scholarly journals Decreases in Antimicrobial Use Associated With Multihospital Implementation of Electronic Antimicrobial Stewardship Tools

2019 ◽  
Vol 71 (5) ◽  
pp. 1168-1176 ◽  
Author(s):  
Christopher J Graber ◽  
Makoto M Jones ◽  
Matthew Bidwell Goetz ◽  
Karl Madaras-Kelly ◽  
Yue Zhang ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Veterans Affairs ◽  
Comparative Data ◽  
Absolute Difference ◽  
Antimicrobial Use ◽  
Post Intervention ◽  
Web Based ◽  
Geographically Dispersed ◽  
Learning Collaboratives ◽  
Visualization Tools

Abstract Background Antimicrobial stewards may benefit from comparative data to inform interventions that promote optimal inpatient antimicrobial use. Methods Antimicrobial stewards from 8 geographically dispersed Veterans Affairs (VA) inpatient facilities participated in the development of antimicrobial use visualization tools that allowed for comparison to facilities of similar complexity. The visualization tools consisted of an interactive web-based antimicrobial dashboard and, later, a standardized antimicrobial usage report updated at user-selected intervals. Stewards participated in monthly learning collaboratives. The percent change in average monthly antimicrobial use (all antimicrobial agents, anti-methicillin-resistant Staphylococcus aureus [anti-MRSA] agents, and antipseudomonal agents) was analyzed using a pre–post (January 2014–January 2016 vs July 2016–January 2018) design with segmented regression and external comparison with uninvolved control facilities (n = 118). Results Intervention sites demonstrated a 2.1% decrease (95% confidence interval [CI], −5.7% to 1.6%) in total antimicrobial use pre–post intervention vs a 2.5% increase (95% CI, 0.8% to 4.1%) in nonintervention sites (absolute difference, 4.6%; P = .025). Anti-MRSA antimicrobial use decreased 11.3% (95% CI, −16.0% to −6.3%) at intervention sites vs a 6.6% decrease (95% CI, −9.1% to −3.9%) at nonintervention sites (absolute difference, 4.7%; P = .092). Antipseudomonal antimicrobial use decreased 3.4% (95% CI, −8.2% to 1.7%) at intervention sites vs a 3.6% increase (95% CI, 0.8% to 6.5%) at nonintervention sites (absolute difference, 7.0%; P = .018). Conclusions Comparative data visualization tool use by stewards at 8 VA facilities was associated with significant reductions in overall antimicrobial and antipseudomonal use relative to uninvolved facilities.

scholarly journals 1058. Decreases in Antibiotic Use Associated with the Implementation of Electronic Antibiotic Visualization Tools for Stewards at Eight Veterans Affairs (VA) Healthcare Facilities

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S374-S374
Author(s):  
Christopher J Graber ◽  
Makoto M Jones ◽  
Matthew B Goetz ◽  
Karl Madaras-Kelly ◽  
Yue Zhang ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Antibiotic Use ◽  
Antimicrobial Use ◽  
Post Intervention ◽  
Healthcare Facilities ◽  
Use Of Data ◽  
Patterns Of Use ◽  
Learning Collaboratives ◽  
Visualization Tools ◽  
Pilot Implementation

