scholarly journals Increasing Voluntary Public Health Reporting to the NHSN Antimicrobial Use Option

2020 ◽  
Vol 41 (S1) ◽  
pp. s296-s297
Author(s):  
Heather Dubendris ◽  
Amy Webb ◽  
Melinda Neuhauser ◽  
Arjun Srinivasan ◽  
Wendy Wise ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Stewardship ◽  
Self Report ◽  
Antimicrobial Use ◽  
Health Departments ◽  
Public Health Reporting ◽  
Use Stage ◽  
Education And Development ◽  
Health Registry ◽  
Over Time

Background: The CDC NHSN launched the Antimicrobial Use Option in 2011. The Antimicrobial Use Option allows users to implement risk-adjusted antimicrobial use benchmarking within- and between- facilities using the standardized antimicrobial administration ratio (SAAR) and to evaluate use over time. The SAAR can be used for public health surveillance and to guide an organization’s stewardship or quality improvement efforts. Methods: Antimicrobial Use Option enrollment grew through partner engagement, targeted education, and development of data benchmarking. We analyze enrollment over time and discuss key drivers of participation. Results: Initial 2011 Antimicrobial Use Option enrollment efforts awarded grant Funding: to 4 health departments. These health departments partnered with hospitals, which encouraged vendors to build infrastructure for electronic antimicrobial use reporting. CDC supported vendors through outreach and education. In 2012, with CDC support, Veterans’ Affairs (VA) Informatics, Decision-Enhancement, and Analytic Sciences Center and partners began implementation of Antimicrobial Use Option reporting and validation of submitted data. These early efforts led to enrollment of 64 facilities by 2014 (Fig. 1). As awareness of the antimicrobial use option grew, we focused on facility engagement and development of benchmark metrics. A second round of grant Funding: in 2015 supported submission to the Antimicrobial Use Option from additional facilities by Funding: a vendor, a healthcare system, and an antimicrobial stewardship network. In 2015, CMS recognized the Antimicrobial Use Option as a choice for public health registry reporting under Meaningful Use Stage 3, resulting in an increase in participating hospitals. Antimicrobial Use Option enrollment increased in 2015 (n = 120), coinciding with national prioritization of antimicrobial stewardship. In 2016, the SAAR, was released in NHSN. We leveraged the SAAR to encourage participation from additional facilities and began quarterly calls to encourage continued participation from existing users. In 2016, the Department of Defense began submitting data to the Antimicrobial Use Option, resulting in 207 facilities enrolled in 2016, which grew to 616 in 2017. As of November 2019, 12 vendors self-report submission capabilities and 1,470 facilities, of ~6,800 active NHSN participants, are enrolled in the Antimicrobial Use Option. Two states have passed requirements regulating Antimicrobial Use Option reporting with Tennessee’s requirement going into effect in 2021. Conclusions: The Antimicrobial Use Option offers evidence that collaboration with partners, and leveraging of benchmarking metrics available to a national surveillance system can lead to increased voluntary participation in surveillance of high-priority public health data. Moving forward, we will continue expanding analytic capabilities and partner engagement.Funding: NoneDisclosures: None

scholarly journals 152. Applying A Difference-in-Difference Analysis to Assess Effect of Antimicrobial Stewardship Strategies on Changes in Antimicrobial Use

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S86-S86
Author(s):  
Ann F Chou ◽  
Yue Zhang ◽  
Makoto M Jones ◽  
Christopher J Graber ◽  
Matthew B Goetz ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Clinical Pharmacist ◽  
Antibiotic Use ◽  
Feedback Mechanism ◽  
Health Care Facilities ◽  
Antimicrobial Use ◽  
Time Points ◽  
The Difference ◽  
The Impact ◽  
Over Time

