Antibiotic Stewardship Program(ASP) is crucial in optimizing the use of antibiotics to effectively treat infections, combat antibiotic resistance and improve clinical outcomes.
The Joint Commission recently announced: “Effective January 1, 2023, new and revised antibiotic stewardship requirements will apply to all Joint Commission accredited hospitals and critical access hospitals.”
Is your organization operating an ASP that meets all of the most current industry standards? When was the last time you conducted an evaluation to make sure all the marks set by the program are not missed? Presented to you by the PrecisePK Team, a practical guide to the implementation and advancement of an antibiotic stewardship program at any stage for all hospitals.
- Breakdown of 12 elements of performance (EPs)
- Step-by-step Guide to the Antibiotic Stewardship Improvement Cycle (Click to Download)
- Expedite Your Plan & Special financial plan for critical access hospitals
Breakdown of 12 elements of performance (EPs) by The Joint Commission
What is New?
Hospitals to Allocate Financial Resources
Staffing and information technology can look forward to receiving financial resources from their hospitals to support their antibiotic stewardship program.
Option 1: On days of therapy per 1000 days present or 1000 patient days, the antibiotic stewardship program must perform monitoring by analyzing data on the hospital’s antibiotic use.
Option 2: Report antibiotic use data to the National Healthcare Safety Network’s Antimicrobial Use Option of the Antimicrobial Use and Resistance Module.
Strategize Antibiotic Prescribing
To optimize antibiotic prescribing, one or both of these strategies have to be implemented:
Preauthorization-- Internal review and approval process prior to the use of specific antibiotics.
Prospective review-- A member of the antibiotic stewardship program will review and provide feedback practices of antibiotic prescribing practices, including the treatment of positive blood cultures.
Antibiotic Guidelines Implemented are Evidence-Based
At least two evidence-based guidelines are expected to improve antibiotic use for the most common indications. These guidelines will also be based on national procedures and account for local susceptibilities, formulary options, and the patients served.
Examples of candidates for evidence-based guidelines (not a completed list):
Area under the curve(AUC)-Guided Vancomycin Dosing
Antibiotic dosages in patients with impaired renal function
Clinical Pharmacokinetic Guidelines (Aminoglycosides & Vancomycin)
Clostridioides difficile colitis
Surgical prophylactic antibiotics
Urinary tract infections
Adherence to at least one of the evidence-based guidelines ought to be evaluated by hospitals, including antibiotic selection and duration of therapy. Measurements can be at the group level (departmental, unit, clinician subgroup) or at the individual prescriber level. Hospitals also have the option to obtain adherence data for a selection of patients from appropriate clinical areas by analyzing electronic health records or by performing chart reviews.
Revised Elements Summary
The Antibiotics stewardship program will also have to fulfill the following revised elements:
- Appoints leaders for the program
- Leaders’ responsibilities
- Has a multidisciplinary committee
- Shows coordination across organizations
- Documents the use of evidence-based antibiotics guidelines
- Collects, analyzes, and reports data
- Takes action on improvement opportunities
Step-by-step Guide– Antibiotic Stewardship Improvement Cycle
Step 1: Financial planning
Healthcare leaders often find it challenging to allocate financial resources to antimicrobial stewardship. However, in the long run, data for the Return On Investment suggests that the quicker financial supports are in place, the better. Positive outcomes include $376,500 in savings of malpractice claims due to preventable inpatient ADEs¹ and a 10.5% reduction in the incidence of nephrotoxicity from using TDM software (aminoglycosides)².
Step 2: Construct leadership and committees
The scope of responsibilities carried out by the appointed leaders or committee members is lengthy but can be realized, streamlined, and even automated in simple processes. With model-informed precision dosing software like PrecisePK, the use of antibiotics can be monitored, improved, and documented in real-time based on published research evidence. Eliminating adverse events, and reaching the therapeutic level can also be targeted effortlessly with our predictive analysis feature. For more detailed information on all of PrecisePK’s features, visit here.
