Methods:A literature review resulted in no report of CPAs being applied to LTC residents on antibiotics for UTI. Recognizing the dispensing and consultant pharmacist role varies by organization, we drafted a multi-layered CPA that can be customized by facility. The draft was reviewed by physicians, pharmacists, and nurses with expertise in infectious diseases, LTC, and CPAs. Through frequent meetings and collaborative editing, consensus was achieved. The final CPA includes antibiotic renal dose adjustment, discontinuation of antibiotics in asymptomatic patients with negative urinalysis or culture, and oral antibiotic modification based on organism susceptibility.
Results:The CPA template is supported by the WI HAI in LTC Coalition. It has been presented at the state level and is available for use by LTC facilities and pharmacists that may apply any/all level(s) of the CPA. An organization policy template and initial CPA competency for pharmacists have been designed to support implementation. Committed pilot sites have been identified.
Conclusion: A CPA is an innovative approach to expand the role of the dispensing and consultant pharmacist in antimicrobial stewardship initiatives in the LTC setting. Using an expert panel to develop templated resources that can be customized at the facility level may assist pharmacists and LTC providers in moving forward with this type of clinical practice change.
M. Palmer, None
L. Traynor, None
J. Boero, None
C. Crnich, None