Você está na página 1de 14

ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS

SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

CHECKLIST FOR CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES& CORE MEMMBERS OF MULTIDISCIPLINARY
ANTIMICROBIAL STEWARDSHIP TEAMS
CORE MEMBERS OF MULTIDISCIPLINARY ANTIMICROBIAL STEWARDSHIP TEAMS: LEADERSHIP & ACCOUNTABILITY
LEADERSHIP FEASIBLE CHALLENGES STRATEGY
Is there a senior executive responsible for the Either yes or no. If no, state Type in foreseen Type in plans and
overall leadership for antimicrobial management in Challenges and put in challenges in each factors that you
❑Yes
and control, and the development and Kindly strategy to make it work. aspect of the AMS think this element
type in a
implementation of an antimicrobial stewardship ❑No For yes, put your strategies Program is feasible
slash “/”
programme? mark to & plans
Does your facility have a formal, written indicate Either yes or no. If no, state Type in foreseen Type in plans and
yes or no.
statement of support from leadership that in Challenges and put in challenges in each factors that you
❑Yes
supports efforts to improve antimicrobial use strategy to make it work. aspect of the AMS think this element
(antimicrobial stewardship)? ❑No For yes, put your strategies Program is feasible
& plans
Does your facility receive any budgeted financial Either yes or no. If no, state Type in foreseen Type in plans and
support for antimicrobial stewardship activities in Challenges and put in challenges in each factors that you
❑Yes
(e.g., support for salary, training, or IT support)? strategy to make it work. aspect of the AMS think this element
❑No For yes, put your strategies Program is feasible
& plans
ACCOUNTABILITY
Is there a physician leader responsible for Either yes or no. If no, state Type in foreseen Type in plans and
program outcomes of stewardship activities at in Challenges and put in challenges in each factors that you
❑Yes
your facility? strategy to make it work. aspect of the AMS think this element
❑No For yes, put your strategies Program is feasible
& plans
DRUG EXPERTISE
Is there a pharmacist leader responsible for Either yes or no. If no, state Type in foreseen Type in plans and
working to improve antimicrobial use at your in Challenges and put in challenges in each factors that you
❑Yes
facility? strategy to make it work. aspect of the AMS think this element
❑No For yes, put your strategies Program is feasible
& plans
Acknowledgements: Information largely adapted from:
1. Antimicrobial Stewardship in Australian Hospitals (M Duguid& M Cruickshank, 2010)
[Available at http://www.safetyandquality.gov.au/wp-content/uploads/2012/02/Antimicrobial_stewardship_prelim_execsummary.pdf]

Page 1 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS
2. Safety and Quality Improvement Guide Standard 3: Preventing & Controlling Healthcare Associated Infections (Australian Commission on Quality and Safety in Health
Care, 2012) [Available athttp://www.safetyandquality.gov.au/wp-content/uploads/2012/10/Standard3_Oct_2012_WEB.pdf]
3. Antimicrobial Stewardship Teams & Committees Fact Sheet A component of the QUAH Antimicrobial Stewardship Toolkit © Clinical Excellence Commission 2013 Updated
December 2013 SHPN (CEC) 130488 [Available at http://www.cec.health.nsw.gov.au/__documents/programs/hai/quah/fact-sheet-ams-teams-and-committees.pdf]
4. CDC. Core Elements of Hospital Antibiotic Stewardship Programs. Atlanta, GA: US Department of Health and Human Services, CDC; 2014.
[Available at http://www.cdc.gov/getsmart/healthcare/ implementation/core-elements.html ]

CHECKLIST FOR CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES & CORE MEMMBERS OF MULTIDISCIPLINARY
ANTIMICROBIAL STEWARDSHIP TEAMS
CORE MEMBERS OF MULTIDISCIPLINARY STEWARDSHIP TEAMS: GOVERNANCE AND COMMITTEES
KEY SUPPORT FOR THE ANTIMICROBIAL STEWARDSHIP PROGRAMME FEASIBLE CHALLENGES STRATEGY
Does your organisation have:
Either yes or no. If Type in foreseen Type in plans and factors
no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
❑Yes
 Drug and Therapeutic Committee in strategy to make
❑No it work. For yes, put
your strategies &
plans
Either yes or no. If Type in foreseen Type in plans and factors
no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
❑Yes
 Infection Prevention and Control Committee in strategy to make
❑No it work. For yes, put
your strategies &
plans
❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
 Patient Medication Safety Committee in strategy to make
it work. For yes, put
your strategies &
plans
 AMS Committee ❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this