Abstract Background About 30–50% of inpatient antimicrobial therapy is sub-optimal. Health care facilities have utilized various antimicrobial stewardship (AS) strategies to optimize appropriate antimicrobial use, improve health outcomes, and promote patient safety. However, little evidence exists to assess relationships between AS strategies and antimicrobial use. This study examined the impact of changes in AS strategies on antimicrobial use over time. Methods This study used data from the Veterans Affairs (VA) Healthcare Analysis & Informatics Group (HAIG) AS survey, administered at 130 VA facilities in 2012 and 2015, and antimicrobial utilization from VA Corporate Data Warehouse. Four AS strategies were examined: having an AS team, feedback mechanism on antimicrobial use, infectious diseases (ID) attending physicians, and clinical pharmacist on wards. Change in AS strategies were computed by taking the difference in the presence of a given strategy in a facility between 2012–2015. The outcome was the difference between antimicrobial use per 1000 patient days in 2012–2013 and 2015–2016. Employing multiple regression analysis, changes in antimicrobial use was estimated as a function of changes in AS strategies, controlling for ID human resources in and organizational complexity. Results Of the 4 strategies, only change in availability of AS teams had an impact on antimicrobial use. Compared to facilities with no AS teams at both time points, antibiotic use decreased by 63.9 uses per 1000 patient days in facilities that did not have a AS team in 2012 but implemented one in 2015 (p=0.0183). Facilities that had an AS team at both time points decreased use by 62.2 per 1000 patient days (p=0.0324). Conclusion The findings showed that AS teams reduced inpatient antibiotic use over time. While changes in having feedback on antimicrobial use and clinical pharmacist on wards showed reduced antimicrobial use between 2012–2015, the differences were not statistically significant. These strategies may already be a part of a comprehensive AS program and employed by AS teams. In further development of stewardship programs within healthcare organizations, the association between AS teams and antibiotic use should inform program design and implementation. Disclosures All Authors: No reported disclosures

scholarly journals Assessing Robustness of Antimicrobial Stewardship in Colorado Hospitals and Barriers to Improvement

2021 ◽  
Vol 1 (S1) ◽  
pp. s15-s15
Author(s):  
Daniel Dodson ◽  
Matthew Kronman ◽  
Sarah Parker ◽  
Christopher Czaja
Keyword(s):  
Public Health ◽  
Antimicrobial Stewardship ◽  
Pediatric Patients ◽  
Antibiotic Use ◽  
Audit And Feedback ◽  
Defined Daily Dose ◽  
Health Departments ◽  
Web Based ◽  
Public Health Departments ◽  
Core Elements

Background: Adherence to core elements of antimicrobial stewardship programs (ASPs) is increasing nationally but the robustness of programs and inclusion of pediatrics is poorly understood. We describe the details of ASP in Colorado hospitals and identify steps by which academic centers and public health departments can assist community ASPs. Methods: We invited ASP leaders at the 102 acute-care hospitals (ACHs) and critical-access hospitals (CAHs) in Colorado to participate in a web-based survey regarding their ASPs. Questions related to adherence to Centers for Disease Control and Prevention (CDC) core elements, barriers to improvement, desired resources, and extension to pediatrics. Enrollment began in August 2020. Hospital types were compared using the Fisher exact test. Results: As of January 1, 2021, 31 hospitals (30% of targeted hospitals) completed the web-based survey including 19 ACH and 12 CAH. Hospitals were distributed across the state. Median number of beds was 52 (range, 11–680). Of the responding hospitals, 87% were adherent to all CDC core elements. However, if action was defined as prospective audit and feedback or prior authorization, tracking was defined as measuring antibiotic use in days of therapy (DOT) or defined daily dose (DDD) quarterly, and reporting was defined as providing unit- or provider-specific antibiotic use reports annually. Overall adherence fell to 35% including 81% for action, 58% for tracking, and 58% for reporting. CAHs were less likely to adhere to these strict criteria than ACHs (Figure 1). In the 27 hospitals (87% of hospitals) caring for pediatric patients, adherence to a strict action for at least 1 pediatric population was 59%. Reported barriers to improved ASP were available time and personnel, information technology support, perceived concerns about provider attitudes, and education gaps (Figure 2). CAHs were less likely to use the NHSN antibiotic use or resistance modules or have a data analyst than ACHs (Figure 3). Pediatric pharmacy expertise and guidelines were often not available in hospitals caring for pediatric patients. Desired ASP resources included assistance with data analysis, access to stewardship expertise and education, and treatment guidelines, including for pediatrics. Conclusions: Adherence to CDC core elements of an ASP was excellent but fell dramatically when stricter criteria were used and was worse in pediatric patients. Academic centers and public health departments can assist community hospitals by providing educational resources, assistance in analyzing data including using the NHSN ED: /AR modules, and ASP expertise and clinical care guidelines including those for pediatrics.Funding: NoDisclosures: None

Antimicrobial Stewardship Programs in Florida's Acute Care Facilities

2013 ◽  
Vol 34 (6) ◽  
pp. 634-637 ◽  
Author(s):  
Lilian Abbo ◽  
Kaming Lo ◽  
Ronda Sinkowitz-Cochran ◽  
Anne Carol Burke ◽  
Richard S. Hopkins ◽  
...  
Keyword(s):  
Acute Care ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Use ◽  
Health Departments ◽  
Care Facilities ◽  
Acute Care Facilities ◽  
Collaborative Efforts

