212Skills Learned during Critical Care Prospective Audit and Feedback are Utilized outside of the Stewardship Environment

نویسندگان

  • Karim Ali
  • Gina Dimitra Fleming
  • Kenny Ma
  • Ryan D'sa
  • Jeff Powis
چکیده

Background. Antimicrobial stewardship programs (ASP) are crucial to optimize antimicrobial utilization in critical care. Prospective audit and feedback is the major intervention used by stewardship programs, yet the impact on clinicians’ antimicrobial prescribing behaviours outside of the stewardship environment is unknown. We sought to understand if skills learned during prospective audit and feedback are translated to other areas of clinicians’ practice. Methods. Antimicrobial stewardship, through biweekly prospective audit and feedback, was initiated in a 14 bed closed medical-surgical ICU at a single site of a multi-site, community hospital. ICU physicians working in the stewardship ICU also worked in another site ICU at the same community hospital where stewardship had not been formally introduced. We compared antimicrobial utilization between the stewardship and non-stewardship ICUs before and after antimicrobial stewardship implementation using time series analysis. Results. Broad-spectrum antimicrobial use and anti-pseudomonal antimicrobial use decreased post ASP implementation in the stewardship ICU as well as the nonstewardship ICU. In the stewardship ICU broad-spectrum antibiotic use and antipseudomonal antibiotic use was decreased by 21.2% (p =0.023) and 20.6% (p = 0.017) respectively compared to 29.8% (p = 0.071) and 38.1% (p = 0.025) in the non-stewardship ICU. Conclusion. Prospective audit and feedback has the potential to change antimicrobial prescribing behaviours among ICU clinicians. Skills learned during prospective audit and feedback are translated to practice settings outside of the stewardship environment. Disclosures. All authors: No reported disclosures.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

When Antimicrobial Stewardship Isn′t Watching: The Educational Impact of Critical Care Prospective Audit and Feedback

Prospective audit and feedback (PAF) is an effective strategy to optimize antimicrobial use in the critical care setting, yet whether skills gained during PAF influence future antimicrobial prescribing is uncertain. This multisite study demonstrates that knowledge learned during PAF is translated and incorporated into the practice of critical care physicians even when not supported by an antimi...

متن کامل

Prospective audit for antimicrobial stewardship in intensive care: impact on resistance and clinical outcomes.

BACKGROUND The impact of antimicrobial audit and feedback on outcomes of critically ill adults is unclear. METHODS A prospective study was performed in the intensive care units (ICU) of a public hospital in Atlanta, GA. Critically ill adults receiving empiric imipenem or piperacillin-tazobactam were eligible. Outcomes for 3 periods were compared: baseline (B, February to May 2006), model 1 (M...

متن کامل

Reducing co-administration of proton pump inhibitors and antibiotics using a computerized order entry alert and prospective audit and feedback

BACKGROUND Antibiotics and proton pump inhibitors (PPIs) are associated with Clostridium difficile infection (CDI). Both a computer order entry alert to highlight this association as well as antimicrobial stewardship directed prospective audit and feedback represent novel interventions to reduce the co-administration of antibiotics and PPIs among hospitalized patients. METHODS Consecutive pat...

متن کامل

Antibiotic Prescribing Trends Before and After Implementation of an Audit and Feedback Program in Internal ward of a Tertiary Hospital in Tehran

We implemented a post prescribing review and feedback program to investigate its effect on appropriateness of antimicrobial use and antimicrobial consumption rate.A pre-post interventional study conducted in internal ward of Imam Hossein teaching hospital. For nine months of intervention phase, medical file of all patients who received intravenous antibiotic were reviewed by a clinical ph...

متن کامل

Antibiotic Prescribing Trends Before and After Implementation of an Audit and Feedback Program in Internal ward of a Tertiary Hospital in Tehran

We implemented a post prescribing review and feedback program to investigate its effect on appropriateness of antimicrobial use and antimicrobial consumption rate.A pre-post interventional study conducted in internal ward of Imam Hossein teaching hospital. For nine months of intervention phase, medical file of all patients who received intravenous antibiotic were reviewed by a clinical ph...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 1  شماره 

صفحات  -

تاریخ انتشار 2014