1009. Answering the Call for Antimicrobial Stewardship in Oregon
Session: Poster Abstract Session: Stewardship: Implementing Programs
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • FINAL_32807.pdf (1.9 MB)
  • Background : As a response to the emergence of multi-drug resistant organisms in hospitals, implementation of an antimicrobial stewardship program (ASP) has been shown to improve patient outcomes, reduce antimicrobial resistance, and cut costs. The Oregon Public Health Division and Patient Safety Commission surveyed inpatient facilities to assess needs for establishing ASPs.

    Methods: In August 2012, surveys were sent to pharmacists, physicians, infection preventionists, and laboratory personnel in 62 acute-care hospitals in Oregon via on-line survey monkey®. Adapted from the Illinois and California Antimicrobial Stewardship Questionnaires, our 25-question survey queried hospitals regarding the presence of an ASP and activities, the current resources available in hospitals to initiate or maintain an ASP, trends observed among hospitals with ASPs, and information technology support.

    Results: Fifty-six (90%) of 62 facilities responded. The table below displays important needs assessment factors based on hospital size.

     

     

    Small: ≤ 50 beds (n=30)

    Medium: 50-100 beds (n=14)

    Large: >100 beds (n=12)

    Hospitals with ASP

    13 (43%)

    7 (50%)

    8 (67%)

    Well established ASP

    0

    1 (14.3%)

    6 (50%)

    Barriers-Funding

    11 (37%)

    6 (43%)

    12 (100%)

    Barriers-Staffing

    19 (63%)

    12 (85%)

    11 (92%)

    Antimicrobial use measures

    7 (23%)

    3 (21%)

    5 (42%)

    Annual Antibiogram

    24 (80%)

    12 (85%)

    12 (100%)

    Available ID* consult

    17 (57%)

    9 (64%)

    12 (100%)

    Available Clinical Pharmacist

    19 (38%)

    6 (43%)

    11 (92%)

    ID* = Infectious Disease

     

    Compared to medium and large facilities, smaller hospitals were less likely to have an ASP established (Relative Risk = 0.6, 95% confidence interval 0.4-1.0). The survey suggests that lack of support for programs is the main barrier to ASP implementation. Most facilities reported lacking means for antimicrobial use measurement.

    Conclusion: Our initiative identified that more than half of the small- and medium-sized hospitals in Oregon have not established a formal ASP. Identified barriers were: 1) lack of ID consultation and pharmacy support; 2) lack of funding; 3) insufficient staffing support; and 4) inability to collect antimicrobial use data. This needs assessment has stimulated and informed the development of the Oregon Antimicrobial Stewardship Initiative.

    Robert F. Arao, MPH1, Ann Thomas, MD, MPH2, Zintars G. Beldavs, MS2, Melissa Parkerton, MA3, Lynne Strasfeld, MD4, Shahrzad Mohammadi, MPH5 and Graeme Forrest, MBBS5, (1)Public Health Division, Oregon Health Authority, Portland, OR, (2)Oregon Health Authority, Portland, OR, (3)Oregon Patient Safety Commission, Portland, OR, (4)Division of Infectious Disease, Oregon Health and Science University, Portland, OR, (5)Division of Infectious Disease, Veterans Affairs Medical Center, Portland, OR

    Disclosures:

    R. F. Arao, None

    A. Thomas, None

    Z. G. Beldavs, None

    M. Parkerton, None

    L. Strasfeld, None

    S. Mohammadi, None

    G. Forrest, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.