Antimicrobial stewardship programs (ASP) are well established across the health care continuum and are essential to supporting the optimal use of antibiotics for improved patient health outcomes. Education to inform and engage prescribers/ clinicians in stewardship activities is a basic and essential stewardship strategy to improve antimicrobial prescribing.
ASP was implemented at Baycrest in 2012. To improve the effectiveness of educational efforts and ensure the safe use of antimicrobials, ASP conducts prospective audit and feedback on antimicrobial prescribing and provides corresponding interventions and measurements of outcomes. During the audits and data analysis, opportunities to improve documentation of antimicrobial indications and better track antibiotic utilization patterns were identified.
As a result, Baycrest ASP developed an eHealth solution, in which all antibiotic, antiviral and antifungal medication orders, are prompted to specify a clinical indication at time of order entry in the electronic health record (Meditech). With this new function, the indication for initiating antimicrobials becomes clear and is readily available in the medication order as well as the medication administration record (MAR). The information helps clinicians, especially those providing cross coverage and nursing staff identify infectious symptoms to be monitored and enhance communication of antimicrobial treatment for safe transitions of care as MARs are sent with patients when transferred out. Since the indication data is captured in the electronic health system, it also enables the ASP team to better analyze antimicrobial utilization, identify trends and guide future initiatives to further improve antimicrobial use.