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- Title
2095. Antimicrobial Stewardship (ASP) in Rural and Critical Access Hospitals (CAHs) Using TeleStewardship® Services.
- Authors
Ased, Sumaya J; Horne, John; Vivekanandan, Renuga; Destache, Christopher J
- Abstract
Background MDstewardship® is a physician-owned company that uses TeleStewardship® services, which consist of telephone and HIPPA-compliant teleconferencing and texting, to provide rural and critical access hospital (CAH) ASP services, ensuring facilities remain compliant with Joint Commission ASP requirements. MDstewardship® also provides monthly webinars to all participating hospital personnel for continuing education. Webinars are live, interactive, and contain topics based on IDSA guidelines. MDstewardship® personnel discuss antibiotics with the hospital staff using a HIPPA-compliant secure audio-video feed, phone conference, or secure-text. CAH pharmacists discuss the antibiotics currently being given in their institution and MDstewardship® personnel provide further ASP recommendations. ASP recommendations are provided by MDstewardship® clinically-trained infectious disease pharmacists and infectious disease physicians, and are communicated to on-site pharmacists or directly with providers. Methods MDstewardship® is active with many rural CAHs in Nebraska, and over 20 hospitals nationally. Here we report our ASP results for 10 CAHs in Nebraska from August 2018 to April 2019. A total of 401 ASP recommendations were given over that time. Results The top three most common infectious diseases diagnoses involving recommendations were UTI (16.7%), pneumonia (15.2%), and bacteremia (13.7%). Most common ASP interventions included alternative therapy (15.7%), additional therapy (13.7%), oral step-down therapy (12.7%), and further laboratory monitoring (12.5%). Additional daily antimicrobial stewardship assistance includes: development of hospital protocols, order-sets, antibiograms and guideline adherence. Total acceptance of ASP recommendations averages > 90%. Reimbursement is based on a contract over 12 months. Conclusion The use of TeleStewardship® services allow CAHs to have 24/7 infectious disease specialist and clinically trained antimicrobial stewardship pharmacist support with a high number of interventions and a high acceptance of recommendations. The goal of this program is to give the right antibiotic, right dose, for the right duration, for each patient. Disclosures All authors: No reported disclosures.
- Subjects
NEBRASKA; JOINT Commission on Accreditation of Healthcare Organizations; HOSPITAL personnel; COMMUNICABLE diseases; URINARY tract infections; HOSPITALS; DIAGNOSIS
- Publication
Open Forum Infectious Diseases, 2019, Vol 6, pS708
- ISSN
2328-8957
- Publication type
Article
- DOI
10.1093/ofid/ofz360.1775