Description
Internal ASB project:
- % necessary use of abx (patient had symptoms) has gone up over time
- New ER doc – enthusiastic
- Will continue to collect data – Brett enjoying abstracting data
- Goal was 10% increase and sustained – continue monitoring data to ensure it is sustained
- 1 provider – 100% appropriate
- Could target late adopters using one-on-one detailing
- Sharing info with ED medical director and have him have conversations with providers (use champion to have convo)
CAP:
- Slow data collection – met requirements
- Created report that pulls data from EHR that pulls ICD code
- One or more ICD code present + present in ER
- Has been more difficult to dedicate time to submit CAP data
- Haven’t met as a team for the CAP project yet
- New IDSA CAP guidelines – shared and can distribute across facility
- Can meet minimum of 3 cases – aiming for more
- vary between 10-30 per month that meet criteria for inclusion
- Goal: submit 10 CAP cases/month to establish a clear sense of baseline
- Believe duration exceeding 3-5 days
4/25/24 Check-in:
- Good relationship between pharmacists and prescribers to help drive trends
- 100% of recommended drug changes were accepted by providers in 2023
- Brett has good relationship with ED provider – helps get buy-in
Project Resources
Core Elements
Education
Educating clinicians about resistance and optimal prescribing.
PDSA Cycles
Progress on PDSA Cycle 2
ASB
QI work for ASB
- Doing well on documenting symptoms/treating only when there are symptoms (in ED)
Low percent of necessary abx use for January
- Targeted education – mid level providers driving trend
- Sent providers information on patients without symptoms/proper use of abx
- Have been meeting 75% goal since Q3 2023 (only 2 months where it did not meet)
Use example of woman coming in with sprained ankle, getting UA, getting antibiotics
Next step: when culture comes back negative a few days later, follow up with patient to stop antibiotic
- Implement robust review patient
Continue running monthly ASB reports internally
Progress on PDSA Cycle 1
Data Report
4/25/24:
- Reviewed CAP report
- No fluoroquinolone use
- Could improve duration
- Some documented penicillin allergies but reaction not specified
- work on removing
Interested in comparing duration and antibiotic choice to other facilities
Get and document history of penicillin allergies for patients
Continue submitting cases – having a lot of data is useful to getting buy-in