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Resource Stewardship

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https://www.readbyqxmd.com/read/28056822/the-first-occurrence-of-a-ctx-m-esbl-producing-escherichia-coli-outbreak-mediated-by-mother-to-neonate-transmission-in-an-irish-neonatal-intensive-care-unit
#1
Ciara O'Connor, Roy K Philip, John Kelleher, James Powell, Alan O'Gorman, Barbara Slevin, Neil Woodford, Jane F Turton, Elaine McGrath, Cathriona Finnegan, Lorraine Power, Nuala H O'Connell, Colum P Dunne
BACKGROUND: Escherichia coli (E. coli) comprise part of the normal vaginal microflora. Transfer from mother to neonate can occur during delivery resulting, sometimes, in neonatal bacterial disease. Here, we aim to report the first outbreak of CTX-M ESBL-producing E. coli with evidence of mother-to-neonate transmission in an Irish neonatal intensive care unit (NICU) followed by patient-to-patient transmission. METHODS: Investigation including molecular typing was conducted...
January 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28034534/antimicrobial-stewardship-practices-in-virginia
#2
Kimberly B Lee, Jesus Aaron Ramirez, Rebeccah Collins, John Bucheit, Kakotan Sanogo, Michael P Stevens
The Society of Healthcare Epidemiology of America, the Centers for Disease Control and Prevention, and the President's Council of Advisors on Science and Technology recognize the need to combat antimicrobial resistance through the promotion of antimicrobial stewardship programs. Health care facilities in Virginia were surveyed using a 23-item survey focused on facility characteristics and antimicrobial stewardship strategies. Antimicrobial stewardship activities were highly variable and many are missing key personnel and resources...
December 26, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/28031432/implementation-of-rapid-molecular-infectious-disease-diagnostics-the-role-of-diagnostic-and-antimicrobial-stewardship
#3
Kevin Messacar, Sarah K Parker, James K Todd, Samuel R Dominguez
New rapid molecular infectious disease diagnostic technologies enable expedited accurate microbiologic diagnoses. However, diagnostic and antimicrobial stewardship are necessary to ensure these technologies conserve, rather than consume, additional health care resources and optimally impact patient care. Diagnostic stewardship is needed to implement appropriate tests for the clinical setting and direct testing towards appropriate patients. Antimicrobial stewardship is needed to ensure prompt, appropriate clinical action to translate faster diagnostic test results in the laboratory into improved outcomes at the bedside...
December 28, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28027333/personalized-prescription-feedback-using-routinely-collected-data-to-reduce-antibiotic-use-in-primary-care-a-randomized-clinical-trial
#4
Lars G Hemkens, Ramon Saccilotto, Selene Leon Reyes, Dominik Glinz, Thomas Zumbrunn, Oliver Grolimund, Viktoria Gloy, Heike Raatz, Andreas Widmer, Andreas Zeller, Heiner C Bucher
Importance: Feedback interventions using routinely collected health data might reduce antibiotic use nationwide without requiring the substantial resources and structural efforts of other antibiotic stewardship programs. Objective: To determine if quarterly antibiotic prescription feedback over 2 years reduces antibiotic use when implemented in a complex health care system. Design, Setting, and Participants: Pragmatic randomized trial using routinely collected claims data on 2900 primary care physicians with the highest antibiotic prescription rates in Switzerland...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28001135/a-survey-of-physicians-attitudes-toward-decision-making-authority-for-initiating-and-withdrawing-va-ecmo-results-and-ethical-implications-for-shared-decision-making
#5
Ellen C Meltzer, Natalia S Ivascu, Meredith Stark, Alexander V Orfanos, Cathleen A Acres, Paul J Christos, Thomas Mangione, Joseph J Fins
OBJECTIVE: Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians' attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/27999061/from-guidelines-to-practice-a-pharmacist-driven-prospective-audit-and-feedback-improvement-model-for-peri-operative-antibiotic-prophylaxis-in-34-south-african-hospitals
#6
Adrian J Brink, Angeliki P Messina, Charles Feldman, Guy A Richards, Dena van den Bergh
BACKGROUND: Few data exist on the implementation of process measures to facilitate adherence to peri-operative antibiotic prophylaxis (PAP) guidelines in Africa. OBJECTIVES: To implement an improvement model for PAP utilizing existing resources, in order to achieve a reduction in surgical site infections (SSIs) across a heterogeneous group of 34 urban and rural South African hospitals. METHODS: A pharmacist-driven, prospective audit and feedback strategy involving change management and improvement principles was utilized...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27975076/the-role-of-antimicrobial-stewardship-in-the-clinical-microbiology-laboratory-stepping-up-to-the-plate
#7
Shawn H MacVane, John M Hurst, Lisa L Steed
We report the development of a collaborative relationship between antimicrobial stewardship and clinical microbiology that incorporates stewardship practices into daily laboratory rounds. Antimicrobial stewardship involvement on rounds was a welcomed and effective initiative with substantial rates of intervention. New opportunities to positively impact use of antimicrobials and laboratory resources were realized.
