Antimicrobial Stewardship in LTPAC Toolkit

ASCP’s Antimicrobial Stewardship in Long-Term and Post-Acute Care Toolkit will help you facilitate antimicrobial stewardship programs in your nursing facilities. The toolkit provides practical guidance on how to initiate, grow, and sustain an antimicrobial program that becomes an integral part of your facility’s Quality Assurance Improvement Program (QAPI) and ensures compliance with infection prevention regulations in the CMS Long-Term Care Final Rule.

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Up to 70% of nursing home residents receive at least one systemic antibiotic per year, with a large proportion of those prescriptions considered unnecessary or inappropriate. Overuse of antibiotics can have serious consequences in older adults, including side effects, drug interactions, the emergence of antimicrobial resistance, and C. difficile infections.

Improving the use of antibiotics to protect patients and reduce the threat of antibiotic resistance is now a national priority. In 2015, The Centers for Disease Control (CDC) published The Core Elements of Antibiotic Stewardship for Nursing Homes. This adaptation of the CDC’s Core Elements of Hospital Antibiotic Stewardship recognizes that although the elements of a stewardship program remain the same—leadership commitment, accountability, drug expertise, action, tracking, reporting, and education—implementation in a nursing facility poses some challenges.

The Centers for Medicare and Medicaid Services (CMS) has also recognized that long-term care facility residents are vulnerable to the overuse of antibiotics. The agency recently finalized a rule to improve the care and safety of residents in long-term care facilities that participate in the Medicare and Medicaid program. Included in this rule is a regulation that requires nursing homes to establish an Infection Prevention and Control Program (IPCP).

The American Society of Consultant Pharmacists developed this toolkit to help you facilitate antimicrobial stewardship programs in your nursing facilities. Using the CDC’s Core Elements of Antibiotic Stewardship for Nursing Homes (PDF) as a guide, the toolkit provides practical guidance on how to initiate, grow, and sustain an antimicrobial program that becomes an integral part of your facility’s Quality Assurance Improvement Program (QAPI) and ensures compliance with infection prevention regulations in the CMS Long-Term Care Final Rule. For more information about other ASCP educational offerings on infection prevention, please visit our Infection Prevention Practice Resource Center.

The ASCP Antimicrobial Stewardship Toolkit contains everything you’ll need to implement a strong infection control program in your facilities, including:

  • Sample facility microbial stewardship mission statements
  • 6 sets of slides to help you educate clinical staff on:
    • Staff engagement
    • C. difficile
    • Antibiograms
    • Antimicrobial resistance
    • Unnecessary medications (F329)
    • Drug interactions
  • Sample policies and procedures
  • Quick reference sheets
  • Review of special dosing concerns
  • Review of common medication interactions
  • Antibiotic initiation criteria from Loeb and McGeer
  • Library of consultant pharmacist recommendations to facility clinical leadership
  • Antibiogram information and implementation resources
  • Facility and resident assessment forms
  • Data collection forms
  • Facility education modules and convenient 1-page “leave behind” fliers
  • Appendix of useful online resources

In addition to the ASCP Antimicrobial Toolkit, don’t forget to take advantage of the next ASCP Antimicrobial Stewardship Workshop, which will be held on Thursday, November 2. at the ASCP Annual Meeting at the Gaylord Hotel in Kissimmee, Florida!

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