Category: Federal Forum Posters
Purpose: Antimicrobial resistance is an ever-increasing concern. Unnecessary antibiotic prescribing for acute respiratory infections (ARI) in Veterans Affairs (VA) facilities has been identified as a chief area for improvement, particularly in urgent care and other outpatient settings. This has led to development of a national VA campaign aimed at antimicrobial stewardship for ARI. The objective of this process improvement project is to decrease unnecessary antimicrobial prescribing for ARI in the urgent care setting at a VA in the upper Midwest.
Methods: This performance improvement project will be presented to the Antimicrobial Stewardship subcommittee. Shadowing of urgent care providers will occur to gain familiarity with workflow and providers’ outlook on antimicrobial stewardship. Informal communication will be used to determine interventions that providers feel would be most beneficial. These tailored interventions will be instituted and measured utilizing an audit and feedback approach. Potential interventions include but are not limited to a “watchful waiting” protocol, rapid Strep test protocol, computerized decision support, reference guides, and continuing education. Patient education initiatives will be discussed with urgent care staff. Intervention start dates will be recorded for data assessment purposes. The following provider- and facility-specific data will be collected via the Veterans Affairs (VA) Academic Detailing Service: overall antibiotic prescribing rate for uncomplicated acute respiratory infection (ARI), antibiotic prescribing rate for uncomplicated bronchitis and ARI – not otherwise specified, preferred antibiotic prescribing rate for uncomplicated rhinosinusitis, and preferred antibiotic prescribing rate for uncomplicated pharyngitis. Data will be recorded without provider identifiers, and individual patient data will not be utilized. Individual data will be communicated monthly to each urgent care provider. Data will be compared to the previous data collection and to data from one year prior.
Results: not applicable
Conclusion: not applicable
Kristen Schroeder– PGY1 Pharmacy Resident, St. Cloud VA Health Care System, St. Cloud, MN