1999 Performance Improvement Program Monitoring Activity/Performance Measure

Antibiotic Therapy Interruptions

• FOCUS: Monitor all instances of interruption in antibiotic therapy

• INDICATORS (NUMERATOR): Total number of interruptions in antibiotic therapy categorized by type of therapy, reason for interruption, and length of interruption

• DENOMINATOR: Total number of patients with antibiotic therapy during the designated reporting period

• EXCLUSIONS: None

• THRESHOLD: 95% of all antibiotic therapy will not result in interruption

• COMPONENTS: Components of care monitored by this indicator include:

1. Assessment of agency’s ability to properly monitor patient’s therapy.
2. Appropriateness of therapy to facilitate desirable outcome.
3. Assessment of company’s ability to accept patients for therapy.

• DIMENSIONS: Efficacy, continuity, and efficiency

• DATA SOURCE: Antibiotic therapy interruption log, nurses’ notes

• PURPOSE: The intent of this activity is to evaluate the components of care listed above by monitoring the company’s ability to assess and monitor the patient towards minimizing potential therapy interruptions. The frequency of interruptions can also be reduced by assuring the appropriateness of drug therapy and proper monitoring. Therapy interruptions can cause dissatisfaction in the services being provided by the company, as well as prolong the need for treatment which could adversely affect the well-being of the patient and overall effectiveness of the therapy.

• FREQUENCY: Daily monitoring with log sheet review monthly and formal quarterly report

• TYPES TO BE MONITORED: Patients receiving administration of antibiotic therapy by all routes

• METHOD OF REVIEW: Staff will document all therapy interruptions along with type of therapy and reason for interruption on the appropriate form and/or log sheet. Interventions will be taken immediately as appropriate. On a monthly basis, the director of nursing will evaluate all log sheets, identify any trends, and take appropriate measures to correct any identified problem areas. A quarterly report will be prepared by the director of nursing and presented to the PI Committee during the regularly scheduled quarterly meeting.

The quarterly report shall include the following:

1. How many patients were on antibiotic therapy during the quarter, categorized by route and type of therapy.
2. How many patients experienced therapy inter- ruption, categorized by the reason for interrup- tion and how long.
3. The interruption-to-therapy ratio.
4. Department evaluation and analysis in narrative form.
5. Appropriate graph and other statistical analysis.

The PI Committee will evaluate the report and make any recommendations necessary to assure that the actions taken were effective.