Core Elements of Antibiotic Stewardship for Nursing Homes

At a glance

• CDC recommends that all long-term care facilities and nursing homes take steps to improve antibiotic prescribing practices and reduce inappropriate use.
• The Core Elements of Antibiotic Stewardship for Nursing Homes adapts the Core Elements of Hospital Antibiotic Stewardship into practical ways to initiate or expand antibiotic stewardship activities in long-term care (LTC) facilities.

Overview

The Core Elements of Antibiotic Stewardship for Nursing Homes adapts the CDC Core Elements of Hospital Antibiotic Stewardship into practical ways to initiate or expand antibiotic stewardship activities in long-term care facilities. While the elements are the same for both hospitals and long-term care facilities, the implementation of these elements may vary based on facility staffing and resources. This guide provides examples of how the Core Elements can be applied by nursing home leadership, clinicians and staff to monitor and improve antibiotic use.

Core Elements documents

The Core Elements of Antibiotic Stewardship for Nursing Homes

CDC's framework for nursing home antibiotic stewardship programs.

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The Core Elements of Nursing Home Antibiotic Stewardship Programs Checklist

Checklist for implementing The Core Elements of Antibiotic Stewardship for Nursing Homes.

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Leadership commitment

Demonstrate support and commitment to safe and appropriate antibiotic use in your facility.

• Creating a Culture to Improve Antibiotic Use in Nursing Homes
• Stewardship Leadership Commitment Letter for Nursing Homes

Accountability

Identify physician, nursing and pharmacy leads responsible for promoting and overseeing antibiotic stewardship activities in your facility.

• Leading Antibiotic Stewardship in Nursing Homes

Drug expertise

Establish access to consultant pharmacists or other individuals with experience or training in antibiotic stewardship for your facility.

• 5 Ways Consultant Pharmacists Can Be Antibiotics Aware

Action

Implement at least one policy or practice to improve antibiotic use in your facility.

• Appendix A: Policy and Practice Actions to Improve Antibiotic Use
• Toolkit to Improve Antibiotic Use in Long-Term Care | Agency for Healthcare Research and Quality
• Stewardship Commitment Poster for Nursing Homes
• Minnesota Antimicrobial Stewardship Program Resources for Long-term Care Facilities | Minnesota Department of Health
• For Nursing Homes | Rochester Patient Safety Collaborative | University of Rochester
• Antimicrobial Stewardship in Long-Term Care Facilities | Colorado Department of Public Health and Environment

Tracking

Monitor at least one process measure of antibiotic use and at least one outcome from antibiotic use in your facility.

• Appendix B: Tracking and Reporting Antimicrobial Use—Beginner
• Appendix C: Tracking and Reporting Antimicrobial Use—Advanced
• Infection Tracking Logs | Center for Long-Term Care Quality and Innovation | Brown University

Reporting

Provide regular feedback on antibiotic use and resistance to prescribing clinicians, nursing staff and other relevant staff for your facility.

Education

Provide resources to clinicians, nursing staff, LTC residents, and families about antimicrobial resistance and opportunities for improving antibiotic use.

• Antibiotic Stewardship Courses
• You Can Help! Improving Antibiotic Stewardship & Infection Prevention in Nursing Homes
• Nursing Home Healthcare Professionals: Effective Communication Toolkit
• What You Need to Know About Antibiotics in a Nursing Home
• What to Ask Your Healthcare Provider about Antibiotics
• Top 10 Infection Prevention Questions to Ask a Nursing Home's Leaders

For other settings

Core Elements of Hospital Antibiotic Stewardship Programs

A framework for implementing antibiotic stewardship in hospital settings.

Core Elements of Outpatient Antibiotic Stewardship

A framework for implementing antibiotic stewardship in outpatient settings.

Core Elements of Human Antibiotic Stewardship Programs in Resource-Limited Settings

A framework for implementing antibiotic stewardship in resource-limited settings.

Core Elements of Antibiotic Stewardship for Health Departments

A framework for implementing antibiotic stewardship in health departments.

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