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Erschienen in: Journal of General Internal Medicine 3/2021

08.01.2021 | Perspective

Preparing for the New Joint Commission Requirements: a Model for Tracking Outcomes of an Ambulatory Antibiotic Stewardship Program in Primary Care

verfasst von: Eliana V. Hempel, MD, Nicholas Duca, MD, Ryan Kipp, MD, John van Harskamp, RN, Gregory Caputo, MD

Erschienen in: Journal of General Internal Medicine | Ausgabe 3/2021

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Abstract

Since 2007, inpatient antibiotic stewardship programs have been required for all Joint Commission–accredited hospitals in the USA. Given the frequency of ambulatory antibiotic prescribing, in June 2019, the Joint Commission released new standards for antibiotic stewardship programs in ambulatory healthcare. This report identified five elements of performance (EPs): (1) Identify an antimicrobial stewardship leader, (2) establish an annual antimicrobial stewardship goal, (3) implement evidence-based practice guidelines related to the antimicrobial stewardship goal, (4) provide clinical staff with educational resources related to the antimicrobial stewardship goal, and (5) collect, analyze, and report data related to the antimicrobial stewardship goal. We provide eight practical tips for implementing the EPs for antimicrobial stewardship: (1) Identify a collaborative leadership team, (2) partner with informatics, (3) identify national prescribing patterns, (4) perform a needs assessment based on local prescribing patterns, (5) review guidelines for diagnosis and treatment of the selected condition, (6) identify systems-level interventions to help support providers in making appropriate treatment decisions, (7) prioritize individual EPs for your institution, and (8) re-assess local data to identify areas of strength and deficiency in local practice.
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Literatur
1.
Zurück zum Zitat Dellit TH, Owens RC, McGowan JE, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007;44(2):159–177.CrossRef Dellit TH, Owens RC, McGowan JE, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007;44(2):159–177.CrossRef
4.
Zurück zum Zitat Gerber JS, Prasad PA, Fiks AG, et al. Effect of an Outpatient Antimicrobial Stewardship Intervention on Broad-Spectrum Antibiotic Prescribing by Primary Care Pediatricians: A Randomized Trial. JAMA. 2013;309(22):2345–2352.CrossRef Gerber JS, Prasad PA, Fiks AG, et al. Effect of an Outpatient Antimicrobial Stewardship Intervention on Broad-Spectrum Antibiotic Prescribing by Primary Care Pediatricians: A Randomized Trial. JAMA. 2013;309(22):2345–2352.CrossRef
5.
Zurück zum Zitat Meeker D, Linder JA, Fox CR, et al. Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial. JAMA. 2016;315(6):562–570.CrossRef Meeker D, Linder JA, Fox CR, et al. Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial. JAMA. 2016;315(6):562–570.CrossRef
6.
Zurück zum Zitat Finkelstein, JA, Huang SS, Kleinman K, et al. Impact of a 16-Community Trial to Promote Judicious Antibiotic Use in Massachusetts. Pediatrics. 2008;121(1):e15-e23.CrossRef Finkelstein, JA, Huang SS, Kleinman K, et al. Impact of a 16-Community Trial to Promote Judicious Antibiotic Use in Massachusetts. Pediatrics. 2008;121(1):e15-e23.CrossRef
7.
Zurück zum Zitat Little P, Stuart B, Francis N, et al. Effects of internet-based training on antibiotic prescribing rates for acute respiratory-tract infections: a multinational, cluster, randomised, factorial, controlled trial. Lancet. 2013;382(9899):1175–1182.CrossRef Little P, Stuart B, Francis N, et al. Effects of internet-based training on antibiotic prescribing rates for acute respiratory-tract infections: a multinational, cluster, randomised, factorial, controlled trial. Lancet. 2013;382(9899):1175–1182.CrossRef
8.
Zurück zum Zitat Klepser ME, Dobson EL, Pogue JM, et al. A call to action for outpatient antibiotic stewardship. JAPhA. 2017;57(4):457–463.PubMed Klepser ME, Dobson EL, Pogue JM, et al. A call to action for outpatient antibiotic stewardship. JAPhA. 2017;57(4):457–463.PubMed
9.
Zurück zum Zitat Goossens H, Ferech M, Vander Stichele R, Elseviers M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365(9459):579–587.CrossRef Goossens H, Ferech M, Vander Stichele R, Elseviers M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365(9459):579–587.CrossRef
10.
Zurück zum Zitat Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency Department Visits for Antibiotic-Associated Adverse Events. Clin Infect Dis. 2008;47(6):735–743.CrossRef Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency Department Visits for Antibiotic-Associated Adverse Events. Clin Infect Dis. 2008;47(6):735–743.CrossRef
11.
Zurück zum Zitat Chitnis AS, Holzbauer SM, Belflower RM, et al. Epidemiology of community-associated clostridium difficile infection, 2009 through 2011. JAMA Intern Med. 2013;173(14):1359–1367.CrossRef Chitnis AS, Holzbauer SM, Belflower RM, et al. Epidemiology of community-associated clostridium difficile infection, 2009 through 2011. JAMA Intern Med. 2013;173(14):1359–1367.CrossRef
12.
Zurück zum Zitat Vaughn VM, Flanders SA, Snyder A, et al. Excess antibiotic treatment duration and adverse events in patients hospitalized with pneumonia: a multihospital cohort study. Ann Intern Med. 2019;171(3):153–163.CrossRef Vaughn VM, Flanders SA, Snyder A, et al. Excess antibiotic treatment duration and adverse events in patients hospitalized with pneumonia: a multihospital cohort study. Ann Intern Med. 2019;171(3):153–163.CrossRef
14.
Zurück zum Zitat Cunha CB. Antimicrobial stewardship programs: principles and practice. Med Clin. 2018;102(5):797–803. Cunha CB. Antimicrobial stewardship programs: principles and practice. Med Clin. 2018;102(5):797–803.
16.
Zurück zum Zitat Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among us ambulatory care visits, 2010-2011. JAMA. 2016;315(17):1864–1873.CrossRef Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among us ambulatory care visits, 2010-2011. JAMA. 2016;315(17):1864–1873.CrossRef
18.
Zurück zum Zitat Chow A, Benninger M, Brook I, et al. IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults. Clin Infect Dis. 2012;54 (8):e72–e112.CrossRef Chow A, Benninger M, Brook I, et al. IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults. Clin Infect Dis. 2012;54 (8):e72–e112.CrossRef
20.
Zurück zum Zitat Makary MA, Mehta A, Xu T. Improving wisely using physician metrics. AJMQ. 2018;33(1):103–105. Makary MA, Mehta A, Xu T. Improving wisely using physician metrics. AJMQ. 2018;33(1):103–105.
Metadaten
Titel
Preparing for the New Joint Commission Requirements: a Model for Tracking Outcomes of an Ambulatory Antibiotic Stewardship Program in Primary Care
verfasst von
Eliana V. Hempel, MD
Nicholas Duca, MD
Ryan Kipp, MD
John van Harskamp, RN
Gregory Caputo, MD
Publikationsdatum
08.01.2021
Verlag
Springer International Publishing
Erschienen in
Journal of General Internal Medicine / Ausgabe 3/2021
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-020-06365-1

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