Methods: In November 2014, the RI Department of Health collaborated with a task force comprised of local healthcare-associated infections stakeholders to adapt and administer an Advancing Excellence campaign survey to assess LTCF AMS. We faxed and emailed survey notices to all RI LTCFs (N=88) and requested that each facility respond via an electronic version (SurveyMonkey). In the week prior to and following the survey deadline, we phoned Administrations of LTCFs that had not responded and requested that their staff respond. Response data were analyzed using descriptive statistics in Stata 13 and Excel6.
Results: Representatives from 99% (87/88) of RI's LTCFs responded to the survey. The mean size of facilities was 101 beds. Most respondents were directors of nursing (59%). Half (51%) reported having written policies for AMS activities. Few (28%) reported having a formal, written statement of support for AMS. Even fewer (15%) reported having any budgeted financial AMS support. Few (38%) reported having a process to review antibiotic orders after 3 days to assess appropriateness. Most (92%) reported having a monthly report of antibiotic use provided by pharmacy. Most (75%) reported that feedback was provided to medical personnel regarding their antibiotic prescribing practices. Most (89%) reported having a pharmacist or physician who provides expertise on antibiotic use. Only 54% reported having a physician available for infectious diseases (ID) consult within 48 hours of a request. Mean AMS allocations for ID physicians was 0.02 full-time equivalents (FTE), with most (83%) reporting 0. Mean AMS allocations for ID pharmacists was 0.006 FTE, with most (84%) reporting 0.
Conclusion: AMS practices vary widely among RI LTCFs. The majority of facilities face significant barriers to AMS, such as limited financial support and lack of trained physicians and pharmacists. Interventions and resources are critically needed to overcome these barriers and advance AMS throughout RI LTCFs.
R. Baier, None
S. Kavoosifar, None
L. Mermel, CareFusion: Consultant , Consulting fee and Research grant
Marvao Medical: Consultant , Consulting fee and Research grant
Bard: Consultant , Consulting fee
Fresenius: Consultant , Consulting fee
3M: Consultant , Consulting fee
K. Laplante, Cubist Pharmaceuticals: Grant Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee , Grant recipient and Speaker honorarium
Pfizer Pharmaceuticals: Grant Investigator , Grant recipient
Theravance Biopharma: Grant Investigator and Scientific Advisor , Consulting fee and Grant recipient
Durata: Scientific Advisor , Consulting fee
Forest Laboratories: Scientific Advisor , Consulting fee
Marvao: Grant Investigator , Grant recipient
Melinta: Scientific Advisor , Consulting fee
Davol: Scientific Advisor , Consulting fee
Theradoc: Scientific Advisor , Consulting fee
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