当前位置： SCI文献检索 > INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY期刊下所有文献 > Antibiotic prescribing in 4 assisted-living communities: incidence and potential for improvement.

Antibiotic prescribing in 4 assisted-living communities: incidence and potential for improvement.

Abstract：

OBJECTIVE:To describe the prevalence, characteristics, and appropriateness of systemic antibiotic use in assisted living (AL) and to conduct a preliminary quality improvement intervention trial to reduce inappropriate prescribing. DESIGN:Pre-post study, with a 13-month intervention period. SETTING:Four AL communities. PARTICIPANTS:All prescribers, all AL staff who communicate with prescribers, and all patients who had an infection during the baseline and intervention periods. INTERVENTION:A standardized form for AL staff, an online education course and 5 practice briefs for prescribers, and monthly quality improvement meetings with AL staff. MEASUREMENTS:Monthly inventory of all systemic antibiotic prescriptions; interviews with the prescriber, AL staff member, closest family member, and patient (when capable) regarding 85 antibiotic prescribing episodes (30 baseline, 55 intervention), with data review by an expert panel to determine prescribing appropriateness. RESULTS:The mean number of systemic antibiotic prescriptions was 3.44 per 1,000 resident-days at baseline and 3.37 during the intervention, a nonsignificant change (P = .30). Few prescribers participated in online training. AL staff use of the standardized form gradually increased during the program. The proportion of prescriptions rated as probably inappropriate was 26% at baseline and 15% during the intervention, a nonsignificant trend (P = .25). Drug selection was largely appropriate during both time periods. CONCLUSIONS:AL antibiotic prescribing rates appear to be approximately one-half those seen in nursing homes, with up to a quarter being potentially inappropriate. Interventions to improve prescribing must reach all physicians and staff and most likely will require long time periods to have the optimal effect.

journal_name

Infect Control Hosp Epidemiol

journal_title

Infection control and hospital epidemiology

authors

Sloane PD,Zimmerman S,Reed D,Beeber AS,Chisholm L,Kistler C,Khandelwal C,Weber DJ,Mitchell CM

doi

10.1086/677821

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

S62-8

eissn

0899-823X

issn

1559-6834

journal_volume

35 Suppl 3

pub_type

杂志文章,多中心研究

在线工具

Antibiotic prescribing in 4 assisted-living communities: incidence and potential for improvement.