Program Schedule

Skills Learned during Critical Care Prospective Audit and Feedback are Utilized outside of the Stewardship Environment

Session: Poster Abstract Session: Antibiotic Stewardship
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
  • 212_IDweek.pdf (3.9 MB)
  • Background: Antimicrobial stewardship programs (ASP) are crucial to optimize antimicrobial utilization in critical care. Prospective audit and feedback is the major intervention used by stewardship programs, yet the impact on clinicians’ antimicrobial prescribing behaviours outside of the stewardship environment is unknown. We sought to understand if skills learned during prospective audit and feedback are translated to other areas of clinicians’ practice.

    Methods: Antimicrobial stewardship, through biweekly prospective audit and feedback, was initiated in a 14 bed closed medical-surgical ICU at a single site of a multi-site, community hospital. ICU physicians working in the stewardship ICU also worked in another site ICU at the same community hospital where stewardship had not been formally introduced. We compared antimicrobial utilization between the stewardship and non-stewardship ICUs before and after antimicrobial stewardship implementation using time series analysis.

    Results: Broad-spectrum antimicrobial use and anti-pseudomonal antimicrobial use decreased post ASP implementation in the stewardship ICU as well as the non-stewardship ICU.  In the stewardship ICU broad-spectrum antibiotic use and anti-pseudomonal antibiotic use was decreased by 21.2% (p =0.023) and 20.6% (p = 0.017) respectively compared to 29.8% (p = 0.071) and 38.1% (p = 0.025) in the non-stewardship ICU.

    Conclusion: Prospective audit and feedback has the potential to change antimicrobial prescribing behaviours among ICU clinicians. Skills learned during prospective audit and feedback are translated to practice settings outside of the stewardship environment.

    Karim Ali, MD, MBBS1, Gina Dimitra Fleming, BSc. PhM1, Kenny Ma, Bsc. PhM1, Ryan D'sa, MD. FRCPC. FRCP Edin.1 and Jeff Powis, MD, MSc, FRCPC2, (1)Niagara Health System, St Catharines, ON, Canada, (2)Medicine, University of Toronto, Toronto, ON, Canada


    K. Ali, None

    G. D. Fleming, None

    K. Ma, None

    R. D'sa, None

    J. Powis, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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