Antibiotic Stewardship Initiatives & Programs

This collection of tools provides descriptions of what antibiotic stewardship means and how to develop an effective program. Information is also provided on how antibiotic stewardship can be incorporated into performance improvement initiatives to improve patient outcomes and reimbursement.

Guidelines/Recommendations

The Pharmacist’s Role and Responsibility in Antimicrobial Stewardship

The American Society of Health System Pharmacists recently released a statement giving guidance to pharmacists in understanding the key role they play in the Antibiotic Stewardship program. This statement outlines the Society’s stance on the pharmacist’s duty to effectively and responsibly prevent infection in patients.

While providing a background on the need for Antibiotic Stewardship, this downloadable document also outlines the individual responsibilities of pharmacists as it pertains to antibiotic moderation in instances of infection control.

Guidelines/Recommendations

Core Elements of Outpatient Antimicrobial Stewardship

The CDC guide to incorporating antibiotic stewardship best practices into the outpatient office practice setting. This information offers a framework for implementation based on committment, action tracking & reporting and education & expertise in the outpatient setting.

Guidelines/Recommendations

The Physician Champion in Performance Improvement

This resource provides you with an informational guide to help identify the perfect Physician Champion candidate for the project at hand. The guide is comprised of a two-page white sheet on desirable traits to look for in a good physician leader. In addition, the guide also discusses the expectations of the physician during a project and provides tips to make the physician successful in their project role.

Guidelines/Recommendations

IHI & CDC: Antibiotic Stewardship Driver Diagram and Change Package

This resource provides tactics to reduce the use of inappropriate antibiotic medications in healthcare organizations.

Articles

Association for Professionals in Infection Control and Epidemiology APIC

APIC provides consolidated information of vendor technology for surveillance of construction issues and environmental services with a focus on infection control.

Articles

Public Health Foundation PHF-Antibiotic Stewardship Program

This resource provides the framework for antibiotic stewardship programs to ensure safe patient care.

Antibiotic Stewardship Performance Improvement Tools

Measurement of data is helpful in improving processes within an organization. These tools are helpful in providing some direction with the types of data that can be compiled and used for performance improvement with antibiotic usage.

Evaluation tools

Antibiotic Audit Report

Use this document to assist you with auditing individual patient records related to antibiotic stewardship. The document facilitates collection of all related information on one page.

Guidelines/Recommendations

Antibiotic Stewardship Measurement Framework from IHI

A table offers recommendations for measuring outcomes in your Antibiotic Stewardship program. The measure includes infection control and medication usage to help determine program effectiveness.

Evaluation tools

Gap Analysis Tool for Antimicrobial Management Program

This resource provides you with another example of an in-depth Gap Analysis tool for antimicrobial management programs. The downloadable checklist and evaluation matrix will guide you in evaluating the current state of your antibiotic stewardship program by comparing it to program elements that are considered best practices.

Checklists

Core Elements of Hospital Antibiotic Stewardship Program Checklist

This resource provides you with an updated checklist to evaluate the current state of your facility’s antibiotic stewardship program. This checklist can be used as a gap analysis tool where you compare your program against elements which are considered best practice fundamentals of an antibiotic stewardship program. Through this analysis, you will be able to identify the areas of your facility’s antibiotic prescribing program that need improvement.

Articles

Clinical Practice Guidelines for Antibiotic Prescribing

This resource provides outpatient healthcare professionals with recommendations for prescribing antibiotics in the outpatient arena.

Antibiotic Stewardship Educational Resources

It may be difficult for some staff members to understand their role in antibiotic stewardship. These resources can be used to educate staff members on how they can promote antibiotic stewardship through vigilence and patient education.

Webinar Slides

PowerPoint Education for Staff Training in Antibiotic Stewardship 1.0

This PowerPoint presentation was created for organizations to use when training general staff members about antibiotic stewardship. This is only a PowerPoint presentation with no voiceover and is set up for staff to be able to read through and understand. The information is directed at clinicians and provides a basic overview of the antibiotic resistance crisis, what resistance means in the real world and how general staff members can make an impact in reducing the problems associated with antibiotic misuse.