We surveyed acute care facilities in Florida to assess components of and barriers to sustained antimicrobial stewardship programs (ASPs). Most respondents with and without ASPs are doing some stewardship-related activities to improve antimicrobial use. Collaborative efforts between facilities and health departments are important to providing better resources for ASPs.

scholarly journals 1629. Targeted Antimicrobial Use Admission Provides an Actionable Denominator for Antimicrobial Stewardship Programs Evaluating Inpatient Length of Therapy

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S42-S42
Author(s):  
April Dyer ◽  
Elizabeth Dodds Ashley ◽  
Angelina Davis ◽  
Melissa Johnson ◽  
Travis Jones ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Hospital Admissions ◽  
Antibiotic Use ◽  
Audit And Feedback ◽  
Electronic Prescribing ◽  
Antimicrobial Use ◽  
Number Of Patients ◽  
Length Of Therapy ◽  
The Impact ◽  
Over Time

Abstract Background Actionable, easy to interpret antibiotic use (AU) metrics provide antimicrobial stewardship programs (ASPs) with clear targets. Current aggregate AU metrics lack the ability to discriminate between long courses in a limited number of patients versus short courses in a large number of patients. Methods We developed a novel AU denominator termed “targeted antimicrobial use admission,” defined as an inpatient admission in which a selected agent or group of agents was administered. When used with length of therapy (LOT), it provides the average number of days patients receive the targeted agent(s) during inpatient hospital admissions. To demonstrate the added utility of this metric, we used descriptive statistics to compare it to LOT, LOT/1,000 patient days, LOT/1,000 admissions, and LOT/admission to quantify intravenous (IV) vancomycin use among 25 hospitals in the Duke Antimicrobial Stewardship Outreach Network (DASON) for calendar year 2017. The metric was also used to compare hospitals to one another and track durations at an example hospital over time. Results Total LOT included 128,680 days of IV vancomycin (table). LOT/targeted antimicrobial use admission is the only metric that allows programs to quickly assess agent durations. Conclusion Stewardship programs seeking to shorten durations of therapy can track this metric over time to determine the impact of their ASP efforts (Figure 1). The metric can also be used to compare average durations of IV vancomycin by hospital to determine when and if agent-focused audit and feedback or antibiotic timeouts may be useful (Figure 2). The network mean provides a target for agent-specific de-escalations, in days, for facilities with longer durations. LOT/targeted antimicrobial use admission provides an actionable metric for quantifying antimicrobial durations. This metric is easy to interpret and can feasibly be captured through the electronic prescribing record to aid in selecting ASP strategy. Disclosures All authors: No reported disclosures.

scholarly journals 207Metrics for Analyzing an Antimicrobial Stewardship Program's Impact on Antimicrobial Use and Cost over Time

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S92-S92
Author(s):  
Jessica Johnston ◽  
Erica E. Reed ◽  
Karri A. Bauer ◽  
Kurt Stevenson
Keyword(s):  
Antimicrobial Stewardship ◽  
Antimicrobial Use ◽  
Over Time

scholarly journals Pharmacy Students’ Knowledge and Perceptions about Antimicrobial Stewardship

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Nehad J Ahmed ◽  
Khalil Y Abujheisha ◽  
Mohamed F. Balaha
Keyword(s):  
Public Health ◽  
Saudi Arabia ◽  
Antibiotic Resistance ◽  
Antimicrobial Stewardship ◽  
Bacterial Resistance ◽  
Background Knowledge ◽  
Antibiotic Use ◽  
Pharmacy Students ◽  
Antimicrobial Use ◽  
Global Public Health

Introduction: Antibiotic resistance is considered one of the serious threats to global public health. Antimicrobial stewardship programs should be implemented by all hospitals to improve antimicrobial use. It is important that pharmacy students have a sound knowledge of antimicrobial stewardship. Objective: The aim of this study was to determine pharmacy students’ knowledge and perceptions about antimicrobial stewardship. Methodology: The study included a questionnaire that was used to assess the background knowledge of pharmacy students and their perceptions on antimicrobial stewardship. Results and Discussion: Out of 103 students who completed the survey, 25 students (24.27%) reported that they know what antimicrobial Stewardship is, and only 39 students were familiar with antimicrobial stewardship programs in Saudi Arabia. Most of the students (95.14%) reported that they need more antimicrobial stewardship training. Conclusion: Our results, therefore, recommend that pharmacy students should have more training on bacterial resistance, antibiotic use and antimicrobial stewardship.

