Question

"Nursing Home Antimicrobial Stewardship"

• Identification of problem and impact on nursing practice.

Answer 1

INTRODUCTION

- Nursing Home Antimicrobial Stewardship is a programme or activities that includes appropriate selection,dosing,route and duration of anti-microbial therapy or any programme that encourages judicious use of antibiotics-Stewardship is defined as "the conducting,supervising or managing of some activities"

-Main goal is to establish a collaborative effort among health care professionals to support each other in acheiving the best possible outcomes for our patients

   -Antibiotics are relatively so effective,non-toxic and inexpensive ,so easy to use so more abuse may occur

-Stewardship programmes consist of the following elements such as;

-EFFICACY

-TOXICITY

-RESISTANCE -INDUCTION

-COST

-DISCONTINUATION

IDENTIFICATION OF PROBLEMS

  This programme may help to identify the following problems;

   -antibiotics are prescribed necessarily or not

-broad -spectrum antibiotics are used too generously

-narrow-spectrum antibiotics are used incorrectly

-the duration of antibiotic treatment is too short or too long

-the dose of antibiotics is lower or higher than appropriate for the specific patient

--identification of treatment problems

-increased mortality and morbidity rates reasons

-length of hospital stays

-need for expensive and broad spectrum antibiotics

-identification of supplemental antimicrobial therapy strategies

-prevent the transmission of drug resistant organisms

-problems in timely and optimal selection ,dose ans duration of an antimicrobial agents

-identify the toxicity rates of the antimicrobial therapy

IMPACT ON NURSING PRACTICE

It includes the following impact on nursing practices;

  -ensure all the healthcare staff are importance of antibiotic therapy regimen guidlines

-establish effective communication structures within your hospitals

-start with core evidence based stewardship interventions depending on the needs

-a number of interventions are key to the success of a hospital based anti-microbial Stewardship programme

-it should be a patient safety priority

-establish a clear aim or goal that should be shared by all the stakeholders and provide a sense of security

  -make a strong collaborations between a multi-professional stewardship team and the clinical leaders

  -giving basic knowledge of infection management

-best practices for prescribing to support safe and effective prescribing ,administration,and monotoring of anti-microbial therapy

-professional training for new staff

-continuing professional development for all prescribers

-it is a part of many patiennts safety programmes

   -improves accuontability and research programmes

  -appropriate use of guidance;

-indications for antibiotics

-choice of agents

-route of administration of treatment

-use of investigations

-duration of therapy

-interpretation of microbiology

-it is an inter-personal effort across the continum of care

-involves timely and optimal selection of dose and duration of antibiotics

-improves enviornmental decontamination

   -infection control

-quality improvement teams in the care of antibiotic therapy

-reduce costs by encouraging heterogenous prescribing patterns

-avoid overuse of antibiotics

  -improving antibiotic use in a safety pattern

-only use an antimicrobial when clearly indicated

-use of evidence -based hospital antibiotic guidlines and policies

-use of empirical therapy for critically ill patients

   -decrease anti-microbial consumption in longitudinal studies

  -provision of written guidlines

SUMMARY

This programmes first goal is to work with health care practitioners to help each patiet receive the most appropriate antimicrobial with correct dose and duration.The main core elements as follows;

-leadership committee

-accountability

-drug expertise

  -action and tracking

-reporting ane education