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27934550/healthcare-resource-allocation-decisions-affecting-uninsured-services
#8
Krista Lyn Harrison, Holly A Taylor
Purpose Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health services for the uninsured in the USA and the organizational values affecting these decisions. Design/methodology/approach The study used comparative case study methodology at two geographically diverse sites. Researchers collected data from program documents, meeting observations, and interviews with program stakeholders. Findings Five resource allocation or policy decisions relevant to providing healthcare services were described at each site across three categories: designing the health plan, reacting to funding changes, and revising policies...
November 21, 2016: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/27927861/what-is-the-more-effective-antibiotic-stewardship-intervention-pre-prescription-authorization-or-post-prescription-review-with-feedback
#9
Pranita D Tamma, Edina Avdic, John F Keenan, Yuan Zhao, Gobind Anand, James Cooper, Rebecca Dezube, Steven Hsu, Sara E Cosgrove
BACKGROUND: The optimal approach to conducting antibiotic stewardship interventions has not been defined. We compared days of antibiotic therapy (DOT) using pre-prescription authorization (PPA) versus post-prescription review with feedback (PPRF) strategies. METHODS: A quasi-experimental, crossover trial comparing PPA and PPRF for adult inpatients prescribed any antibiotic was conducted. For the first four months, two medicine teams were assigned to the PPA arm and the other two teams to the PPRF arm...
December 7, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27917966/enabling-sustainable-pastoralism-policies-and-investments-that-optimise-livestock-production-and-rangeland-stewardship
#10
R Ouedraogo, J Davies
Pastoralism is a system of dynamically managing livestock and land for economic, social and environmental benefit. To a large extent, pastoralism is an adaptation to ecological and climatic variability and is not simply a livestock production system but provides significant environmental services to humanity. Evidence from a range of national contexts shows that sustainable pastoralist development requires an understanding of the dual environmental and economic roles of pastoralism and an adaptation of policies and investments to support both...
November 2016: Revue Scientifique et Technique
https://www.readbyqxmd.com/read/27913975/clinical-impact-of-an-antibiotic-stewardship-program-at-a-children-s-hospital
#11
Brian R Lee, Jennifer L Goldman, Diana Yu, Angela L Myers, Leslie M Stach, Erin Hedican, Mary Anne Jackson, Jason G Newland
INTRODUCTION: Antibiotic stewardship programs (ASP) improve appropriate antibiotic use. Data are limited on the clinical benefit of ASPs in children's hospitals. This study's objective was to determine the impact of an ASP on length of stay (LOS) and readmission rate among patients admitted to children's hospitals. METHODS: Data from a prospective-audit-with-feedback ASP were used to examine the ASP review characteristics, including antibiotic(s) prescribed, clinical indication, recommendations made by the ASP, and agreement with recommendations...
December 2, 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27902375/improving-time-to-optimal-staphylococcus-aureus-treatment-using-a-penicillin-binding-protein-2a-assay
#12
Sonia N Rao, Sheila K Wang, Jose Gonzalez Zamora, Amy P Hanson, Radhika S Polisetty, Kamaljit Singh
The penicillin-binding protein 2a (PBP2a) assay is a quick, accurate and inexpensive test for determining methicillin susceptibility in Staphylococcus aureus. A pre-post-study design was conducted using a PBP2a assay with and without the impact of an antimicrobial stewardship intervention to improve time to optimal therapy for methicillin-susceptible and methicillin-resistant S. aureus isolates. Our results demonstrate significantly improved time to optimal therapy and support the use of a PBP2a assay as part of an programme for all healthcare facilities, especially those with limited resources...
December 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27880667/the-current-treatment-landscape-other-fungal-diseases-cryptococcosis-fusariosis-and-mucormycosis
#13
Olivier Lortholary, Mario Fernández-Ruiz, John R Perfect
Compared with major invasive mycoses such as aspergillosis and candidiasis, the antifungal stewardship management strategies of other fungal diseases have different opportunities and considerations. Cryptococcosis, fusariosis and mucormycosis are globally prevalent invasive fungal diseases (IFDs), but are not currently included in antifungal prophylaxis guidelines for immunocompromised hosts. Since the implementation of biomarkers as part of diagnostic screening strategies, the concept of pre-emptive antifungal therapy has emerged for these IFDs...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27832047/core-elements-of-outpatient-antibiotic-stewardship
#14
Guillermo V Sanchez, Katherine E Fleming-Dutra, Rebecca M Roberts, Lauri A Hicks
The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. This report augments existing guidance for other clinical settings. In 2014 and 2015, respectively, CDC released the Core Elements of Hospital Antibiotic Stewardship Programs and the Core Elements of Antibiotic Stewardship for Nursing Homes. Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients...
