PO Box 1488
Warrenville, IL 60555
Phone: 331.248.7888
Email: sidp@affinity-strategies.com
Antimicrobial stewardship is often an inpatient effort and overlooked at transitions of care. Dr. April Dyer (@aprildyerid) and Dr. Rachel Kenney (@rkenneypharmd) share insight with host Dr. David Ha (@DHpharmD) on current practice and barriers, and strategies for pharmacists to bring antimicrobial stewardship in the discharge process.
Episode content:
- 00:14: Welcome and introductions:
- 04:39: Project overview: “Developing Patient Safety Outcome Measures and Measurement Tools for Antimicrobial Stewardship Program”
- 06:45: Scope of the problem (Scarpato et al.)
- 07:56: Michigan data (Vaughn et al.)
- 09:13: Building a business case
- 12:32: Where to Start?
- 12:54: Henry Ford Health System experience
- 15:18: IT solutions
- 17:22: 1% rule
- 20:26: Identifying and engaging key players
- 20:47: Outpatient pharmacy
- 22:29: Skilled nursing facilities
- 23:19: Case management relationship
- 24:23: Barriers to implementation
- 29:08: Quantifying total duration
- 30:00: Identify electronic methods to capture total duration therapy attributable to hospitalization
- 32:16: CDC recommendation “Use the shortest effective antibiotic duration”
- 33:16: Final remarks & acknowledgements
- 34:38: Outro
References:
- Scarpato SJ, Timko DR, Cluzet VC, et al. An Evaluation of Antibiotic Prescribing Practices Upon Hospital Discharge. Infection Control and Hospital Epidemiology. 2017;38(3):353-355. doi:10.1017/ice.2016.276
- Madaras-Kelly KJ, Burk M, Caplinger C, et al. Total duration of antimicrobial therapy in veterans hospitalized with uncomplicated pneumonia: Results of a national medication utilization evaluation. Journal of Hospital Medicine. 2016;11(12):832-839. doi:10.1002/jhm.2648
- Feller J, Lund BC, Perencevich EN, et al. Post-discharge oral antimicrobial use among hospitalized patients across an integrated national healthcare network. Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2020;26(3):327-332. doi:10.1016/j.cmi.2019.09.016
- Daniels LM, Weber DJ. Interventions to improve antibiotic prescribing at hospital discharge: A systematic review. Infection Control and Hospital Epidemiology. Published online September 1, 2020:1-4. doi:10.1017/ice.2020.367
- Vaughn VM, Gandhi TN, Chopra V, et al. Antibiotic Overuse after Hospital Discharge: A Multi-Hospital Cohort Study. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. Published online September 11, 2020. doi:10.1093/cid/ciaa1372
- Dyer AP, Dodds Ashley E, Anderson DJ, et al. Total duration of antimicrobial therapy resulting from inpatient hospitalization. Infection Control and Hospital Epidemiology. 2019;40(8):847-854. doi:10.1017/ice.2019.118
- Bianchini ML, Kenney RM, Lentz R, Zervos M, Malhotra M, Davis SL. Discharge Delays and Costs Associated with Outpatient Parenteral Antimicrobial Therapy for High priced Antibiotics. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. Published online October 31, 2019. doi:10.1093/cid/ciz1076
Disclosures Dr. April Dyer and Rachel Kenney report no relevant financial disclosures. SIDP reports no relevant financial disclosures.
April Dyer PharmD, MBA, MSCR, BCPS
April Dyer is a Liaison Clinical Pharmacist with the Duke Antimicrobial Stewardship Outreach Network (DASON) in Durham, North Carolina. She obtained her Doctor of Pharmacy, Masters of Business Administration, and Masters of Science and Clinical Research from Campbell University. Dr. Dyer works with six community hospitals as an ASP consultant to improve quality of patient care, enhance patient safety, and promote appropriate antimicrobial use in community hospitals.
Rachel Kenney PharmD, BCIDP
Dr. Rachel Kenney is a Pharmacy Specialist in Antimicrobial Stewardship at Henry Ford Hospital in Detroit, Michigan. Kenney is a graduate of the University of Michigan College of Pharmacy and completed her PGY1 Pharmacy Residency at Detroit Receiving Hospital and PGY2 Infectious Diseases Pharmacy Residency at the Mayo Clinic-Rochester. Dr. Kenney is the Residency Program Director for the Infectious Diseases Pharmacy Residency and the lead antimicrobial stewardship pharmacist at Henry Ford Health.
