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||___|
|Infection control representative||___|
|Strategies in place
Prospective audit with intervention and feedback
|Guidelines and clinical pathways||___|
|Antimicrobial order forms||___|
|Formulary restriction and preauthorization||___|
|Streamlining or de-escalation of therapy||___|
|Parenteral to oral conversion||___|
|Health care information technology||___|