Articles

Antibiotic Stewardship Resource Bundles

Resource bundles by the CDC to promote efforts on Antibiotic Stewardship The resources are broken down into different healthcare settings such as outpatient, long term care, and dental care.

Sample Job Descriptions

A job description is a tool that describes, in plain language, the functions and responsibilities of a position. A great leadership idea for reinforcing a commitment to antibiotic stewardship is to add language into the job descriptions incorporating these responsibilities into activities for certain positions. These are a few good examples of language to use in job descriptions to support antibiotic stewardship as a priority at the facility.

Policy Templates

Sample Job Description for Director of Pharmacy

Sample job description from Alameda Health System for Director of Pharmacy. This job description incorporates antibiotic stewardship responsibilities.

Policy Templates

Sample Job Description for a Clinical Pharmacist

Sample job description from Duke University for a Clinical Pharmacist to manage the antibiotic stewardship program.

Antibiotic Stewardship Sample Policies

Below is a collection of sample policies and procedures that facility administrators may use to effectively implement the Antibiotic Stewardship Program within their clinic or hospital.

Policy Templates

Sample Antibiotic Stewardship Policy

A sample organization-wide antibiotic stewardship policy that includes measures of success.

Policy Templates

Sample 2 Antibiotic Stewardship Policy

A sample organization-wide antibiotic stewardship policy that incorporates a Physician Champion.

Policy Templates

Sample 3 Antibiotic Stewardship Policy

A sample organization-wide antibiotic stewardship policy.

Assessment tools

Medication Tracking Log

A sample tool that can be used to track the use of antibiotics in your organization.

Policy Templates

Antibiotic Soft Stop Order Notice

A tool that be placed on medical records to prompt the physician to either discontinue or reorder antibiotics after 14 days.

Policy Templates

Antibiotic Time Out

A sample policy for re-evaluating the need for continuation of an antibiotic.

Policy Templates

Extended Infusion Auto-substitution for Zosyn

A sample policy to guide pharmacy dosing of Zosyn.

Guidelines/Recommendations

Guidance on Contract Language

Sample language that can be used in a contract with an Infectious Disease Physician to oversee Antibiotic Stewardship program.

Policy Templates

IV to PO Conversion Protocol

Sample IV to PO conversion protocol to facilitate transition of IV medications to oral.

Assessment tools

LIP Reassessment of Volume Status and Tissue Perfusion

Tool to facilitate the volume status and tissue perfusion reassessment 6 hours after a patient presents in septic shock.

Policy Templates

Renal Dosing Clarification Order

A sample renal dosing clarification order that can be used by pharmacist when adjusting doses per an approved dosing program.

Assessment tools

Pharmacy Rounding Form

Sample tool that can be used by pharmacist during patient rounds.

Policy Templates

Sample Physician Order set for Pneumonia

Sample physician order set for pneumonia. These orders are designed according to evidence-based practice and with antibiotic stewardship in mind.

Policy Templates

Sample Physician Order set for Pneumonia/Sepsis

Sample physician order set for pneumonia/sepsis. These orders are designed according to evidence-based practice and with antibiotic stewardship in mind.

Policy Templates

Sample Antibiotic Review Policy

A sample policy that describes the process of pharmacy review of organizational antibiotic use.

Policy Templates

Sample Policy for Protected Antimicrobials

Sample policy describing review of use of antimicrobials that are on the restricted use list.

Policy Templates

Renal Dosing Program

Sample policy that provides clinical directive for renal dose adjustments for adults based on the degree of renal impairment.

Policy Templates

Renal Dosing Protocol

Detailed sample protocol for renal adjustments on specific medications.

Policy Templates

Sample Sepsis Physician Order Set

Sample physician order set for sepsis. These orders are designed according to evidence-based practice and with antibiotic stewardship in mind.