Abstract Background To identify areas for improved antibiotic use, we developed and pilot-tested visualization tools to quantify antibiotic use at 8 VA facilities. These tools allow a facility to review its patterns of total use, and use by antibiotic class, compared with patterns of use at VA facilities with similar (or user-selected) complexity levels. Methods Antibiotic stewards from 8 VA facilities participated in iterative report development and implementation, with the final product consisting of two components: an interactive web-based antibiotic dashboard and a standardized antibiotic usage report updated at user-selected intervals. Stewards also participated in monthly learning collaboratives. The percent change in average monthly antimicrobial use (all antibiotics; anti-methicillin-resistant S. aureus agents (anti-MRSA); and broad-spectrum agents predominantly used for hospital-onset/multi-drug-resistant organisms (anti-MDRO)) was analyzed using a pre-post (January 2014–January 2016 vs. July 2016–January 2018) with un-involved controls (all other inpatient VA facilities, n = 132) design modeled using Generalized Estimation Equations segmented regression. Results Intervention sites had a 2.1% decrease (95% CI = [−5.7%,1.6%]) in all antibiotic use pre-post-intervention, vs. a 2.5% increase (95% CI = [0.8%, 4.1%]) in nonintervention sites (P = 0.025 for difference). Anti-MRSA antibiotic use decreased 11.3% (95% CI = [−16.0%,−6.3%]) at intervention sites vs. a 6.6% decrease (95% CI=[−9.1%, −3.9%]) at nonintervention sites (P = 0.092 for difference). Anti-MDRO antibiotic use decreased 3.4% (95% CI = [−8.2%,1.7%]) at intervention sites vs. a 3.6% increase (95% CI = [0.8%,6.5%]) at nonintervention sites (P = 0.018 for difference) (Figure 1). Examples of graphs include overall antibacterial use (Figure 2), and usage of broad-spectrum Gram-negative therapy (Figure 3) in intensive care units. Conclusion The use of data visualization tools use and participation in monthly learning collaboratives by antimicrobial stewards in a pilot implementation project at eight VA facilities was associated with decreases in antimicrobial use relative to uninvolved sites. Disclosures All authors: No reported disclosures.

eMap: A Web Application for Identifying and Visualizing Electron or Hole Hopping Pathways in Proteins

2019 ◽  
Author(s):  
Ruslan N. Tazhigulov ◽  
James R. Gayvert ◽  
Melissa Wei ◽  
Ksenia B. Bravaya
Keyword(s):  
Web Application ◽  
Shortest Paths ◽  
Coarse Grained ◽  
Decay Parameter ◽  
Electron Hole ◽  
Web Based ◽  
Aromatic Amino Acid Residue ◽  
Pathways Model ◽  
Visualization Tools ◽  
Effective Decay

<p>eMap is a web-based platform for identifying and visualizing electron or hole transfer pathways in proteins based on their crystal structures. The underlying model can be viewed as a coarse-grained version of the Pathways model, where each tunneling step between hopping sites represented by electron transfer active (ETA) moieties is described with one effective decay parameter that describes protein-mediated tunneling. ETA moieties include aromatic amino acid residue side chains and aromatic fragments of cofactors that are automatically detected, and, in addition, electron/hole residing sites that can be specified by the users. The software searches for the shortest paths connecting the user-specified electron/hole source to either all surface-exposed ETA residues or to the user-specified target. The identified pathways are ranked based on their length. The pathways are visualized in 2D as a graph, in which each node represents an ETA site, and in 3D using available protein visualization tools. Here, we present the capability and user interface of eMap 1.0, which is available at https://emap.bu.edu.</p>

First Responders’ and Librarians’ Intention to Use Web-Based Resources for Response Information During Biological, Chemical, and Radiological Terrorism Events

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
James Turner ◽  
Terri Rebmann ◽  
Travis Loux ◽  
Donghua Tao ◽  
Alexander Garza
Keyword(s):  
Disaster Response ◽  
First Responders ◽  
Internet Access ◽  
Intention To Use ◽  
National Library ◽  
Post Intervention ◽  
Web Based ◽  
Emergency Responders ◽  
Internet Connection ◽  
Response Information

AbstractEmergency planners and first responders often access web-based information resources during disasters; however, these tools require an active Internet connection, which may be unavailable during a disaster. The National Library of Medicine (NLM) provides several free non-web-based disaster response tools. This study assessed intention to use web-based and non-web-based informational and response tools during disasters among emergency responders and librarians. Educational workshops were held in four Missouri cities in spring, 2016. The NLM tools were presented and attendees practiced using the tools during disaster scenarios. Pre- and post-intervention data about NLM tool awareness and intention to use these tools versus other web-based resources was collected. McNemar tests assessed a pre/post change in intention to use each resource. Four workshops were held, with a total of 74 attendees. Intention to use the NLM tools was low prior to the workshops (range: 20.3–39.2%), but increased significantly immediately afterwards (p < .001 for all pre/post comparisons). The workshops resulted in increased NLM tool awareness and increased intention to use the tools during future disasters. This provides evidence of attendees’ perceptions of the usefulness of the non-web-based NLM tools in place of other web-based tools in situations without Internet access.

