Nursing homes must have an antibiotic stewardship program that includes antibiotic-use protocols and a system to monitor antibiotic use as part of their infection prevention and control program (IPCP), according to §483.80 (Infection Control) of the Code of Federal Regulations. The antibiotic stewardship program is another component of the Phase 2 rollout of the Reform of Requirements for Long-term Care Facilities, and surveyors will assess compliance with this new requirement of participation under F881 during the Infection Control Facility Task that is a mandatory part of the new survey process. Antibiotic Stewardship refers to a set of commitments and activities designed to optimize the treatment of infections while reducing adverse events associated with antibiotic use. Core elements for Antibiotic Stewardship in Nursing Homes consists of:
- Leadership
- Accountability
- Drug expertise
- Action
- Tracking
- Reporting
- Education
During Drug Regimen Review (DRR), the consultant pharmacist will help identify and flag, orders for antibiotics that are not consistent with antibiotic stewardship practices. Pharmacy DRR – Antibiotic Stewardship UDA in Point Click Care will be utilized to create flow sheet for Action, Tracking, and Reporting of data regarding antibiotic usage in the facility. The consultant pharmacist will work with the physician, preventionist, and DON to review microbiology culture data (antibiogram) and make recommendations to the providers to help educate and guide in appropriate antibiotic selection. The consultant pharmacist shall assist the facility in developing a list of appropriate antibiotics and quantity to be kept in the Emergency Drug Kit. The consultant pharmacist shall participate in the Antibiotic Stewardship Committee meetings on a regular basis.