The Swiss Prison Study (SWIPS): Protocol for Establishing a Public Health Registry of Prisoners in Switzerland (Preprint)

2020 ◽  
Author(s):  
Thomas Gaisl ◽  
Naser Musli ◽  
Patrick Baumgartner ◽  
Marc Meier ◽  
Silvana K Rampini ◽  
...  
Keyword(s):  
Public Health ◽  
Medical History ◽  
Large Scale ◽  
International Classification Of Diseases ◽  
Disease Prevalence ◽  
Vulnerable Population ◽  
International Classification ◽  
Classification Of Diseases ◽  
Health Registry

BACKGROUND The health aspects, disease frequencies, and specific health interests of prisoners and refugees are poorly understood. Importantly, access to the health care system is limited for this vulnerable population. There has been no systematic investigation to understand the health issues of inmates in Switzerland. Furthermore, little is known on how recent migration flows in Europe may have affected the health conditions of inmates. OBJECTIVE The Swiss Prison Study (SWIPS) is a large-scale observational study with the aim of establishing a public health registry in northern-central Switzerland. The primary objective is to establish a central database to assess disease prevalence (ie, International Classification of Diseases-10 codes [German modification]) among prisoners. The secondary objectives include the following: (1) to compare the 2015 versus 2020 disease prevalence among inmates against a representative sample from the local resident population, (2) to assess longitudinal changes in disease prevalence from 2015 to 2020 by using cross-sectional medical records from all inmates at the Police Prison Zurich, Switzerland, and (3) to identify unrecognized health problems to prepare successful public health strategies. METHODS Demographic and health-related data such as age, sex, country of origin, duration of imprisonment, medication (including the drug name, brand, dosage, and release), and medical history (including the International Classification of Diseases-10 codes [German modification] for all diagnoses and external results that are part of the medical history in the prison) have been deposited in a central register over a span of 5 years (January 2015 to August 2020). The final cohort is expected to comprise approximately 50,000 to 60,000 prisoners from the Police Prison Zurich, Switzerland. RESULTS This study was approved on August 5, 2019 by the ethical committee of the Canton of Zurich with the registration code KEK-ZH No. 2019-01055 and funded in August 2020 by the “Walter and Gertrud Siegenthaler” foundation and the “Theodor and Ida Herzog-Egli” foundation. This study is registered with the International Standard Randomized Controlled Trial Number registry. Data collection started in August 2019 and results are expected to be published in 2021. Findings will be disseminated through scientific papers as well as presentations and public events. CONCLUSIONS This study will construct a valuable database of information regarding the health of inmates and refugees in Swiss prisons and will act as groundwork for future interventions in this vulnerable population. CLINICALTRIAL ISRCTN registry ISRCTN11714665; http://www.isrctn.com/ISRCTN11714665 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/23973

Faculty and Resident Physicians' Attitudes, Perceptions, and Knowledge about Antimicrobial Use and Resistance

2011 ◽  
Vol 32 (7) ◽  
pp. 714-718 ◽  
Author(s):  
Lilian Abbo ◽  
Ronda Sinkowitz-Cochran ◽  
Laura Smith ◽  
Ella Ariza-Heredia ◽  
Orlando Gómez-Marín ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Antimicrobial Use ◽  
Inappropriate Use ◽  
Resident Physicians

We surveyed faculty and residents to assess attitudes, perceptions, and knowledge about antimicrobial use and resistance. Most respondents were concerned about resistance when prescribing antibiotics and agreed that antibiotics are overused, that inappropriate use is professionally unethical, and that others, but not themselves, overprescribe antibiotics. Antimicrobial stewardship programs should capitalize on these perceptions.

scholarly journals Predictors of historical change in drug treatment coverage among people who inject drugs in 90 large metropolitan areas in the USA, 1993–2007

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Barbara Tempalski ◽  
Leslie D. Williams ◽  
Brooke S. West ◽  
Hannah L. F. Cooper ◽  
Stephanie Beane ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Treatment ◽  
Resource Availability ◽  
People Who Inject Drugs ◽  
Census Data ◽  
Poverty Rate ◽  
Community Action ◽  
Historical Change ◽  
Treatment Coverage ◽  
Over Time

