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Antibiotic Stewardship Program In West Texas VA Outpatient Clinics

Antibiotic Stewardship Program In West Texas VA Outpatient Clinics. By: Elizabeth Moos, RN & Dawn McCright, MT(ASCP). Proposal . Improve Availability of Antimicrobial Data Electronic Antibiogram Establish Specific Treatment Modalities Electronic Order Sets

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Antibiotic Stewardship Program In West Texas VA Outpatient Clinics

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  1. Antibiotic Stewardship Program In West Texas VA Outpatient Clinics By: Elizabeth Moos, RN & Dawn McCright, MT(ASCP)

  2. Proposal • Improve Availability of Antimicrobial Data • Electronic Antibiogram • Establish Specific Treatment Modalities • Electronic Order Sets • Compare Past Treatment Practice with New • Oct ’07 - Mar ’08 vs. Oct ’08 - Mar ’09 • Evaluate and Measure Outcome • Antibiotic Use (costs) • MRSA and Clostridium difficile rate • Patient Return & Hospitalization

  3. Rational • Mitigate Emerging Infections and Resistance • Reduce Return Clinic Visits & Hospitalization • Reduce Pharmaceutical Costs • Standardize Treatment • Enhance Veteran Care

  4. Measure • Initial Look Back of Prior Treatment Practice • Baseline • Compare Initial Look Back with Outcome • Oct ’07 - Mar ’08 vs. Oct ’08 - Mar ’09 • MRSA and C. difficile rate • Costs

  5. Initial Findings • October 2007 through May 2008 (BASELINE) • Inconsistency with Treatment Practices • Empiric use of Antibiotic • Suspected Cost Increase • Suspected Increase in Antimicrobial Resistance

  6. Respiratory

  7. Wounds

  8. UTI

  9. Other: Eye, Ear, GI, etc.

  10. Not Indicated

  11. Steps In Development of Order Sets • Locate Infectious Disease Physician • Presentation to Providers • Form Taskforce to Develop Order Sets • Obtain Order Set Examples for Use by IT • Test Order Sets • Train Providers in Order Set Use • Implement in Clinics

  12. Bronchitis

  13. Challenges • Timeliness of Forming Team • Insufficient Data Collection Support • Timeliness of Infectious Disease Support • Timeliness of Development of Treatment Modalities • Patient Education

  14. Expected Outcomes • Decrease Treatment Cost • Enhanced Education of Staff & Public • Enhanced Treatment & Intervention • Standardized Treatments • Eventual Decrease or Leveling of Emerging & Resistant Organisms • Enhanced Veteran Care

  15. Future Plans • Expand to ALL WTVAHCS Clinics • Partner with Other Facilities • Involve Community Hospitals • Develop Integrated Sharing of Information • Increase Patient Awareness

  16. Questions

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