Less is more

CDC track­ing sys­tem takes aim at an­tibi­otic use

Modern Healthcare - - THE WEEK IN HEALTHCARE - Mau­reen Mck­in­ney

When it comes to an­tibi­otics, the Cen­ters for Dis­ease Con­trol and Pre­ven­tion is urg­ing providers to take a less-is­more ap­proach. The CDC has launched two new an­tibi­otics-re­lated ini­tia­tives aimed at help­ing hos­pi­tals un­der­stand how they’re us­ing the drugs an­tibi­otics are pre­scribed un­nec­es­sar­ily, and mis­use and overuse are fu­el­ing the growth of drug-re­sis­tant bac­te­ria. And with few new an­tibi­otics com­ing down the pipe­line, the sit­u­a­tion is be­com­ing in­creas­ingly dire, said Dr. Ar­jun Srini­vasan, head of the CDC’S Get Smart About Health­care pro­gram. “The threat of un­treat­able in­fec­tions is real,” Srini­vasan said in a news re­lease about the track­ing sys­tem. “Although pre­vi­ously un­think­able, the day when an­tibi­otics don’t work in all sit­u­a­tions is upon us.”

The agency says it is work­ing with ven­dors of elec­tronic med­i­ca­tion ad­min­is­tra­tion records and bar cod­ing sys­tems to en­sure they build NHSN com­pat­i­bil­ity into their prod­ucts, Srini­vasan said in an in­ter­view. Once those ca­pa­bil­i­ties are in place, Nhsn-par­tic­i­pat­ing hos­pi­tals—now num­ber­ing more than 4,800—will be able to use their elec­tronic phar­macy sys­tems to ac­cess the an­tibi­otic track­ing mod­ule.

“Many hos­pi­tals don’t have those EMAR or bar cod­ing sys­tems yet, but it is the di­rec­tion that the field is mov­ing in,” Srini­vasan said, adding that the track­ing tool will be­come “more and more use­ful over time.”

The goal of the CDC’S pi­lot project with IHI is to test the­o­ries about an­timi­cro­bial stew­ard­ship on a small scale and then use the re­sults to carry out larger-scale pi­lot projects in the fu­ture, ac­cord­ing to Diane Jacobsen, an IHI di­rec­tor. “Clin­i­cal the­ory and ex­per­tise is one piece, but that doesn’t tell us how fea­si­ble and prac­ti­cal these steps are in the real world, and what we may be miss­ing,” Jacobsen said.

Eight hos­pi­tals, rep­re­sent­ing a range of care set­tings, were cho­sen to par­tic­i­pate in the eight-month pi­lot. Each hos­pi­tal chose one or two tar­get ar­eas, such as timely an­tibi­otic main­te­nance and de-es­ca­la­tion.

“The de­liv­ery and use of an­tibi­otics in hos­pi­tals is very com­plex,” Srini­vasan said. “The only way to make it eas­ier is to break it down into dis­crete steps and show prac­ti­cal in­ter­ven­tions for each one. That’s what this project does.”

Com­mu­nity Hos­pi­tal, Tal­lassee, Ala., was one of the hos­pi­tals se­lected for the pi­lot. Of­fi­cials at the 69-bed hos­pi­tal had worked with IHI in the past and jumped at the chance to take part, said Heather John­son, clin­i­cal qual­ity of­fi­cer and in­fec­tion preven­tion­ist at the hos­pi­tal.

“We are a small, independent com­mu­nity hos­pi­tal, so it re­ally helps us to be able to part­ner with larger hos­pi­tals that have more re­sources,” John­son said. “For us, it was a great op­por­tu­nity.”

Other par­tic­i­pat­ing hos­pi­tals in­clude 307bed Rogue Val­ley Med­i­cal Cen­ter, Med­ford, Ore., and 456-bed Ron­ald Rea­gan UCLA Med­i­cal Cen­ter, Los An­ge­les.

Both ini­tia­tives were an­nounced in con­junc­tion with the CDC’S fourth an­nual Get Smart About An­tibi­otics Week, which ran Nov. 14-20. While past cam­paigns have mainly tar­geted pri­mary-care physi­cians and in­pa­tient hos­pi­tals, this year the CDC also reached out to nurs­ing homes and other long-term-care set­tings, Srini­vasan said.

As many as 70% of long-term-care fa­cil­ity res­i­dents re­ceive an­tibi­otics at least once a

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.