Page 2 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

Challenges and put of the AMS Program element is feasible


in strategy to make
it work. For yes, put
your strategies &
plans
❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
o Executive representative in strategy to make
it work. For yes, put
your strategies &
plans
❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
o Infectious diseases physician in strategy to make
it work. For yes, put
your strategies &
plans
❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
o Clinical pharmacist in strategy to make
it work. For yes, put
your strategies &
plans
❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
o Clinical microbiologist in strategy to make
it work. For yes, put
your strategies &
plans

Page 3 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

Either yes or no. If Type in foreseen Type in plans and factors


no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
❑Yes
o Infection prevention professional in strategy to make
❑No it work. For yes, put
your strategies &
plans
Either yes or no. If Type in foreseen Type in plans and factors
no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
❑Yes
o Nursing leadership in strategy to make
❑No it work. For yes, put
your strategies &
plans
Either yes or no. If Type in foreseen Type in plans and factors
no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
❑Yes
o Hospital epidemiologist in strategy to make
❑No it work. For yes, put
your strategies &
plans
Either yes or no. If Type in foreseen Type in plans and factors
no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
❑Yes
o Information systems specialist in strategy to make
❑No it work. For yes, put
your strategies &
plans
 AMS Team ❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
in strategy to make
it work. For yes, put

Page 4 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

your strategies &


plans
❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
o Infectious diseases physician in strategy to make
it work. For yes, put
your strategies &
plans
❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
o Clinical pharmacist in strategy to make
it work. For yes, put
your strategies &
plans
❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
o Clinical microbiologist in strategy to make
it work. For yes, put
your strategies &
plans
❑Yes Either yes or no. If Type in foreseen Type in plans and factors
❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible
o Infection prevention professional in strategy to make
it work. For yes, put
your strategies &
plans
o Clinical nurse consultant or clinical nurse ❑Yes Either yes or no. If Type in foreseen Type in plans and factors
educator ❑No no, state in challenges in each aspect that you think this
Challenges and put of the AMS Program element is feasible

Page 5 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

in strategy to make
it work. For yes, put
your strategies &
plans

Page 6 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

CHECKLIST FOR CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES & CORE MEMMBERS OF MULTIDISCIPLINARY
ANTIMICROBIAL STEWARDSHIP TEAMS
CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES
POLICIES - GUIDELINES - STANDARDS FEASIBLE CHALLENGES STRATEGY
Does your facility have an authoritive and credible ∕❑Yes Either yes or no. If no, state Type in foreseen Type in plans and factors
antimicrobial policy? (refer policy statement) in Challenges and put in challenges in that you think this
❑No
strategy to make it work. each aspect of element is feasible
For yes, put your strategies the AMS
& plans Program
Does your facility have a policy that requires ∕❑Yes Either yes or no. If no, state Type in foreseen Type in plans and factors
prescribers to document in the medical record or in Challenges and put in challenges in that you think this
❑No
during order entry a dose, duration, and indication for strategy to make it work. each aspect of element is feasible
all antimicrobial prescriptions? For yes, put your strategies the AMS
& plans Program
Does your facility have facility-specific standard ❑Yes Either yes or no. If no, state Type in foreseen Type in plans and factors
treatment guidelines which are based on national ❑No in Challenges and put in challenges in that you think this
guidelines and local susceptibility data? strategy to make it work. each aspect of element is feasible
For yes, put your strategies the AMS
& plans Program
Does your facility have an essentials medicine list? ∕❑Yes Either yes or no. If no, state Type in foreseen Type in plans and factors
in Challenges and put in challenges in that you think this
❑No
strategy to make it work. each aspect of element is feasible
For yes, put your strategies the AMS
& plans Program
Does your facility have a formulary? ∕❑Yes Either yes or no. If no, state Type in foreseen Type in plans and factors
in Challenges and put in challenges in that you think this
❑No
strategy to make it work. each aspect of element is feasible
For yes, put your strategies the AMS
& plans Program
Does you facility have a list of restricted antimicrobials ∕❑Yes Either yes or no. If no, state Type in foreseen Type in plans and factors
and a ‘protocol’ for approval and use of restricted in Challenges and put in challenges in that you think this
❑No
antimicrobials? strategy to make it work. each aspect of element is feasible

