Antimicrobial Stewardship Programs: What Does it Take to Keep Up With Evidence-Based Leading Practices?

Antimicrobial Stewardship Programs (ASPs) play a paramount role within hospitals and medical institutions to help ensure antibiotic prescribing enables better patient outcomes, helps reduce antimicrobial resistance and reduces infection spread of multidrug-resistant organisms.

Back in 2018, The Joint Commission, The Pew Charitable Trusts, and the CDC co-sponsored a meeting from key experts that identified 6 evidence-based leading practices that ASPs should be doing beyond having basic infrastructure for improving antibiotic prescribing.

As a follow-up, 2 years later, The Joint Commission Department of Research worked with partners to create a prevalence study to assess which Joint Commission-accredited hospitals had incorporated the 6 evidence-based leading practices.

The surveyors conducted telephone interviews with subset of ASP personnel at hospitalswho participated in the 2020 survey. Thirty hospitals were selected based on leading practices implemented, hospital size and system membership. A third-party qualitative researcher interviewed all participants using a semi-structured interview guide.

“Specific factors related to personnel, relationships and IT resources have an outsized impact on implementing multiple leading antimicrobial stewardship practices in hospitals,” the investigators reported. “These results suggest hospital ASPs could benefit by targeting resources toward these areas.”

Factors for implementing 6 evidence-based leading practices included things such as ASP team capacity, ID expertise, having a physician champion, relationships with clinicians and relevant departments, structure of EHRs, adequate software, and IT resources. Conversely, small and rural hospitals often did not have the resources or personnel dedicated to ASP to be able to incorporate the additional practices.

The poster, “Implementing Leading Antimicrobial Stewardship Practices in United States Hospitals – A Qualitative Study,” was presented during the Society for Healthcare Epidemiology of America Conference 2022 (SHEA).