HAIIP Antimicrobial Stewardship Program

Resources to Support an Antimicrobial Stewardship Program

Physicians, nurses, and pharmacy and laboratory staff can work together to improve and optimize antimicrobial use (AU) through effective antimicrobial stewardship (AS) programs (ASP).  ASP interventions have been demonstrated to improve patient outcomes and reduce adverse consequences, including combatting antimicrobial resistance (AR) and mitigating Clostridioides difficile infections. 

Antimicrobial Resistance happens when germs like bacteria and fungi develop the ability to defeat the drugs designed to kill them. That means the germs are not killed and continue to grow. Resistant infections can be difficult, and sometimes impossible to treat. 

Antibiotic Stewardship is the coordinated effort to ensure clinicians prescribe antibiotics only when needed and are used appropriately to achieve the best clinical outcomes while minimizing unintended consequences.

Visit the resources below for additional information.

• CDPH Antimicrobial Stewardship 
• CDC Core Elements of Antibiotic Stewardship for Nursing Homes

San Bernardino County Department of Public Health (SBCDPH) Antibiotic Stewardship Resource Guide

Table of Contents

• Developing and Implementing Antibiotic Stewardship Programs (ASPs)
• Improving and Sustaining ASP
• Creating a Culture of Safety
• Learn Best Practices for Infection and Allergy Management
• Therapeutic Guidelines

Developing and Implementing Antibiotic Stewardship Programs (ASPs)

Centers for Disease Control and Prevention (CDC)

Core Elements for ASP

• CDC Core Elements of Antibiotic Stewardship for Nursing Homes | Antibiotic Prescribing and Use

Core Elements of ASP Guide and Checklist by CDC

• The Core Elements of Antibiotic Stewardship for Nursing Homes (cdc.gov)
• The Core Elements of Antibiotic Stewardship for Nursing Homes: Checklist (cdc.gov)

Implementation Resources for Nursing Homes Organized by CDC’s Core Elements

• Core Elements of Antibiotic Stewardship for Nursing Homes | Antibiotic Prescribing and Use (cdc.gov)

Agency for Healthcare Research and Quality (AHRQ)

Developing an Antibiotic Stewardship Program | Agency for Healthcare Research and Quality (presentation)

Tools to Aid in Development of Stewardship Program

• Implementation Guide for Long-Term Care Antibiotic Stewardship Programs (PDF, 402 KB)
• Comprehensive Program with Timeline and Supporting Materials (PDF, 465 KB)
• Gap Analysis for Antibiotic Stewardship Programs in Long-Term Care (DOCX, 382 KB)
• General Implementation Tools
• Choosing an Intervention and Measuring Change
• Collecting Microbiological Specimens
• Discussing Infectious Concerns About Residents

California Department of Public Health (CDPH)

Skilled Nursing Facility Antibiotic Stewardship Program Implementation Toolkit

• SNFs Antibiotic Stewardship Program (ASP) Toolkit

Data Tracking and Reporting

• Toolkit for National Healthcare and Safety Network Antimicrobial Use and Resistance Module

Infectious Diseases Society of America (IDSA)

• Implementing an Antibiotic Stewardship Program: Guidelines by IDSA and the Society for Healthcare Epidemiology of America

Improving and Sustaining ASP

CDPH

Antimicrobial Stewardship Collaborative Network (ASCN)

• California Antimicrobial Stewardship Collaborative Network (ASCN)

CDC

Explore and Visualize Data on Antimicrobial Resistance and Patient Safety

• Antimicrobial Resistance and Patient Safety Portal (CDC)

AHRQ

Our Moments of Antibiotic Decision-Making Questions and Implementation by AHRQ

• Four Moments of Antibiotic Decision Making | Agency for Healthcare Research and Quality (ahrq.gov)

The Four Moments of Antibiotic Decision-Making Posters

• The Four Moments of Antibiotic Decision Making Posters | Agency for Healthcare Research and Quality (ahrq.gov)

The Four Moments of Antibiotic Decision-Making Form

• The Four Moments of Antibiotic Decision-Making Form
• Completion Guide for the Four Moments of Antibiotic Decision-Making Form
• Tracking and Measuring Antibiotic Use (presentation)
• Appropriate Collection of Microbiological Specimens (presentation, narrated presentation, and one-page document)
• Communicating Infectious Concerns with Antibiotic Prescribers (presentation and narrated presentation)
• Discussing Infectious Concerns About Residents with Family Members and Caregivers (presentation and narrated presentation)
• Sustaining Your Antibiotic Stewardship Program (presentation)
• Sustaining Your Antibiotic Stewardship Program Guide (PDF, 401 KB)

Creating a Culture of Safety

• Partnering With a Senior Executive
• Improving Antibiotic Use is a Patient Safety Issue
• Improving Teamwork and Communication
• Identifying Targets to Improve Antibiotic Use
• Changing the System to Improve Antibiotic Safety
• Antibiotic Use Commitment Poster (DOCX, 870 KB)
• Staff Safety Assessment Form (DOCX, 330 KB)
• Implementation Guide (PDF, 402 KB)
• Learning From Antibiotic–Associated Adverse Events Form (DOCX, 227 KB)
• Gap Analysis Tool (DOCX, 382 KB)
• The Four Moments of Antibiotic Decision Making Form and Guide

Learn Best Practices for Infection and Allergy Management

For Healthcare Practitioners and Nursing Staff:

• Assessment and Management of the Resident With a Suspected Urinary Tract Infection
• Assessment and Management of the Resident With a Suspected Respiratory Tract Infection
• Assessment and Management of the Resident With a Suspected Skin or Soft Tissue Infection
• Penicillin Allergies and Other Side Effects of Antibiotic Use

Primarily Intended for Healthcare Practitioners:

• One-Page Document – Management of Clostridioides difficile Infection (PDF, 212 KB)

Additional Tools:

• Best Practices Pocket Cards and Posters
• Appropriate Collection of Microbiological Specimens
• Antimicrobial Resistance

Therapeutic Guidelines

Infectious Diseases Society of America (IDSA)

• Alphabetical Guidelines (idsociety.org)