Page 7 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

For yes, put your strategies the AMS


& plans Program
Does your facility have infection prevention and ∕❑Yes Either yes or no. If no, state Type in foreseen Type in plans and factors
control policy and guidelines; e.g. hand washing? in Challenges and put in challenges in that you think this
❑No
strategy to make it work. each aspect of element is feasible
For yes, put your strategies the AMS
& plans Program

Page 8 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

CHECKLIST FOR CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES & CORE MEMMBERS OF MULTIDISCIPLINARY
ANTIMICROBIAL STEWARDSHIP TEAMS
WHAT NEXT - SPECIFIC INTERVENTIONS TO IMPROVE ANTIMICROBIAL USE
FEASIBLE CHALLENGES STRATEGY
BROAD INTERVENTIONS
Is there a formal procedure for all clinicians to review the Either yes or Type in Type in plans and factors that
appropriateness of all antimicrobials 48 hours after the no. If no, state foreseen you think this element is
initial orders (e.g. antimicrobial time out)? in Challenges challenges in feasible
and put in each aspect
∕❑Yes strategy to of the AMS
❑No make it work. Program
For yes, put
your
strategies &
plans
Do specified antimicrobial agents have a specific criteria ∕❑Yes Either yes or Type in Type in plans and factors that
for use and need to be approved prior to dispensing (i.e., no. If no, state foreseen you think this element is
❑No
pre-authorization) at your facility? in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS
make it work. Program
For yes, put
your
strategies &
plans
Does a physician or pharmacist review courses of ❑Yes Either yes or Type in Type in plans and factors that
therapy for specified antimicrobial agents (i.e., no. If no, state foreseen you think this element is
∕❑No
prospective audit with feedback) at your facility? in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS
make it work. Program
For yes, put

Page 9 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

CHECKLIST FOR CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES & CORE MEMMBERS OF MULTIDISCIPLINARY
ANTIMICROBIAL STEWARDSHIP TEAMS
WHAT NEXT - SPECIFIC INTERVENTIONS TO IMPROVE ANTIMICROBIAL USE
your
strategies &
plans
PHARMACY DRIVEN INTERVENTIONS
Protocol for changing from intravenous to oral Either yes or Type in Type in plans and factors that
antimicrobial therapy in appropriate situations? no. If no, state foreseen you think this element is
in Challenges challenges in feasible
and put in each aspect
❑Yes strategy to of the AMS
❑No make it work. Program
For yes, put
your
strategies &
plans
Protocol for dose adjustments in cases of organ Either yes or Type in Type in plans and factors that
dysfunction? no. If no, state foreseen you think this element is
in Challenges challenges in feasible
and put in each aspect
∕❑Yes strategy to of the AMS
❑No make it work. Program
For yes, put
your
strategies &
plans
Protocol for alerts in situations where therapy might be ❑Yes Either yes or Type in Type in plans and factors that
unnecessarily duplicative? ❑No no. If no, state foreseen you think this element is
in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS
make it work. Program