scholarly journals Effectiveness of web-based and mobile health interventions designed to enhance adherence to physical activity for people with inflammatory arthritis: a systematic review

2021 ◽  
Author(s):  
Mandeep Sekhon ◽  
Claire White ◽  
Emma Godfrey ◽  
Aliya Amirova ◽  
Åsa Revenäs ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Inflammatory Arthritis ◽  
Risk Of Bias ◽  
Health Interventions ◽  
Behaviour Change Techniques ◽  
Post Intervention ◽  
Web Based ◽  
Intervention Content ◽  
Secondary Outcomes

Abstract Objective The aim of this systematic review was to assess the evidence from randomised controlled trials (RCT) and cohort studies for the effectiveness of digital interventions designed to enhance adherence to physical activity (PA) for people with inflammatory arthritis (IA) and describe the intervention content using established coding criteria. Methods Six electronic databases were searched for published and unpublished studies. Independent data extraction and quality assessment (Cochrane risk of bias II or ROBIN I) were conducted by two reviewers. The primary outcome was self-reported adherence to PA post-intervention. Secondary outcomes included self-reported adherence to PA at other timepoints, level of PA or engagement with intervention at any follow-up timepoint. Intervention content was assessed using the Consensus on Exercise Reporting Template and the Behaviour Change Techniques taxonomy version 1. Results From 11,136 reports, four moderate risk of bias studies (three RCTs, one cohort study) including 1,160 participants with rheumatoid arthritis or juvenile inflammatory arthritis were identified. Due to heterogeneity of outcomes, a narrative synthesis was conducted. Only one RCT reported a small between group difference in adherence to PA [mean difference (95% confidence intervals) -0.46 (-0.82. -0.09)] in favour of the intervention. There were no between group differences in any secondary outcomes. Interventions included between 3–11 behaviour change techniques but provided minimal exercise prescription information. Conclusion There is currently limited moderate quality evidence available to confidently evaluate the effect of web-based and mobile health interventions on adherence to PA or level of PA post intervention in people with IA.

Antimicrobial Use Control Measures to Prevent and Control Antimicrobial Resistance in US Hospitals

2006 ◽  
Vol 27 (10) ◽  
pp. 1088-1095 ◽  
Author(s):  
Alan J. Zillich ◽  
Jason M. Sutherland ◽  
Stephen J. Wilson ◽  
Daniel J. Diekema ◽  
Erika J. Ernst ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Antimicrobial Resistance ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Veterans Affairs ◽  
Control Measures ◽  
Antimicrobial Use ◽  
Cross Sectional ◽  
Term Care ◽  
Recommended Practices

