Purpose: A tool to review types of antimicrobial stewardship interventions, comparing process measures, antibiotic metrics, and other factors to track.
Source: Developed by B. Ostrowsky and P. Chung, Montefiore Medical Center, for ERASE C. difficile Project toolkit.
Intervention Type1,2 | Process/Monitoring | Possible Antibiotic Use Measures To Access Impact | Additional Measures, Including Benefits/Unintended Consequence |
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Formulary changes, restrictions, and preauthorization |
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Audit and feedback to providers |
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Flow and algorithms for empiric and streamlined regimens for specific diagnoses or pathogens |
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Antibiotic order forms and automatic stop orders |
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Novel approaches to use of technology and stewardship staff |
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Educational component for clinicians and patients |
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1. Traditional methods such as intravenous to oral switch programs and dose optimization may be used by a well-rounded antimicrobial stewardship team, but on their own will likely not be effective interventions directed at decreasing C. difficile infection.
2. Categories adapted from Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Guidelines for Developing an Institutional Program To Enhance Antimicrobial Stewardship (PDF; Plugin Software Help).
Instructions: Use when considering ways to monitor processes and outcomes related to targeted interventions.