Purpose: To help assess which ASP elements are currently in place in terms of staff and strategies.
Source: Adapted from Greater New York Health Assocation/United Hospital Fund ASP Chapter 2, "The Antimicrobial Stewardship Core Team," and Chapter 3-B, "Core Strategies."
Instructions: Complete checklist, review responses to ascertain the level of leadership support, and target areas that need strengthening to move forward.
Staff Resource | Check If Available: |
---|---|
Infectious disease–trained physician | ___ |
Clinical pharmacist | ___ |
Clinical microbiologist | ___ |
Infection control representative | ___ |
Hospital epidemiologist | ___ |
Information technology | ___ |
Strategies in place Prospective audit with intervention and feedback |
___ |
Education | ___ |
Guidelines and clinical pathways | ___ |
Antimicrobial cycling | ___ |
Antimicrobial order forms | ___ |
Formulary restriction and preauthorization | ___ |
Combination therapy | ___ |
Streamlining or de-escalation of therapy | ___ |
Dose optimization | ___ |
Parenteral to oral conversion | ___ |
Health care information technology | ___ |