Session Type
Meeting
Search Results for stewardship
Abstract Number: 133
SHM Converge 2021
Background: Acute otitis media (AOM) is a commonly overtreated pediatric diagnosis. Since 2014, the American Academy of Pediatrics (AAP) has recommended a ‘wait-and-see’ strategy and shorter antibiotic courses for mild or moderate AOM in qualifying patients. While this strategy has been successfully implemented in some pediatric emergency units (EUs), studies have shown that 30-90% of […]
Abstract Number: 134
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Surgical site infections (SSI) can complicate any operative procedure although this risk is mitigated through the use of preoperative antibiotic prophylaxis. While antibiotic prophylaxis can provide great benefit, inappropriate use can lead to the development of multi-drug resistant organisms causing increased morbidity, mortality, and cost. Although national clinical guidelines for preoperative antibiotics prophylaxis were […]
Abstract Number: 145
SHM Converge 2021
Background: The management of cellulitis in young infants has not been well-studied and appears to be largely variable. Infants with cellulitis often present without fever and only skin findings, with only a small minority having invasive infection. There is no consensus on the need for admission and further workup, such as a lumbar puncture. The […]
Abstract Number: 158
SHM Converge 2021
Background: Community acquired pneumonia (CAP) is one of the leading causes of hospitalization in the United States.[1] In an effort to improve the quality of care for this resource-intensive disease, our institution implemented a clinical decision support (CDS) pathway for CAP comprised of three phases: (1) education on best practices, (2) education and a CDS […]
Abstract Number: 184
Hospital Medicine 2020, Virtual Competition
Background: Nearly half of hospitalized patients with bacteriuria or treated for pneumonia receive unnecessary antibiotics (non-infectious/non-bacterial syndrome, e.g., asymptomatic bacteriuria), excess duration (antibiotics prescribed for longer than necessary), or avoidable fluoroquinolones (safer alternative available) at hospital discharge.1-3 However, it is unknown whether antibiotic overuse at discharge varies between hospitals or is associated with patient outcomes. […]
Abstract Number: 186
Hospital Medicine 2020, Virtual Competition
Background: Between 2007 and 2015, inpatient fluoroquinolone use declined in U.S. Veterans Affairs (VA) hospitals. Whether fluoroquinolone use at discharge has also declined, in particular since antibiotic stewardship programs became mandated at VA hospitals in 2014, is unknown. Methods: In this retrospective cohort study of hospitalizations with infection between January 1, 2014 and December 31, […]
Abstract Number: 187
Hospital Medicine 2020, Virtual Competition
Background: Clinicians often diagnose bacterial infections such as urinary tract infection (UTI) and pneumonia in patients who are asymptomatic or have non-bacterial causes of their symptoms. Misdiagnosis of infection leads to unnecessary antibiotic use and potentially delays correct diagnoses. Interventions to improve diagnosis often focus on infections separately. However, if misdiagnosis is linked at the […]
Abstract Number: 188
SHM Converge 2024
Background: Inpatient stewardship has appropriately become a large focus of acute inpatient care. The Vizient™ Clinical Data Base contains hospital discharge data used for benchmarking, and we observed significantly elevated cardiac MRI (cMRI) use at our tertiary hospital, relative to other tertiary academic medical centers, with resource utilization percentile averaging in the top decile (figure […]
Abstract Number: 194
SHM Converge 2024
Background: Inappropriate diagnosis of urinary tract infections (UTI) contributes to antibiotic overuse. We previously validated and refined a patient safety measure that defines inappropriate diagnosis of UTI (i.e., treatment of asymptomatic bacteriuria [ASB]) and was endorsed by the National Quality Forum. Use of this measure as a pay-for-performance metric in the Michigan Hospital Medicine Safety […]
Abstract Number: 206
SHM Converge 2023
Background: Closing the gap between evidence-supported antibiotic use and prescribing patterns among clinicians is a vital component of curbing excessive antibiotic use, a practice that fosters antimicrobial resistance and exposes patients to the side effects of antimicrobial agents. Providing medication prescribing information via scorecard has been shown to improve clinician adherence to quality metrics in […]