• QualityInsightsRenalNetwork3• NewJerseyAPICchapters• AlexT.Makris,MD,CMD
CollaborativeMission
Topromotetheuseoftheappropriateagent,dose,duration,androuteofadministrationofantimicrobialagentsacrossthecontinuumofcaretoimprovequalityofpatientcareandpatientsafetywhilereducingexcessivecosts
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NJHAAntimicrobialStewardshipCollaborative
• 36months,beginninginJanuary2017,andendinginDecember2019
• Contentwillbedeliveredthroughlearningsessionsledbyexpertfacultyandpeer-to-peersharing
• MonthlyWebinarsandmultiplein- personlearningsessions
• Acombinationofoutcome,process,andantimicrobialusemetricswillbecollectedtomeasureprogress
CollaborativeGoals
• Bytheendof2019thecollaborativeparticipantswilldemonstrate100%implementationofallsevenCDCcoreelementsofantibioticstewardship
• Establishastatewidebaselineantimicrobialuserate
OpportunitiesforImprovement
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Doesyourfacilityhaveapolicythatrequiresprescriberstodocumentinthemedicalrecordorduringorderentryadose,duration,andindicationforallantibiotic
prescriptions?
19.4%
80.6%
Yes
No
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Yes No
Isthereaformalprocedureforallclinicianstoreviewtheappropriatenessofallantibiotics48hoursaftertheinitial
orders(e.g.antibiotictimeout)?
19.4%
80.6%
Yes
No
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Yes No
CDCsevencoreelementsofantibioticstewardship
• LeadershipCommitment:Dedicatingnecessaryhuman,financialandinformationtechnology resources;
• Accountability:Appointingasinglephysicianleaderandasinglenurseleaderresponsibleforprogramoutcomes;
• DrugExpertise:Appointingasinglepharmacistleaderresponsibleforworkingtoimproveantimicrobialuse;
• Action: Implementing policiesandinterventionstoimproveantimicrobialuse,suchassystemicevaluationofongoingtreatmentneedafterasetperiodofinitialtreatment(i.e.“antibiotictimeout”after48hours);
• Tracking: Monitoringantimicrobialprescribingandresistancepatterns;• Reporting:Regularreportinginformationonantimicrobialuseand
resistancetodoctors,nursesandrelevantstaff;• Education:Educatingcliniciansaboutresistanceandoptimalprescribing.
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TieredApproachtoImplementationofPractices
AntimicrobialUseData
NewJerseyAntimicrobialStewardshipLearning- ActionCollaborativeResources
ShannonDavilaRN,MSN,CIC,CPHQDirector,InstituteforQualityandPatientSafety,NJHA
LaurenRava,MPPProjectCoordinator,NJHA