Antibiotic Stewardship Program: Why Do You Need One?

Antibiotics are among the most frequently prescribed medications in skilled nursing facilities, with up to 70% of residents receiving one or more courses of systemic antibiotics a year. Where things get concerning is that up to 75% of antibiotics prescribed are done so unnecessarily or inappropriately.

Antibiotics can have serious side effects, including adverse drug reactions and the Clostridium Difficile infection. Individuals who are unnecessarily exposed to antibiotics are at risk for serious adverse events with no clinical benefit. Antibiotics can kill beneficial bacteria and upset the microbial balance in the gut.

Bacteria become increasingly resistant to antibiotics, leading to chronic infections that are difficult to treat. The use of antibiotics is also linked to obesity and autoimmune diseases. The Centers for Disease Control and Prevention (CDC) estimates more than two million people are infected with antibiotic-resistant organisms, resulting in approximately 23,000 deaths annually.

As noted by the CDC:

• The potential for spread of resistant organisms means that the misuse of antibiotics can adversely impact the health of patients who are not even exposed to them.
• Antibiotic resistant bacteria are responsible for a multitude of infections including: pneumonia, tuberculosis, and gonorrhea.
• Antibiotic resistant infections are becoming increasingly difficult to treat.
• Antibiotic resistance can affect anyone, not just the sick and elderly.
• Antibiotic resistant infections are the cause of longer hospital stays, increased medical costs, and increased deaths.

What does this mean for your skilled nursing facility?
According to The World Health Organization, “Antibiotic resistance is one of the biggest threats to global health, food security, and development today.” Antibiotic resistance is climbing to alarming levels in parts of the world, and if we do not intervene quickly, we are once again going to be in a period in which common infections and minor injuries can once be deadly. This is why The Centers for Medicare and Medicaid (CMS) is requiring that all skilled nursing facilities (SNFs) have an antibiotic stewardship program in place by November 28 and include, at a minimum, the following:

• A system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases for all residents, staff, volunteers, visitors, and other individuals providing services under a contractual arrangement based upon the facility assessment.
• Written standards, policies, and procedures for the program.

CMS will also require that each facility have an infection preventionist (IP) on staff by November 28th, 2018 and include, at a minimum, the following:

• One or more individual(s) as the IP who are responsible for the facility’s infection prevention and control program (IPCP).
• The IP must:
  • Have primary professional training in nursing, medical technology, microbiology, epidemiology, or other related field
  • Be qualified by education, training, experience or certification
  • Work at least part-time at the facility
  • Have completed specialized training in infection prevention and control
• The individual designated as the IP, or at least one of the individuals if there is more than one IP, must be a member of the facility’s quality assessment and assurance committee and report to the committee on the IPCP on a regular basis.
• The facility will conduct an annual review of its IPCP and update their program, as necessary.

The threat to your residents’ health from adverse antibiotic effects is real, and it’s essential that your facility prepare to take part in the upcoming CMS Antibiotic Stewardship Program.

To learn more about how to ensure your facility is compliant, we invite you to watch this webinar featuring members from Richter Healthcare Consultants and PointClickCare: