From: A practice guide on antimicrobial stewardship in nursing homes
Basic conditions | Recommendations | Elaboration |
---|---|---|
1. Conditions for establishing an antimicrobial stewardship (AMS) program | 1.1 Ensure commitment from the Board of Directors. | ā¢ Define the vision on necessity of an AMS program. ā¢ Allocate human and financial resources. |
Ā | 1.2 Ensure human and financial resources are sufficient to carry out an AMS program that fits the nursing home. | ā¢ Allocate a physician for this task. ā¢ Establish service agreements in which AMS is an integral part of the services for nonemployed professionals. |
Ā | 1.3 Form a project team to set up and implement an AMS program. | ā¢ Establish a project team comprised of members with relevant expertise: a physician, a pharmacist, a medical microbiologist, an infection control practitioner, a member of the management team (MT) or an authorized project team member, on behalf of the MT. |
2. Embedding an AMS program within a nursing home | 2.1 Align antibiotic- and infection control policies and bring both areas of expertise within the responsibility of the same committee. | ā¢ Consolidate AMS and infection control policies under one committee. |
Ā | 2.2 Set up an Antibiotic team (A-team). | ā¢ Establish an A-team comprised of a physician, pharmacist, clinical microbiologist, and preferably also an infection control practitioner. |
Ā | 2.3 Discuss the AMS program with all physicians and make the AMS program a regular topic during meetings (e.g., pharmacotherapy audit meetings (PTAMs)). | ā¢ Involve all physicians from the start and keeping them informed about the process. ā¢ Make the AMS program a regular topic in during meetings (e.g., PTAMs). |
Ā | 2.4 Offer education on antibiotic use and resistance to nurses and carers. | ā¢ Determine the mode(s) of education, as well as whether it should be followed during work or personal time, and the possibility to gain accreditation points. |
Ā | 2.5 Discuss how volunteers should be informed. | ā¢ Use reliable, publicly accessible sources of information to disseminate. |
Ā | 2.6 Discuss how to inform residents/their representatives. | ā¢ Inform residents through various media. ā¢ Use reliable, publicly accessible sources of information to disseminate. |
3. A-team activities | 3.1 Define the responsibilities and authority of the A-team. | ā¢ Keep treatment protocols up-to-date. ā¢ Monitor compliance. ā¢ Emphasize that the opinion of A-team considered as highly valued, although the ultimate responsibility for prescribing antibiotics remains of the individual physician. |
Ā | 3.2 Define the working process of the A-team, including selection criteria. | ā¢ Conduct a periodic retrospective review of the antibiotic prescriptions prior to scheduled plenary meetings (e.g., PTAMs) based on predetermined selection criteria. ā¢ Evaluate the activities of the A-team among colleague physicians. |
Ā | 3.3 Define the tasks of all A-team members. | ā¢ Define the tasks of each A-team member. |