Development and implementation of the Antimicrobial Stewardship Intervention Scoring Tool at a single pediatric institution.

Autor:	Wirtz AL; Department of Pharmacy, Children's Mercy Kansas City, University of Missouri, Kansas, MO, USA., Burns AN; Department of Pharmacy, Children's Mercy Kansas City, University of Missouri, Kansas, MO, USA., Monsees E; Performance Excellence, Children's Mercy Kansas City, University of Missouri, Kansas, MO, USA.; University of Missouri-Kansas City School of Medicine, Children's Mercy Kansas City, University of Missouri, Kansas, MO, USA., Lee BR; University of Missouri-Kansas City School of Medicine, Children's Mercy Kansas City, University of Missouri, Kansas, MO, USA.; Division of Pediatric Infectious Diseases, Children's Mercy Kansas City, University of Missouri, Kansas, MO, USA., Herigon JC; University of Missouri-Kansas City School of Medicine, Children's Mercy Kansas City, University of Missouri, Kansas, MO, USA.; Division of Pediatric Infectious Diseases, Children's Mercy Kansas City, University of Missouri, Kansas, MO, USA.
Jazyk:	angličtina
Zdroj:	Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2024 Sep 16, pp. 1-6. Date of Electronic Publication: 2024 Sep 16.
DOI:	10.1017/ice.2024.114
Abstrakt:	Objective: The primary objective was to grade the potential impact of antimicrobial stewardship program (ASP) interventions on patient safety at a single center using a newly developed scoring tool, the Antimicrobial Stewardship Impact Scoring Tool (ASIST). Design: Retrospective descriptive study. Setting: A 367-bed free-standing, pediatric academic medical center. Methods: The ASP team developed the ASIST which scored each intervention on an impact level (low, moderate, high) based on patient harm avoidance and degree of antibiotic optimization. Intervention frequency and characteristics were collected between May 1, 2022 and October 31, 2023. Intervention rates per impact level were calculated monthly. Results: The ASP team made 1024 interventions further classified as low (45.1%), moderate (47%), and high impact (7.9%). The interventions for general pediatrics (53.9%) and those to modify formulation (62.2%), dose/frequency (58.1%), and duration (57.5%) were frequently low impact. Hematology/oncology (12.5%), sub-specialty (11.7%), and surgical services (11.3%) had the greatest rate of high-impact interventions. Interventions to broaden antibiotics (40.8%) and those associated with antibiotics used to treat bacteremia (20.6%) were frequently classified as high-impact. Conclusion: The ASIST is an effective tool to link ASP interventions to prevention of antimicrobial-associated patient harm. For our ASP team, it provided meaningful data to present to hospital leadership and identified opportunities to prevent future harm and reduce ASP team workload.
Databáze:	MEDLINE
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