Step 3: Adopt evidence-based calculations
Population characteristics evolve over time and so do research findings. To ensure your institutions practice with the most up-to-date information and adhere to national guidelines, it is best to develop synchronized internal guidelines for all medical staff.
Additionally, high performance will depend on capitalizing the software’s capability to adjust to various drug models, account for patient-specific serum concentration levels, and unique patient characteristics such as critical illness, obesity, amputation, and more. Relevant PK parameters will automatically be adjusted with the selection of these characteristics.
Per the latest guidelines, AUC-based monitoring is preferred over trough-based monitoring as the most accurate and optimal way to manage vancomycin dosing. PrecisePK uses Bayesian principles to accurately and easily calculate AUC.
Step 4: Strategic data management
To meet the performance element of Data Monitoring, whether your organization chooses to analyze data on a 1000-patient-days cycle or report to the National Healthcare Safety Network’s Antimicrobial Use Option of the Antimicrobial Use and Resistance Module, here are some elements you want to consider when structuring your data management:
- EHR system integration
- Significant data point measurements (e.g. serum level, dosing regimen plan, serum concentration prediction)
- Analysis paired with interactive graphs for intuitive comprehension
- Real-time monitoring and data-driven analytics for AKI management
What You Can Do With PrecisePK
By providing recommendations and visualizations based on an individualized approach rather than a general approach, patients can reach their therapeutic targets more efficiently. As PrecisePK gathers more data from your patient records, it will automatically adjust its models to help you dose quickly, safely, and accurately.
Step 5: Cross-organizational communication
Implementing an effective communication method can facilitate a highly transparent working environment across your organization's departments and significantly reduce errors due to inadequate transfer of information.
How Will PrecisePK Positively Impact My Internal Communication?
With 30+ years of clinical experience and continuous research and development, PrecisePK integrates seamlessly and securely into your everyday workflow. We ensure the highest degree of safety and standard of support to bring you an optimal clinical experience. Below are some of the technological advantages PrecisePK can provide to help you build a more collaborative and data-driven healthcare setting.
Step 6: Improvement & Optimization
At the end of the Antimicrobial Stewardship Improvement cycle is when all stakeholders gather their observations and experience to identify improvement opportunities and take action on them.
See what the experts have to say about PrecisePK and how we have been an engine to the healthcare industry from clinical to research for improvement and optimization on the use of antibiotics and patient-oriented initiatives.
Jennifer Le, an ID pharmacist specialist, co-author of the new 2020 vancomycin consensus guideline, and UCSD professor of Clinical Pharmacy said “The new version is amazing visually and user-friendly too, requiring minimal training. The unique features of this platform that I find especially helpful for patient care are flexibility in selecting neonatal, pediatric, and adult models to ensure you select the best Bayesian prior for your patient population.”
Lauren Dea Pharm. D., used PrecisePK extensively as a PGY2 Infectious Disease resident and commented “The program has helped my research become vastly more efficient due to the ease of inputting patient information and determining dosing recommendations. I would not have been able to retrospectively collect 4 years of vancomycin orders within a condensed residency year without the streamlined efficiency of entering info into their program. They also developed a unique Bayesian model for our unique patient population with a specific set of Bayesian priors.”
Expedite Your Plan
Rapid Integration and Implementation with PrecisePK– PrecisePK has been pioneering Bayesian and AUC dosing for more than 30 years. Our software development aggregates solutions for all levels of complexity and challenges through first-hand experience for healthcare and research professionals. Our clinical expertise joined with advanced AI data processing ensures that the implementation and integration are rapid and seamless for new users.
Want to expedite your plan to comply with the above requirements for your first-time accreditation or renewal? Contact us today and see how we can help you with customized software features to meet your demands.
PrecisePK also offers special pricing for Critical Access Hospitals. Please contact us for more information.