Antimicrobial Stewardship 5-minute Update

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Antimicrobial Stewardship 5-minute Update


Antimicrobial Stewardship: What’s UP?

The Regina Qu’Appelle Health Region is building the Antimicrobial Stewardship Program to help ensure that patients throughout southern Saskatchewan receive optimal care with respect to antimicrobial use.  Our goal is to educate both health care professionals and the general public about the growing problem of antimicrobial resistance and to ensure that our providers have access to the tools and information required to ensure proper use of our antimicrobial resources.

As a Region, we are committed to improving access to high-quality and cost effective services.  Delivering on this commitment will require tighter coordination of existing antimicrobial stewardship services, strengthened partnerships between health system members, and better connections to the broader health system.   Antimicrobial stewardship networks are being established throughout the region to help achieve this vision.  Once fully developed, the Antimicrobial Stewardship Program will have created a shift in how antimicrobials are perceived, accessed and delivered throughout RQHR.

The Antimicrobial Stewardship Program has been designed to work in collaboration with the Saskatoon Health Region’s Antimicrobial Stewardship Program (as well as other stewardship initiatives throughout the province).

The Antimicrobial Stewardship Program is committed to having good relationships with all of our clinical partners.  We are focused on communicating what the expectations are as we jointly work at methods to improve the overall care and outcomes for our patients.

One of the quality improvement measures that we are promoting is that prescribers must note the indication along with their order for an antimicrobial.  The expectation is that with every order written, there is an indication listed with that order in the physician’s orders section of the patient’s chart.  Another quality improvement measure we are promoting is the easy identification of the MRP.  Is your signature legible? 

Why is this important?

As an example, other support staff that care for our patients, such as pharmacy and nursing, require this information and clarity in communication as part of the care plan.  When an order is sent to pharmacy to be filled and it is illegible or the MRP is unclear, it can cause delays in filling and administering that antimicrobial to the patient. Secondly, it provides more information to the ASP in order to determine appropriateness of use which has broader implications for patient care. 

How is audit and feedback information collected?

The Antimicrobial Stewardship Program has a confidential approach to audit and feedback.  Our goal is not to shame or eliminate prescriber autonomy.  All prescriber information is de-identified before being shared.   The focus of our work is better outcomes for our patients.  When gathering data, we will conduct chart audits and transform the information into communication tools such as graphs and charts and other feedback mechanisms such as information reporting cards. 

*This was a random audit of one unit at the RGH done in January 2017, over a two week period of only new antimicrobial orders.  Physicians, Learning Physicians and Residents. 

How will this information be communicated?

If we are working on a specific project such as the RPIW #92

Audit Metric 1: Indication for prescribing antimicrobial is written on physician order.

We will feed back to the individual prescriber and department head.  The purpose of feedback is to be able to communicate directly with the prescriber.  

Who should I contact if I have questions?  

Any of the Antimicrobial Stewardship Team can help.  Email or call 306-766-3520

Why is this important to the Patient? Future state:

Audit and feedback is a key element in many existing antimicrobial stewardship programs. Including the indication for the use of the antimicrobial will allow the antimicrobial stewardship team to interact directly with prescribers in order to tailor specific antimicrobial therapy for each patient.

Including the indication for prescribing the antimicrobial will also prepare the prescribers for the RQHR’s CPOE system.

Antimicrobial Stewardship Program Team