148. Antimicrobial Stewardship Practices Reported by California Hospitals Annual Hospital Survey Data Submitted Via the National Healthcare Safety Network, 2014
Session: Poster Abstract Session: Antimicrobial Stewardship: Current State and Future Opportunities
Thursday, October 8, 2015
Room: Poster Hall
  • HAI Poster 5 of 5 IDWeek ASP E Epson 9 16 15.pdf (616.9 kB)
  • Background: Since 2008, California acute care hospitals have been required to develop processes for evaluating the judicious use of antibiotics and to report results to their quality improvement committees. A national survey conducted in 2011 found California hospitals were significantly more likely to have an antimicrobial stewardship policy than hospitals in other states. New California legislation further requires hospitals to implement an antimicrobial stewardship policy in accordance with guidelines and to establish a physician-supervised multidisciplinary committee with at least one physician or pharmacist with specific stewardship training by July 1, 2015. 

    Methods: Beginning in 2014, the National Healthcare Safety Network (NHSN) Annual Hospital Survey included questions about antimicrobial stewardship practices. Annual Hospital Survey data submitted by California acute care hospitals via NHSN were analyzed to determine proportions of hospitals implementing specific antimicrobial stewardship practices. 

    Results: Data were available for all 391 California hospitals reporting to NHSN: 290 (74%) reported having a statement from leadership supporting efforts to improve antibiotic use; 359 (92%) reported a physician or pharmacist leader responsible for outcomes of stewardship; 201 (51%) provide dedicated salary support for stewardship activities. Specific stewardship practices are included in Table 1. 

    Conclusion: In the setting of state legislative requirements, we document that substantial numbers of California hospitals are engaged in antimicrobial stewardship. These data will be used to identify opportunities for public health to guide programs that promote and support further implementation and advancement of antimicrobial stewardship practices in California hospitals. 

     Table 1

    Stewardship Practice

    No. (%) Hospitals Responding Yes

    Requiring prescribers to document indication for all antibiotics

    166 (42%)

    Facility-specific antibiotic treatment recommendations

    313 (80%)

    Antibiotic time-out

    133 (34%)

    Antibiotic pre-approval

    275 (70%)

    Antimicrobial prescription audit with feedback

    342 (87%)

    Providing feedback to prescribers regarding improving antibiotic use

    288 (74%)

    Providing antibiotic stewardship education

    278 (71%)

    Monitoring antibiotic use

    310 (79%)

    Erin Epson, MD, Healthcare-Associated Infections Program, California Department of Public Health, Richmond, CA, Kyle Rizzo, MPH, California Epidemiologic Investigation Service (Cal-EIS), Healthcare-Associated Infections Program, Center for Healthcare Quality, California Department of Public Health, Richmond, CA, Sam Horwich-Scholefield, MPH, Healthcare Associated Infections Program, California Department of Public Health, Richmond, CA and Lynn Janssen, MS, CIC, CPHQ, Healthcare-Associated Infections Program, Center for Healthcare Quality, California Department of Public Health, Richmond, CA


    E. Epson, None

    K. Rizzo, None

    S. Horwich-Scholefield, None

    L. Janssen, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.