The Core Elements of Antibiotic Stewardship for Nursing Homes

by admin

The Core Elements of Antibiotic Stewardship for Nursing Homes

by admin

by admin

The Core Elements of Antibiotic Stewardship 

Adapt the CDC Core Elements of Hospital Antibiotic Stewardship into practical ways to initiate or expand antibiotic stewardship activities in nursing homes.

Nursing homes are encouraged to work in a step-wise fashion, implementing one or two activities to start and gradually adding new strategies from each element over time.  Any action taken to improve antibiotic use is expected to reduce adverse events, prevent emergence of resistance, and lead to better outcomes for residents in this setting.

Improving the use of antibiotics in healthcare to protect patients and reduce the threat of antibiotic resistance is a national priority. Antibiotic stewardship refers to a set of commitments and actions designed to “optimize the treatment of infections while reducing the adverse events associated with antibiotic use.” The Centers for Disease Control and Prevention (CDC) recommends that all acute care hospitals implement an antibiotic stewardship program (ASP) and outlined the seven core elements which are necessary for implementing successful ASPs. CDC also recommends that all nursing homes take steps to improve antibiotic prescribing practices and reduce inappropriate use.

Summary of Core Elements for Antibiotic Stewardship in Nursing Homes

Antibiotics are among the most frequently prescribed medications in nursing homes, with up to 70% of residents in a nursing home receiving one or more courses of systemic antibiotics when followed over a year.

Similar to the findings in hospitals, studies have shown that 40–75% of antibiotics prescribed in nursing homes may be unnecessary or inappropriate. Harms from antibiotic overuse are significant for the frail and older adults receiving care in nursing homes. These harms include risk of serious diarrheal infections from Clostridium difficile, increased adverse drug events and drug interactions, and colonization and/or infection with antibiotic-resistant organisms.

This document adapts the CDC Core Elements of Hospital Antibiotic Stewardship into practical ways to initiate or expand antibiotic stewardship activities in nursing homes. While the elements are the same for both hospitals and nursing homes, the implementation of these elements may vary based on facility staffing and resources. Nursing homes are encouraged to work in a step-wise fashion, implementing one or two activities to start and gradually adding new strategies from each element over time. Any action taken to improve antibiotic use is expected to reduce adverse events, prevent emergence of resistance, and lead to better outcomes for residents in this setting.

Download the guides here:

                                                                         

Core Elements of Antibiotic Stewardship                                                          CHECKLIST: Core Elements of Antibiotic Stewardship

 

APPENDIX A: Policy and Practice Actions to Improve Antibiotic Use

 

APPENDIX B: Measures of Antibiotic Prescribing, Use and Outcomes

 

APPENDIX C: Data Sources, Elements, and Measures for Tracking Antibiotic Use   

 

 

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