967. The Oregon Antimicrobial Stewardship Initiative (OASIS)
Session: Poster Abstract Session: Stewardship: Epidemiology of Antibiotic Use
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • OASIS FINAL POSTER sep26.pdf (450.6 kB)
  • Background:

    Inappropriate use of antibiotics may be related to increases in multidrug resistant organisms (MDROs) and Clostridium difficile infections (CDI). Unfortunately, there are few new antibiotics in development to treat increasingly resistant infections. We implemented OASIS as a statewide model to develop antimicrobial stewardship programs (ASP) for hospitals.

    Methods:

    All Oregon hospitals were asked to complete an online survey to assess ASP baseline practices. Thirteen hospitals committed to participate in OASIS, providing antimicrobial utilization and cost data to the Oregon Patient Safety Commission (OPSC), along with a monthly logbook of pharmacy recommendations and outcomes.

    The collaborative provided hospital teams with 3 learning sessions focused on core ASP strategies and program development tools. Participants selected their own interventions of greatest impact based on CDC recommendations for ASP. Pharmacy and therapeutic committees at each hospital approved ASP implementation and guidelines. The OPSC provided a secure web-based platform where hospital teams can view guidelines, updates and directly upload data on a monthly basis. Other educational support includes weekly “Drugs & Bugs” calls to an Infectious Disease Consultant (IDC), webinars, conference calls, and site visits.

    Results:

    Of the 13 participating hospitals, 2 are pediatric and 3 are critical access. The table below displays the number (n) of recommended interventions accepted by providers since January 2013. Seven of 13 hospitals (54%) are providing antimicrobial utilization data while 6 are still facing challenges with adequate IT support and/or complex pharmacy systems.

     

    Recommended Interventions

    Total (n)

    % Acceptance

    Discontinue Anaerobic Double Coverage

    12

    91.7%

    ID Consult Suggested

    31

    48.4%

    Discontinue Antimicrobial Prescription

    67

    80.6%

    Narrow Spectrum of Activity

    94

    77.7%

    Intravenous to Oral switch

    105

    91.4%

    Dose Change

    199

    97.0%

    Other

    155

    73.5%

    Overall

    663

    93.8%

     Conclusion:

    OASIS has provided educational tools and resources for initiation and maintenance of ASP for Oregon hospitals. There has been a high rate of acceptance amongst providers participating in OASIS. Lack of adequate IT support for cost and antimicrobial utilization data is a limitation that is being addressed.

    Shahrzad Mohammadi, MPH, Division of Infectious Disease, Veterans Affairs Medical Center, Portland, OR, Lynne Strasfeld, MD, Division of Infectious Disease, Oregon Health and Science University, Portland, OR, Melissa Parkerton, MA, Oregon Patient Safety Commission, Portland, OR, Robert F. Arao, MPH, Public Health Division, Oregon Health Authority, Portland, OR, Zintars G. Beldavs, MS, Oregon Health Authority, Portland, OR, Graeme Forrest, MBBS, Portland VA Medical Center, Portland, OR and Oregon Antibiotic Stewardship Collaborative

    Disclosures:

    S. Mohammadi, None

    L. Strasfeld, None

    M. Parkerton, None

    R. F. Arao, None

    Z. G. Beldavs, 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.