Infectious disease specialist offers advice on following JC ID guidelines
Tabletop education is one strategy
Hospital pharmacy directors could use the Oakbrook Terrace, IL-based Joint Commission's infectious disease guidelines and guidance in the 2010 National Patient Safety Goals to help confirm what they're doing right, as well as to identify problem areas.
"It's important for us to know we're on the right track," says Deanne Tabb, PharmD, MT (ASCP), infectious disease specialist at The Medical Center, which is part of Columbus Regional Healthcare System in Columbus, OH.
"It opened my eyes to the fact that I need to generate a timelier chart of antibiotic utilization," Tabb says.
The Joint Commission's 2010 National Patient Safety Goals include the following:
• NPSG.07.03.01: Implement evidence-based practices to prevent health care-associated infections due to multidrug-resistant organisms in acute care hospitals.
• NPSG.07.04.01: Implement evidence-based practices to prevent central line-associated bloodstream infections.
• NPSG.07.05.01: Implement evidence-based practices for preventing surgical site infections.
Meeting patient safety goals
One step in ensuring these goals are met is to collect antibiotic use and infection data. Then when problems are discovered, they should quickly be addressed through education and process changes.
Hospital pharmacies can use antibiotic use data to effect change, particularly in rapid cycles, she adds.
"Rapid cycles are set time bursts where you look at something and monitor it for three or four weeks at a time, assessing and analyzing data," Tabb explains.
"You ask, 'What else do I need to do here?'" Tabb says. "You identify opportunities and areas that need to be improved."
The Medical Center focused on education as a part of its process for improving its infectious disease program.
It helps if a hospital has infectious disease physician advocates, but this isn't always possible, Tabb notes.
"Some hospitals have really good infectious disease physician champions and have been doing this for a year, but the majority of hospitals have not even started on this program," she says.
The Joint Commission's guidelines help reinforce the importance of focusing on infectious disease, but hospital pharmacists also need to collect objective data, showing evidence that supports a more judicious use of antibiotics, Tabb adds.
"It's difficult and labor intensive," she adds. "We don't actually have an infectious disease physician who works for the hospital, and there are a lot of institutions that are in the same boat as we are."
The few available infectious disease doctors will visit the hospital for diagnostic consults, but are not available to support antimicrobial stewardship or attend meetings of the antimicrobial subcommittee, Tabb says.
This leaves all antimicrobial stewardship and education work mostly to an infectious disease pharmacist.
Even when hospitals can afford to hire an ID physician, the antimicrobial program still needs an infectious disease pharmacist or clinical pharmacist to run the daily activities, Tabb says.
One of the important roles of an antimicrobial stewardship program involves staff education about why everyone should focus on this area.
"We need to teach people how to use antimicrobials wisely," Tabb says.
But it's important to have hospital leadership support before starting an educational program, and one way to obtain this is through referring to the Joint Commission's recommendations, Tabb notes.
Another strategy is to use a pocket guide with evidence-based durations of therapy and lists of the most commonly treated indications, Tabb says.
This handy guide tool could be developed with input from various hospital committees, which helps to obtain buy-in, she adds.
"I go to different committees, present some of the information, and listen to what their needs are," Tabb says. "It's nice to get recommendations from a couple of physicians, and they'll take ownership because they've asked for it."
Hospital pharmacy directors could use the Oakbrook Terrace, IL-based Joint Commission's infectious disease guidelines and guidance in the 2010 National Patient Safety Goals to help confirm what they're doing right, as well as to identify problem areas.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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