Objective.Clinical practice guidelines and recommended practices to control use of antibiotics have been published, but the effect of these practices on antimicrobial resistance (AMR) rates in hospitals is unknown. The objective of this study was to examine relationships between antimicrobial use control strategies and AMR rates in a national sample of US hospitals.Design.Cross-sectional, stratified study of a nationally representative sample of US hospitals.Methods.A survey instrument was sent to the person responsible for infection control at a sample of 670 US hospitals. The outcome was current prevalences of 4 epidemiologically important, drug-resistant pathogens, considered concurrently: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, ceftazidime-resistant Klebsiella species, and quinolone (ciprofloxacin)-resistant Escherichia coli Five independent variables regarding hospital practices were selected from the survey: the extent to which hospitals (1) implement practices recommended in clinical practice guidelines and ensure best practices for antimicrobial use, (2) disseminate information on clinical practice guidelines for antimicrobial use, (3) use antimicrobial-related information technology, (4) use decision support tools, and (5) communicate to prescribers about antimicrobial use. Control variables included the hospitals' number of beds, teaching status, Veterans Affairs status, geographic region, and number of long-term care beds; and the presence of an intensive care unit, a burn unit, or transplant services. A generalized estimating equation modeled all resistance rates simultaneously to identify overall predictors of AMR levels at the facility.Results.Completed survey instruments were returned by 448 hospitals (67%). Four antimicrobial control measures were associated with higher prevalence of AMR. Implementation of recommended practices for antimicrobial use (P< .01) and optimization of the duration of empirical antibiotic prophylaxis (P<.01) were associated with a lower prevalence of AMR. Use of restrictive formularies (P = .05) and dissemination of clinical practice guideline information (P<.01) were associated with higher prevalence of AMR. Number of beds and Veterans Affairs status were also associated with higher AMR rates overall.Conclusions.Implementation of guideline-recommended practices to control antimicrobial use and optimize the duration of empirical therapy appears to help control AMR rates in US hospitals. A longitudinal study would confirm the results of this cross-sectional study. These results highlight the need for systems interventions and reengineering to ensure more-consistent application of guideline-recommended measures for antimicrobial use.

scholarly journals 1864. Implementation of the National Healthcare Safety Network’s (NHSN) Antimicrobial Use Option in the US Veterans Affairs (VA) Medical Facilities

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S532-S533
Author(s):  
Julia Lewis ◽  
Stacey Slager ◽  
Jeremy Barraza ◽  
Gary Roselle ◽  
Jeanmarie Mayer ◽  
...  
Keyword(s):  
Veterans Affairs ◽  
Antimicrobial Use ◽  
National Healthcare ◽  
Medical Facilities ◽  
The Us ◽  
Us Veterans

Principles of Judicious Use of Antimicrobial Agents for Pediatric Upper Respiratory Tract Infections

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_1) ◽  
pp. 163-165 ◽  
Author(s):  
Scott F. Dowell ◽  
S. Michael Marcy ◽  
William R. Phillips ◽  
Michael A. Gerber ◽  
Benjamin Schwartz
Keyword(s):  
Respiratory Tract ◽  
Antimicrobial Agents ◽  
Respiratory Infections ◽  
The United States ◽  
Antimicrobial Treatment ◽  
Antimicrobial Use ◽  
Upper Respiratory Tract ◽  
Oral Agents ◽  
Upper Respiratory ◽  
Tract Infections

This article introduces a set of principles to define judicious antimicrobial use for five conditions that account for the majority of outpatient antimicrobial use in the United States. Data from the National Center for Health Statistics indicate that in recent years, approximately three fourths of all outpatient antibiotics have been prescribed for otitis media, sinusitis, bronchitis, pharyngitis, or nonspecific upper respiratory tract infection.1Antimicrobial drug use rates are highest for children1; therefore, the pediatric age group represents the focus for the present guidelines. The evidence-based principles presented here are focused on situations in which antimicrobial therapy could be curtailed without compromising patient care. They are not formulated as comprehensive management strategies. For most upper respiratory infections that require antimicrobial treatment, there are several appropriate oral agents from which to choose. Although the general principles of selecting narrow-spectrum agents with the fewest side effects and lowest cost are important, the principles that follow include few specific antibiotic selection recommendations.

