Tennessee Pharmacists Association

The Tennessee Pharmacists Association is actively working with the Tennessee Department of Health to expand the utilization and standardization of Antibiotic Stewardship Programs within health systems in Tennessee. On Tuesday, November 26, the Tennessee Department of Health began implementing their Tennessee Antimicrobial Stewardship Collaborative Pilot. Pharmacists play an essential role in appropriate Antibiotic Stewardship, and TPA encourages all health-system pharmacists to participate in this very important project.

The Tennessee Department of Health has released the following information. If you have questions, please contact Jea-Young Min at jea-young.min@tn.gov or 615-532-8482.

From the Tennessee Department of Health:

The Tennessee Antimicrobial Stewardship Collaborative Pilot, led by the Tennessee Department of Health (TDH) [began] on November [26], 2013 with our first collaborative webinar.

Antimicrobial stewardship programs (ASP) have been shown to be an effective strategy to decrease multi-drug resistant organisms and C. difficile, improve patient safety, and reduce unnecessary antibiotic use. They guide clinicians in selecting the appropriate agent, dose, duration, and route of administration, and frequently reduces overall healthcare costs for the hospital.

The goals of this collaborative are to:
1) Develop and expand antimicrobial stewardship expertise among the Tennessee clinical and public health communities
2) Assess the status of ASPs with a plan to implement and enhance existing programs
3) Provide expert ASP consultation and resources to individual hospitals as needed
4) Reduce unnecessary antibiotic use and improve appropriate use
5) Reduce HAI C. difficile infection (CDI) rates

Hospitals joining the collaborative will be able to participate in monthly conference call webinars in which guest speakers with expertise in antimicrobial stewardship will lead presentations on ASP topics and provide practical recommendations.

We are using a “4-Phase” model of ASP adopted from HCA hospitals, and our webinar topics will be presented according to their appropriate phases. Here is a list of webinar topics we are planning for each phase:

Phase 1

  1. Nov 2013: Assessing the Gaps and Identifying the Champions for ASP (Dr. Ed Septimus)
  2. Dec 2013: Multidisciplinary Team and Leadership Support for ASP (Dr. Juli Horton)
    Date: Tuesday, December 10, 2013
    Time: 1:00 – 2:00 PM Central Time
    Webinar link: http://stateoftennessee.adobeconnect.com/assc/
    Conference call line: (888) 757-2790
    Participant Passcode: 848713

Phase 2

  1. Dose Optimization and Kinetic Dosing
  2. ASP in Small Community Hospitals
  3. ASP Strategies for Specific Clinical Settings and Patient Populations

Phase 3

  1. Approving Institutional Guidelines, Evaluating Use Agents based on Local Needs (front/back-end approach)
  2. Role of the Pharmacist in ASP: Drug Regimen Reviews, Rounding with Team, and More
  3. Measurement in ASP and Reporting Approved Metrics to Stakeholders

Phase 4

  1. De-Escalation
  2. Creating and Utilizing Antibiograms
  3. Rapid Diagnostics, Point of Care Testing, and Biomarkers for Appropriate Use
  4. Sustaining an ASP

Please save the dates for the first two webinars which will cover the fundamentals of ASP. We encourage all hospitals regardless of how advanced their current ASP is, to participate in these webinars to make sure their foundations are solid. After these two webinars, hospitals will be given some time to perform a gap assessment for their current ASP practices and share interests with TDH in a short survey.

We encourage hospitals to identify physician and pharmacist champions, in addition to a multidisciplinary team that includes clinical microbiologists, nurses, hospital epidemiologists, and hospital leadership to participate in ASP. All of these team members will be critical for the success of your program. For example, clinical microbiologists will be especially important for creating and utilizing antibiograms.

In addition to participation in the webinars, hospitals will also be asked to complete an Antibiotic Use Survey every quarter, which will capture the use of common antibiotics and antibiotic classes among inpatients during a single day at their facility, to monitor overall trends in antibiotic use. This survey has been piloted and it is estimated to take about one hour to set up the query the first time. Once the query is set up, it is expected to take 5-10 minutes to complete the survey in the future.

A website for the collaborative will be created on the Tennessee HAI Online Workspace, where TDH will provide recordings of webinar presentations and other resources, and facilities can share ideas and resources with one another.

For more information, please contact Jea-Young Min at jea-young.min@tn.gov or 615-532-8482.

We appreciate and look forward to your participation in this collaborative.