Incorporating Interprofessional Practice Education and Motivational Interviewing Techniques in Antimicrobial Stewardship Programs at Two Academic Medical Centers

Abstract

Background Interprofessional practice education (IPE) is an essential component in educating healthcare residents and students in providing optimal patient centered care in a team environment. Antimicrobial Stewardship Program (ASP) teams with similar approaches were implemented at the two academic medical centers associated with our medical school utilizing an IPE approach in 2012. We describe the implementation/process of the ASPs. Methods A business plan for an ASP was approved at each location. An interprofessional ASP team was identified and includes the ID attending physician, ID fellow physician, ASP pharmacist, medical resident physician (MRP), medical student (MS), pharmacy resident (PR) and pharmacy students (PS). ASP educational seminars were presented for all adult admitting physician groups (Surgery, Ob-Gyn, Internal Medicine, Family Medicine) to discuss the need for the ASP and the prospective audit/feedback process. An ASP patient monitoring form for collecting patient information was developed. ASP rounds occur weekdays during ID rounds. Results The ASP pharmacist, PR and/or PS identify patients receiving intravenous antimicrobials and completes the ASP patient monitoring form. Patients are screened for ASP interventions prior to ASP rounds. Patients requiring interventions are presented during ASP rounds for discussion. The ID fellow or ASP pharmacist intervenes with the primary medical team, frequently utilizing motivational interviewing techniques to convey the ASP team recommendation in a non-coercive and educational manner. Antimicrobial education in relationship to clinical problems in patients enhances the educational learning of healthcare providers. Documentation of the ASP team recommendations is completed in the electronic or paper medical record. ASP acceptance rates were > 88% for antimicrobial recommendations since 2012. In addition, 8 ID fellows (82 rotation months), 26 PR, 82 MRP, 64 PS and approximately 32 MS have gained IPE experience in the ASP team. Conclusions The interprofessional ASP team implementation/process has been successful at our institutions. Antimicrobial stewardship and education are emphasized in all interactions of the ASP team. Motivational interviewing may be a useful technique in conveying ASP recommendations.  Business plan presented and approved at each location  Interprofessional ASP Team  Medicine: ID attending physician, ID fellow physician, MRP, MS  Pharmacy: ASP pharmacist, PR, PS  Education seminars  Adult admitting physician groups  Importance of ASP  Prospective audit and feedback process  Documentation procedures  Combined ASP and ID rounds weekdays  ASP patient monitoring form developed BACKGROUND RESULTS Incorporating Interprofessional Practice Education and Motivational Interviewing Techniques In Antimicrobial Stewardship Programs at Two Academic Medical Centers Pamela Foral, Pharm.D., BCPS1-3; Jennifer Anthone, Pharm.D., BCPS4; John Horne, MD2-4; Leo Dobronski, MD2-4; Javaria Syed, M.D.2-4; Christopher Destache, Pharm.D.1,2,4; Renuga Vivekanandan, MD2-4; Laurel Preheim, MD, FIDSA2-4; Gary Gorby, MD, FIDSA2-4; Marvin Bittner, MD, FIDSA, FSHEA2-4 Creighton University School of Pharmacy & Health Professions1, Creighton University School of Medicine2, VA Nebraska Western Iowa Health Care System3, CHI Creighton University Medical Center4, Omaha, NE