A Web-Based Tool for Visualization of Biomolecular Network Comparison

2014 ◽  
Vol 556-562 ◽  
pp. 5482-5487
Author(s):  
Hui Ran Zhang ◽  
Xiao Long Shen ◽  
Jiang Xie ◽  
Dong Bo Dai
Keyword(s):  
Open Source ◽  
Undirected Graphs ◽  
Web Based ◽  
Network Comparison ◽  
Biomolecular Networks ◽  
Biomolecular Network ◽  
Visualization Tools ◽  
Similarities And Differences ◽  
Adaptive Visualization

Analyzing similarities and differences between biomolecular networks comparison through website intuitively could be a convenient and effective way for researchers. Although several network comparison visualization tools have been developed, none of them can be integrated into websites. In this paper, a web-based tool kit named dynamically adaptive Visualization of Biomolecular Network Comparison (Bio-NCV) is designed and developed. The proposed tool is based on Cytyoscape.js – a popular open-source library for analyzing and visualizing networks. Bio-NCV integrates arjor.js which including the Barnes-Hut algorithm and the Traer Physics library for processing in order to express the dynamically adaptive initialization. In addition, in order to maintain consistency, the counterparts in other networks will change while the nodes and edges in one of the compared networks change. Furthermore, Bio-NCV can deal with both directed and undirected graphs.

scholarly journals KiMoSys 2.0: an upgraded database for submitting, storing and accessing experimental data for kinetic modeling

Database ◽  
2020 ◽  
Vol 2020 ◽  
Author(s):  
Hugo Mochão ◽  
Pedro Barahona ◽  
Rafael S Costa
Keyword(s):  
Experimental Data ◽  
Metabolic Networks ◽  
Model Simulation ◽  
Web Interface ◽  
Concentration Data ◽  
Web Based ◽  
Share Data ◽  
Visualization Tools ◽  
Filter Mechanism ◽  
Machine Readable

Abstract The KiMoSys (https://kimosys.org), launched in 2014, is a public repository of published experimental data, which contains concentration data of metabolites, protein abundances and flux data. It offers a web-based interface and upload facility to share data, making it accessible in structured formats, while also integrating associated kinetic models related to the data. In addition, it also supplies tools to simplify the construction process of ODE (Ordinary Differential Equations)-based models of metabolic networks. In this release, we present an update of KiMoSys with new data and several new features, including (i) an improved web interface, (ii) a new multi-filter mechanism, (iii) introduction of data visualization tools, (iv) the addition of downloadable data in machine-readable formats, (v) an improved data submission tool, (vi) the integration of a kinetic model simulation environment and (vii) the introduction of a unique persistent identifier system. We believe that this new version will improve its role as a valuable resource for the systems biology community. Database URL:  www.kimosys.org

scholarly journals Assessment of Web-Based Training Modules on Learning Facilitation for Advanced Pharmacy Practice Experiences in Pediatrics

2011 ◽  
Vol 16 (3) ◽  
pp. 210-215
Author(s):  
Jennifer L. Morris ◽  
Chad A. Knoderer
Keyword(s):  
Pharmaceutical Care ◽  
Pediatric Patients ◽  
Pharmacy Practice ◽  
Antimicrobial Use ◽  
Multiple Choice Questions ◽  
Web Based ◽  
Learning Facilitation ◽  
Practice Experience ◽  
Monitoring Module ◽  
Training Modules

OBJECTIVES To assess the effectiveness of web-based training (WBT) modules to enhance and facilitate student pharmacists' learning and their ability to provide pharmaceutical care to children during a pediatric advanced pharmacy practice experience (APPE). METHODS Pediatric-specific WBT modules were developed for completion by APPE students during a 4-week rotation. Pediatric modules covered developmental pharmacology; antimicrobial use and monitoring; fluids, electrolytes, and dehydration; and drug information. Students were responsible for completing all modules within the first week of the APPE. Preassessments and postassessments consisted of 8 to 10 multiple-choice questions, with scores ranging from 0 to 100 points. Data were analyzed using descriptive statistics and paired t tests. RESULTS Statistically significant improvements in postassessment scores were achieved for 3 of the 4 modules. Significant improvements were not observed in the antimicrobial use and monitoring module. Most student pharmacists either somewhat or strongly agreed that the modules improved their understanding of pharmaceutical care for children. CONCLUSIONS WBT modules, taken during an APPE rotation, may expand and improve student pharmacists' understanding of pharmaceutical care in pediatric patients.

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