Abstract Background Adequate access to effective treatment and medication assisted therapies for opioid dependence has led to improved antiretroviral therapy adherence and decreases in morbidity among people who inject drugs (PWID), and can also address a broad range of social and public health problems. However, even with the success of syringe service programs and opioid substitution programs in European countries (and others) the US remains historically low in terms of coverage and access with regard to these programs. This manuscript investigates predictors of historical change in drug treatment coverage for PWID in 90 US metropolitan statistical areas (MSAs) during 1993–2007, a period in which, overall coverage did not change. Methods Drug treatment coverage was measured as the number of PWID in drug treatment, as calculated by treatment entry and census data, divided by numbers of PWID in each MSA. Variables suggested by the Theory of Community Action (i.e., need, resource availability, institutional opposition, organized support, and service symbiosis) were analyzed using mixed-effects multivariate models within dependent variables lagged in time to study predictors of later change in coverage. Results Mean coverage was low in 1993 (6.7%; SD 3.7), and did not increase by 2007 (6.4%; SD 4.5). Multivariate results indicate that increases in baseline unemployment rate (β = 0.312; pseudo-p < 0.0002) predict significantly higher treatment coverage; baseline poverty rate (β = − 0.486; pseudo-p < 0.0001), and baseline size of public health and social work workforce (β = 0.425; pseudo-p < 0.0001) were predictors of later mean coverage levels, and baseline HIV prevalence among PWID predicted variation in treatment coverage trajectories over time (baseline HIV * Time: β = 0.039; pseudo-p < 0.001). Finally, increases in black/white poverty disparity from baseline predicted significantly higher treatment coverage in MSAs (β = 1.269; pseudo-p < 0.0001). Conclusions While harm reduction programs have historically been contested and difficult to implement in many US communities, and despite efforts to increase treatment coverage for PWID, coverage has not increased. Contrary to our hypothesis, epidemiologic need, seems not to be associated with change in treatment coverage over time. Resource availability and institutional opposition are important predictors of change over time in coverage. These findings suggest that new ways have to be found to increase drug treatment coverage in spite of economic changes and belt-tightening policy changes that will make this difficult.

scholarly journals A Panel Evaluation of the Changes in the General Public’s Social-Media-Following of United States’ Public Health Departments during COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
pp. 215013272199545
Author(s):  
Areej Khokhar ◽  
Aaron Spaulding ◽  
Zuhair Niazi ◽  
Sikander Ailawadhi ◽  
Rami Manochakian ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
State Level ◽  
The State ◽  
Public Health Department ◽  
Health Departments ◽  
The Public ◽  
Public Health Departments ◽  
The Social ◽  
The U.S

Importance: Social media is widely used by various segments of society. Its role as a tool of communication by the Public Health Departments in the U.S. remains unknown. Objective: To determine the impact of the COVID-19 pandemic on social media following of the Public Health Departments of the 50 States of the U.S. Design, Setting, and Participants: Data were collected by visiting the Public Health Department web page for each social media platform. State-level demographics were collected from the U.S. Census Bureau. The Center for Disease Control and Prevention was utilized to collect information regarding the Governance of each State’s Public Health Department. Health rankings were collected from “America’s Health Rankings” 2019 Annual report from the United Health Foundation. The U.S. News and World Report Education Rankings were utilized to provide information regarding the public education of each State. Exposure: Data were pulled on 3 separate dates: first on March 5th (baseline and pre-national emergency declaration (NED) for COVID-19), March 18th (week following NED), and March 25th (2 weeks after NED). In addition, a variable identifying the total change across platforms was also created. All data were collected at the State level. Main Outcome: Overall, the social media following of the state Public Health Departments was very low. There was a significant increase in the public interest in following the Public Health Departments during the early phase of the COVID-19 pandemic. Results: With the declaration of National Emergency, there was a 150% increase in overall public following of the State Public Health Departments in the U.S. The increase was most noted in the Midwest and South regions of the U.S. The overall following in the pandemic “hotspots,” such as New York, California, and Florida, was significantly lower. Interesting correlations were noted between various demographic variables, health, and education ranking of the States and the social media following of their Health Departments. Conclusion and Relevance: Social media following of Public Health Departments across all States of the U.S. was very low. Though, the social media following significantly increased during the early course of the COVID-19 pandemic, but it still remains low. Significant opportunity exists for Public Health Departments to improve social media use to engage the public better.

Sign in / Sign up

Export Citation Format

Share Document