Page 10 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

CHECKLIST FOR CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES & CORE MEMMBERS OF MULTIDISCIPLINARY
ANTIMICROBIAL STEWARDSHIP TEAMS
WHAT NEXT - SPECIFIC INTERVENTIONS TO IMPROVE ANTIMICROBIAL USE
For yes, put
your
strategies &
plans
Time-sensitive automatic stop orders for specified ❑Yes Either yes or Type in Type in plans and factors that
antimicrobial prescriptions? ❑No no. If no, state foreseen you think this element is
in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS
make it work. Program
For yes, put
your
strategies &
plans
ANTIMICROBIAL USE AND OUTCOME MEASURES
Does your facility track rates of C. difficile infection? Either yes or Type in Type in plans and factors that
no. If no, state foreseen you think this element is
in Challenges challenges in feasible
and put in each aspect
❑Yes strategy to of the AMS
∕❑No make it work. Program
For yes, put
your
strategies &
plans
Does your facility produce an antibiogram (cumulative ∕❑Yes Either yes or Type in Type in plans and factors that
antimicrobial susceptibility report? no. If no, state foreseen you think this element is
❑No
in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS

Page 11 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

CHECKLIST FOR CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES & CORE MEMMBERS OF MULTIDISCIPLINARY
ANTIMICROBIAL STEWARDSHIP TEAMS
WHAT NEXT - SPECIFIC INTERVENTIONS TO IMPROVE ANTIMICROBIAL USE
make it work. Program
For yes, put
your
strategies &
plans
Does your facility monitor antimicrobial use
(consumption) at the unit and/or facility wide level by
one of the following metrics:
 By counts of antimicrobial(s) administered to ❑Yes Either yes or Type in Type in plans and factors that
patients per day (Days of Therapy)? no. If no, state foreseen you think this element is
∕❑No
in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS
make it work. Program
For yes, put
your
strategies &
plans
 By number of grams of antimicrobials used ❑Yes Either yes or Type in Type in plans and factors that
(Defined Daily Dose, DDD)? no. If no, state foreseen you think this element is
∕❑No
in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS
make it work. Program
For yes, put
your
strategies &
plans
 By direct expenditure for antimicrobials ❑Yes Either yes or Type in Type in plans and factors that
(purchasing costs)? no. If no, state foreseen you think this element is
∕❑No
Page 12 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

CHECKLIST FOR CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES & CORE MEMMBERS OF MULTIDISCIPLINARY
ANTIMICROBIAL STEWARDSHIP TEAMS
WHAT NEXT - SPECIFIC INTERVENTIONS TO IMPROVE ANTIMICROBIAL USE
in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS
make it work. Program
For yes, put
your
strategies &
plans
EDUCATION & BEHAVIOUR CHANGE
Does your stewardship program provide education to Either yes or Type in Type in plans and factors that
clinicians and other relevant staff on improving no. If no, state foreseen you think this element is
antimicrobial prescribing? in Challenges challenges in feasible
and put in each aspect
❑Yes strategy to of the AMS
❑No make it work. Program
For yes, put
your
strategies &
plans
Does you stewardship program share facility-specific ❑Yes Either yes or Type in Type in plans and factors that
reports on antimicrobial use with prescribers? no. If no, state foreseen you think this element is
∕❑No
in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS
make it work. Program
For yes, put
your
strategies &
plans
Has a current antibiogram been distributed to ∕❑Yes Either yes or Type in Type in plans and factors that

Page 13 of 14
ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN HOSPITALS
SESSION THREE: INTERACTIVE WORKSHOP SESSIONS

CHECKLIST FOR CORE ELEMENTS OF HOSPITAL ANTIMICROBIAL STEWARDSHIP PROGRAMMES & CORE MEMMBERS OF MULTIDISCIPLINARY
ANTIMICROBIAL STEWARDSHIP TEAMS
WHAT NEXT - SPECIFIC INTERVENTIONS TO IMPROVE ANTIMICROBIAL USE
prescribers at your facility? ❑No no. If no, state foreseen you think this element is
in Challenges challenges in feasible
and put in each aspect
strategy to of the AMS
make it work. Program
For yes, put
your
strategies &
plans
Do prescribers ever receive direct, personalized Either yes or Type in Type in plans and factors that
communication about how they can improve their no. If no, state foreseen you think this element is
antimicrobial prescribing? in Challenges challenges in feasible
and put in each aspect
❑Yes strategy to of the AMS
∕❑No make it work. Program
For yes, put
your
strategies &
plans

Page 14 of 14

Você também pode gostar