Challenge 3B Medication Errors

Antimicrobial Stewardship

Executive Summary Checklist

Inappropriate use of antimicrobial drugs (antibiotics, etc.) is a significant cause of patient morbidity and mortality. This risk can be greatly reduced by an Antimicrobial Stewardship Program (ASP), which requires an implementation plan that includes the following actionable steps:

  • Commitment from institutional leadership (administration, medicine, pharmacy, nursing, microbiology, and technology) to develop and support an Antimicrobial Stewardship Program.
  • Create an multi-disciplinary Antimicrobial Stewardship Committee that includes infection prevention, infectious disease professionals from Medicine and Pharmacy, Microbiology Laboratory, Nursing, and Information Technology. This group will ensure the:
    • accountability of ASP chair or co-chairs.
    • development of protocols to support ASP initiatives and interventions.
    • personnel training and support.
    • necessary infrastructure for measuring antimicrobial use and outcomes.
    • monitoring of microbial resistance and its effect on disease patterns.
    • development of clear goals for the ASP, including timelines and metrics.
    • delivery of regular updates to the institutional antibiogram and compliance with Clinical Laboratory Standards Institute (CLSI) guidelines.
  • Implement Computerized Physician Order Entry (CPOE) with Clinical Decision Support (CDS) and computer-based surveillance software to provide real-time data at the point of care for ASP initiatives.
  • Develop mechanisms to educate clinicians regarding ASP initiatives and progress. Identify and educate clinicians who exhibit outlying prescribing patterns. Monitor progress and include the results in staff educational sessions.
  • All antimicrobial orders are reviewed by a hospital pharmacist.

Between the 2017 World Patient Safety, Science & Technology Summit and the 2017 Midyear Planning Meeting a workgroup comprised of experts representing administrators, clinicians, technologists and patient advocates will meet to update this APSS. If you are interested in joining this workgroup, please email us.

Parent Challenge

  1. Challenge 3: Medications