Antimicrobial Stewardship Practices Reported by California Hospitals—Annual Hospital Survey Data Submitted via the National Healthcare Safety Network, 2014

Abstract

Background. Since 2008, California acute care hospitals have been required to develop processes for evaluating the judicious use of antibiotics and to report results to their quality improvement committees. A national survey conducted in 2011 found California hospitals were significantly more likely to have an antimicrobial stewardship policy than hospitals in other states. New California legislation further requires hospitals to implement an antimicrobial stewardship policy in accordance with guidelines and to establish a physician-supervised multidisciplinary committee with at least one physician or pharmacist with specific stewardship training by 1 July 2015. Methods. Beginning in 2014, the National Healthcare Safety Network (NHSN) Annual Hospital Survey included questions about antimicrobial stewardship practices. Annual Hospital Survey data submitted by California acute care hospitals via NHSN were analyzed to determine proportions of hospitals implementing specific antimicrobial stewardship practices. Results. Data were available for all 391 California hospitals reporting to NHSN: 290 (74%) reported having a statement from leadership supporting efforts to improve antibiotic use; 359 (92%) reported a physician or pharmacist leader responsible for outcomes of stewardship; 201 (51%) provide dedicated salary support for stewardship activities. Specific stewardship practices are included in the table. Conclusion. In the setting of state legislative requirements, we document that substantial numbers of California hospitals are engaged in antimicrobial stewardship. These data will be used to identify opportunities for public health to guide programs that promote and support further implementation and advancement of antimicrobial stewardship practices in California hospitals. Table. Stewardship Practice No. (%) Hospitals Responding Yes Requiring prescribers to document indication for all antibiotics 166 (42%) Facility-specific antibiotic treatment recommendations 313 (80%) Antibiotic time-out 133 (34%) Antibiotic pre-approval 275 (70%) Antimicrobial prescription audit with feedback 342 (87%) Providing feedback to prescribers regarding improving antibiotic use 288 (74%) Providing antibiotic stewardship education 278 (71%) Monitoring antibiotic use 310 (79%) View it in a separate window Disclosures. All authors: No reported disclosures.