Abstract
Background: The life-saving power of antibiotics could be lost forever if leaders fail to implement effective antibiotic stewardship programs at all healthcare levels. Grahams’ Knowledge to Action theory guided the development of an antibiotic stewardship program in a long-term care facility that had received a citation for having no active antibiotic stewardship program as required by federal regulations. Purpose: The purpose of this project was to develop and implement an evidence-based antibiotic stewardship program into one long-term care facility. Methods and Materials: This quality improvement project was a population-based systems charter development. The implementation intervention was designed to change the way health care professionals treat non-acute episodes of upper respiratory infections in a long-term care setting. This project utilized the suspected lower respiratory infection (LRI) Situation, Background, Assessment, Recommendation (SBAR) form to reduce the number of antibiotics given during the early part of cold and influenza season of 2018. An antibiotic stewardship policy was developed by multidisciplinary team members and then implemented into the facilities daily practice. Results: The point-prevalence rate of antibiotics within this facility dropped from 24% in 2017 to 6% in 2018 after implementation of the antibiotic stewardship program. Conclusion: This project demonstrates how long-term care facilities can successfully implement an antibiotic stewardship program and potentially improve overall healthcare outcomes for the residents.
Highlights
Antibiotic-resistant microbes will remain a health concern for all, unless intentional plans are in place to change current prescribing practices in nursing facilities across the nation (Ashford and Cook, 2016; Voelker, 2015)
The project design for this evidence-based practice project was the development of a project charter and subsequent implementation of an antibiotic stewardship program for residents, families, clinical care providers and prescribers in a long-term care facility
This project charter development and implementation was based on research data demonstrating that utilization of evidence-based suspected lower respiratory infection (LRI) SBAR targeted form, multidisciplinary team development of policy, and inclusion of resident, family and clinical staff education will decrease the use of unnecessary antibiotics in the long-term care setting (Crnich et al, 2015; Dar et al, 2016, Squires et al, 2014)
Summary
Antibiotic-resistant microbes will remain a health concern for all, unless intentional plans are in place to change current prescribing practices in nursing facilities across the nation (Ashford and Cook, 2016; Voelker, 2015). The overall aim of this project was to measure a reduction in the number of inappropriate antibiotics prescribed for non-acute respiratory infections during the first half of the cold and influenza season in the fall of 2018 in one long-term care facility in Indiana. Purpose: The purpose of this project was to develop and implement an evidence-based antibiotic stewardship program into one long-term care facility. The implementation intervention was designed to change the way health care professionals treat non-acute episodes of upper respiratory infections in a long-term care setting This project utilized the suspected lower respiratory infection (LRI) Situation, Background, Assessment, Recommendation (SBAR) form to reduce the number of antibiotics given during the early part of cold and influenza season of 2018. Conclusion: This project demonstrates how long-term care facilities can successfully implement an antibiotic stewardship program and potentially improve overall healthcare outcomes for the residents
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