Antibiotic stewardship gain momentum

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Susan LaGrange
Susan LaGrange

Antibiotics can be life-saving. But many industry and government reports reveal misuse and overuse of antibiotics in nursing homes. This creates long-term resistance to infectious organisms, which for a person older than 65 years old may mean hospitalization and even death. The Centers for Disease Control and Prevention identifies how antibiotics are not always ordered with a valid indication, dosage and duration appropriate to treat the infection.

Because overuse is a consistent problem in nursing homes, antibiotic stewardship is gaining importance as a specific component to incorporate in infection prevention and control plans. Facilities with antibiotic stewardship programs are one step ahead of the game by setting up infection prevention and control teams and performance improvement projects. At Pathway Health, we are dedicated to guiding nursing homes and assisted-living facilities to quickly update their infection prevention and control program with a solid antibiotic stewardship component.

The right dose

The attention on infection prevention and control became evident in March, with President Obama's National Action Plan for Combating Antibiotic-Resistant Bacteria. This report emphasizes improving surveillance for more effective response to stop an outbreak, increasing the longevity of current antibiotics with appropriate use, and increasing the development of new antibiotics.

In July, the Centers for Medicare & Medicaid released a proposed rule for long-term care facility reform, including the major responsibilities of an Infection Prevention and Control Officer. This recommendation to develop an antibiotic stewardship program will likely become a federal regulation by the end of 2017.

The CDC also released an initiative, titled ‘CDC Recommends All Nursing Homes Implement Core Elements to Improve Antibiotic Use.' Focused on leadership, accountability, reporting and education, this antibiotic stewardship guidance was “designed to optimize treatment of infections, while reducing adverse events associated with antibiotic use.”

The right path

As clinical leaders, we know a big part of the solution is providing current resources for your staff. From efficient antibiotic stewardship to comprehensive influenza vaccination, consider the following for Infection Prevention and Control:

  1. Communicate the latest findings on antibiotic misuse with all staff members.
  2. Create clear policies for antibiotic treatment and set standards on infection control.
  3. Commit resources to monitor and time to track QAPI progress.
  4. Complete in-depth infection control training to educate staff and leaders.

The right time.

According to the CDC, “Approximately 4.1 million Americans are admitted to or reside in nursing homes each year,” and the number is growing. That is why it is more important than ever to optimize treatment and reduce adverse effects for this at-risk group.

The benefit is for everyone — residents, visitors and staff. Without a robust infection prevention and control plan, an outbreak could bring your facility into question, at a time when public audits and reviews affect the viability of your LTC facility. 

With more regulations around reimbursements and value-based purchasing, managing infections is going to be critical. But with the right leaders guiding you down the right path, you can control infections with confidence.

Recommended Resources:

The Core Elements of Antibiotic Stewardship for Nursing Homes

Leading Antibiotic Stewardship in Nursing Homes

Susan LaGrange, RN, BSN, NHA, is the director of education at Pathway Health.

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