979. Antimicrobial Stewardship Programs in Minnesota Hospitals
Session: Poster Abstract Session: Stewardship: Implementing Programs
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
  • lindsey10.pdf (249.1 kB)
  • Background:

    Antimicrobial resistance is a major public health threat. Antimicrobial stewardship programs (ASP) aim to limit resistant infections, improve patient safety, and reduce healthcare costs. We assessed ASP in MN hospitals.


    An electronic survey was sent to infection preventionists (IP) in February 2013. Hospitals were categorized as critical access (CAH; < 25 beds) or other acute care hospital.


    50% (66/133) responded: 36/76 (47%) CAH; 30/57 (53%) others. 19% (7/36) CAH and 70% (21/30) others reported an ASP. Of responding hospitals, 100% (7/7) with > 400 beds; 100% (4/4) with 200-399 beds; and 55% (11/20) with 26-199 beds had an ASP. 

    Of hospitals with no ASP, 87% (33/38) indicated interest in one; reasons for not having one were lack of resources (37%), clinician support (24%), or administrative support (11%); and time constraints/competing priorities. Identified needs included protocols and order sets; educational materials for physicians, nurses, pharmacists, and patients.  

    Of hospitals with ASPs, 61% (17/28) targeted specific antimicrobials; 25% (7/28) targeted specific pathogens; 32% (9/28) targeted syndromes.  39% (11/28; all non-CAH) with ASP had evaluated their ASP through antimicrobial utilization, antibiograms, provider feedback, and/or infection rates.

    ASP committees varied: 89% (25/28) included a pharmacist, 71% (20/28) a physician, 61% (17/28) an IP, and 39% (11/28) a microbiologist. 56% (14/25) of pharmacists, 70% (14/20) of physicians, 53% of IPs and 36% of microbiologists were compensated for time spent on ASP.  


    Despite guidelines issued 15 years ago, not all MN hospitals have ASP, especially smaller ones. Lack of resources and clinician support were common explanations, although almost all indicated an interest in ASP.  Among hospitals with ASP, some but not all had developed methods to evaluate their ASP.  ASP generally included a pharmacist, physician and often IP, but not all programs compensated staff.  In response to the needs of hospitals, a MN ASP steering group has been working on protocols and tools for establishing ASP, including attention to small hospitals, and suggestions for evaluation and improvement for facilities that already have ASP.

    Lindsey Lesher, MPH, Jane Harper, BSN, MS, CIC, Linn Warnke, RN, MPH, Jean Rainbow, RN, MPH and Ruth Lynfield, MD, Acute Disease Investigation and Control, Minnesota Department of Health, St. Paul, MN


    L. Lesher, None

    J. Harper, None

    L. Warnke, None

    J. Rainbow, None

    R. Lynfield, 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.