Antibiotic stewardship is a change you need to embrace. You can't just say I prefer it the old way, give everyone an antibiotic who asks for one and that will be that. But I get it. You are willing to change, but sometimes the residents and their families aren't.
In my previous blog post, I covered the regulatory requirements for Antibiotic Stewardship Programs set forth by the Centers for Medicare and Medicaid Services and briefly discussed in the Centers for Disease Control and Prevention's Core Elements for Antibiotic Stewardship in the Nursing Home.
It's not news that our planet has a serious antibiotic resistance problem on its hands, or that better antibiotic stewardship across the health care spectrum is essential to solving it.
To comply with these new CMS regulations, nursing facilities must adopt an Antibiotic Stewardship Program in conjunction with an Infection Prevention and Control Program, which includes antibiotic use protocols and a system for monitoring antibiotic use, by November 28, 2017.
So, I have this song from Disney's animated film "Frozen" stuck in my head. The part of the song that goes, "Let it go, let it go ..." See, that's how I feel about urine cultures.
While antibiotics play an important role in improving patient health, some drugs are unnecessarily or inappropriately prescribed and we are seeing an increase in antibiotic resistance in the treatment of issues like urinary tract infections, diarrheal diseases and staph infections.
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Long-term care providers should take pride in their antipsychotic reduction efforts, and certainly should work hard to meet the new goals announced Friday. But it should not escape their notice that just a day earlier, the White House released an ambitious national plan for addressing antibiotic resistant infections. The plan suggests that a facility's antibiotic stewardship is about to join its antipsychotics rate as a defining feature of quality in the eyes of the government.
Coping with the complicated management of infectious diseases is among the many challenges facing long-term care facilities today. Residents with multiple comorbidities often are prescribed broad-spectrum antibiotics and it seems as though methicillin-resistant Staphylococcus aureus (MRSA) and other (increasingly) drug-resistant bugs are everywhere. Outbreaks are common, ranging from norovirus and influenza to Clostridium difficile and scabies.
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A new study contradicts widely held assumptions about how Clostridium difficile infection occurs, which may lead long-term care providers to step up control measures.