November 11, 2016: MMWR. Recommendations and Reports: Morbidity and Mortality Weekly Report. Recommendations and Reports
https://www.readbyqxmd.com/read/27823118/procurement-problems-what-lies-beneath
#15
Jane Bates
Perhaps because we have to budget so carefully ourselves, nurses are mindful not to squander NHS resources. Yet the health service's poor stewardship of taxpayers' money has been hot news on and off for years.
October 5, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27817759/status-of-the-prevention-of-multidrug-resistant-organisms-in-international-settings-a-survey-of-the-society-for-healthcare-epidemiology-of-america-research-network
#16
Nasia Safdar, Sharmila Sengupta, Jackson S Musuuza, Manisha Juthani-Mehta, Marci Drees, Lilian M Abbo, Aaron M Milstone, Jon P Furuno, Meera Varman, Deverick J Anderson, Daniel J Morgan, Loren G Miller, Graham M Snyder
OBJECTIVE To examine self-reported practices and policies to reduce infection and transmission of multidrug-resistant organisms (MDRO) in healthcare settings outside the United States. DESIGN Cross-sectional survey. PARTICIPANTS International members of the Society for Healthcare Epidemiology of America (SHEA) Research Network. METHODS Electronic survey of infection control and prevention practices, capabilities, and barriers outside the United States and Canada. Participants were stratified according to their country's economic development status as defined by the World Bank as low-income, lower-middle-income, upper-middle-income, and high-income...
November 7, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27814531/environmental-impact-of-non-certified-versus-certified-asc-intensive-pangasius-aquaculture-in-vietnam-a-comparison-based-on-a-statistically-supported-lca
#17
Trang T Nhu, Thomas Schaubroeck, Patrik J G Henriksson, Roel Bosma, Patrick Sorgeloos, Jo Dewulf
Pangasius production in Vietnam is widely known as a success story in aquaculture, the fastest growing global food system because of its tremendous expansion by volume, value and the number of international markets to which Pangasius has been exported in recent years. While certification schemes are becoming significant features of international fish trade and marketing, an increasing number of Pangasius producers have followed at least one of the certification schemes recognised by international markets to incorporate environmental and social sustainability practices in aquaculture, typically the Pangasius Aquaculture Dialogue (PAD) scheme certified by the Aquaculture Stewardship Council (ASC)...
December 2016: Environmental Pollution
https://www.readbyqxmd.com/read/27810065/social-media-as-a-tool-for-antimicrobial-stewardship
#18
Jennifer Pisano, Natasha Pettit, Allison Bartlett, Palak Bhagat, Zhe Han, Chuanhong Liao, Emily Landon
BACKGROUND: To increase the reach of our antimicrobial stewardship program (ASP), social media platforms, Facebook and Twitter, were used to increase internal medicine residents' (IMRs') antibiotic (Abx) knowledge and awareness of ASP resources. METHODS: Fifty-five of 110 (50%) IMRs consented to participate; 39 (71%) completed both pre- and postintervention surveys and followed our ASP on social media. Along with 20 basic Abx and infectious diseases (IDs) questions, this survey assessed IMR awareness of ASP initiatives, social media usage, and attitudes and beliefs surrounding Abx resistance...
November 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27773076/pathology-use-stewardship-pre-analytical-review-of-tissue-specimens-previously-processed-by-default-for-mycobacterial-culture-maintains-the-quality-of-laboratory-diagnosis-and-optimises-the-use-of-laboratory-resources
#19
Jeremy Brown, Jason Patterson, Briony Hazelton, Mitchell Brown, Peter Jelfs, Vitali Sintchenko, Sharon C-A Chen
No abstract text is available yet for this article.
February 2016: Pathology
https://www.readbyqxmd.com/read/27771878/forest-stewardship-council-fsc-pesticide-policy-and-integrated-pest-management-in-certified-tropical-plantations
#20
Pedro Guilherme Lemes, José Cola Zanuncio, José Eduardo Serrão, Simon A Lawson
The Forest Stewardship Council (FSC) was the first non-governmental organization composed of multi-stakeholders to ensure the social, environmental, and economic sustainability of forest resources. FSC prohibits certain chemicals and active ingredients in certified forest plantations. A company seeking certification must discontinue use of products so listed and many face problems to comply with these constraints. The aim of this study was to assess the impacts of certification on pest management from the perspective of Brazilian private forestry sector...
October 22, 2016: Environmental Science and Pollution Research International
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