Antimicrobial Stewardship - HAI prevention strategies

An antimicrobial stewardship program (ASP) is a building block for healthcare-associated infection (HAI) prevention.

The practices in the Road Map to a Comprehensive Healthcare-Associated Infection (HAI) Prevention Program, including the antimicrobial stewardship program section, guide organizations in developing the infrastructure necessary to support and sustain infection prevention best practices.

Sample Tools

. A change package from the Institute for Health Care Improvement. (12-page PDF) 

Antimicrobial Stewardship Toolkit. This toolkit from the American Hospital Association contains resources for developing or enhancing a successful Antimicrobial Stewardship Program.

. Description of  the initiative from the California Department of Public Health. Viewed 08/31/12.

Checklist for Core Elements of Hospital Antibiotic Stewardship Programs. This checklist from the Centers for Disease Control and Prevention is a companion to Core Elements of Hospital Antibiotic Stewardship Programs. This checklist should be used to systematically assess key elements and actions to ensure optimal antibiotic prescribing and limit overuse and misuse of antibiotics in hospitals. (4-page PDF)

Core Elements of Hospital Antibiotic Stewardship Programs. This document from the Centers for Disease Control and Prevention summarizes core elements of successful hospital antibiotic stewardship programs. (25-page PDF)

. A PowerPoint presentation from the National Center for Emerging and Zoonotic Infectious Diseases.  (42-page PPT)

Getting Started. Lists the key literature mentioned in the ASP building blocks section. (2-page Word doc)

The Road Map to a Comprehensive Healthcare-Associated Infections (HAI) Prevention Program. Provides evidence-based recommendations and standards for Minnesota hospitals to develop comprehensive HAI prevention programs. Reflects published literature and guidelines from professional organizations and regulatory agencies, as well as identified best practices. (10-page PDF)

. This toolkit assists hospital staff and leadership in developing an effective antimicrobial stewardship program with the potential to reduce C. difficile. An antimicrobial stewardship program is a systematic approach to developing coordinated interventions to reduce overuse and inappropriate selection of antibiotics, and to achieve optimal outcomes for patients in cost-efficient ways.

. Offers resources on antimicrobial stewardship.

Professional Education and Training

A collection of presentations from the October 24. 2013 CHAIN-sponsored Antimicrobial Stewardship Conference that provide examples of a variety of effective strategies for antimicrobial stewardship programs throughout Minnesota.

• A Critical Access Hospital’s ASP. Presented by Amy Dittmer, Pharm.D, Director of Pharmacy, Glencoe Regional Health Services. (10-page PDF)
• Antibiotic Resistance in Minnesota. Presented by Ruth Lynfield, MD, Minnesota Department of Health. (20-page PDF)
• Antibiotic Stewardship 360⁰: Optimizing Outcomes For Common Infectious Syndromes. Presented by Ayesha Rashid MD, and Gary Kravitz, MD, FACP, FIDSA, FSHEA, St. Paul Infectious Disease Associates. (68-page PDF)
• Antimicrobial Stewardship in Ambulatory Care at HCMC. Presented by Mary K Kuzel, PharmD, BCACP, Downtown Medicine Clinics, Hennepin County Medical Center. (7-page PDF)
• Pharmacist-Driven ASP. Presented by Jessica Holt, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Coordinator, Abbott Northwestern Hospital. (11-page PDF)
• Practical Pearls for Effective Sustainable Antimicrobial Stewardship Programs. Presented by Susan Kline, MD, MPH, Medical Director for Infection Control, University of Minnesota Medical Center, Fairview. (43-page PDF)

. Abstract of article from the Wiley Online Library. (3-page PDF)

. This Centers for Disease Control and Prevention online activity was recorded at a live roundtable discussion of the same name, in Atlanta, Georgia, on August 24, 2010. It contains one introduction module and 9 CME/CE modules.

Antimicrobial Stewardship Toolkit. Best practices from the Greater New York Hospital Association United Health Fund Antimicrobial Stewardship Collaborative. (93-page PDF)

. Produced by South Dakota Public Television’s medical program, On Call. (56-minute video)

Antimicrobial Stewardship: Why and How. Slides from a CDC presentation describing antibiotic misuse and its implications. (10-page PDF)

. Presented on January 16, 2014, by CAPT Arjun Srinivasan, MD. (55-minute webinar)

. Website with policies, facts, and patient stories on antimicrobial resistance. Viewed 08/31/2.

. Article from the Department of Medical Microbiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland. (15-page PDF)

. This article reviews strategies and resources available to community hospitals for improving if, when, and how antimicrobial agents are prescribed and delivered. Oxford Journals, viewed 08/30/12.

. Ramanan Laxminarayan, director of the Center for Disease Dynamics, Economics & Policy, discusses the urgent need to preserve antibiotics. He highlights the emerging crisis of antibiotic resistance and likens antibiotics to a natural resource―a call to action for concerned consumers, parents, and patients, encouraging everyone to limit their use of antibiotics in order to preserve their effectiveness for future generations.

. From the Society for Healthcare Epidemiology of America. (10-page PDF)

References, Guidelines, Standards

. From the Society for Healthcare Epidemiology of America. Viewed 08/31/12.

. Policy Statement on Antimicrobial Stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Chicago Journals, viewed 08/30/12

. A set of guidelines for establishing an antimicrobial stewardship program from the State of Wisconsin Department of Health Services. (10-page PDF)

. Recommendations by the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America for developing a program to enhance antimicrobial stewardship in the hospital setting to improve the quality of care. Published in Clinical Infectious Diseases 2007, Jan 15;44(2):159-77. .

Patient Education