Antimicrobial Stewardship for the Community Hospital: Practical Tools & Techniques for Implementation

Antimicrobial resistance is a growing problem worldwide. National and international organizations have recognized this growing problem and have published guidelines and recommendations to combat it. Despite the recognition of the merits and benefits of Antimicrobial Stewardship Programs (ASP), only 48% of all US hospitals currently have an ASP in place. Although antimicrobial resistance is a worldwide concern, it is first and foremost a local problem. Hospitals, as the primary incubators of antimicrobial-resistant pathogens, carry the highest responsibility for proper stewardship of our antimicrobial resources. This educational initiative is designed to overcome and address the barriers to facilitate practical implementation of ASPs in the community hospital setting led by the hospital pharmacist and infectious disease specialist in conjunction with other collaborating physician specialties.
This CME/CE activity was recorded during a scientific roundtable meeting that was presented by the Centers for Disease Control and Prevention and titled "Antimicrobial Stewardship for the Community Hospital: Practical Tools & Techniques for Implementation," which took place on August 24, 2010, in Atlanta, Georgia.
Cooperating Organizations for this initiative include the American Medical Association, the Association for Professionals in Infection Control and Epidemiology, the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the Society of Hospital Medicine, and the Society of Infectious Diseases Pharmacists.

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Method of Participation

"Antimicrobial Stewardship for the Community Hospital: Practical Tools & Techniques for Implementation" is an online CME activity recorded at a live roundtable of the same name, held in Atlanta Georgia on August 24, 2010. There is one introduction module and 9 CME/CE modules. Each module of this program can be viewed separately for CME/CE credit. Credit will be awarded to physicians who successfully complete this activity. Participation should take approximately one hour per module.
To complete this activity and receive credit, the participant should:

Review the educational objectives
Listen to the webcast presentation
Complete the online post-test and evaluation of each module available through the University of Cincinnati.

Please find the link to the Web presentations and Modules below.

Webcast Presentations/Modules:

Addressing the Rising Tide of Antimicrobial Resistance: Why Something Must Be Done
John G. Bartlett, MD (29:15)
Proceed to post-test: Module 1
http://ccpd.uc.edu/activity/13904

The Proven Benefits of Antimicrobial Stewardship
Christopher A. Ohl, MD (41:12)
Proceed to post-test: Module 3
http://ccpd.uc.edu/activity/13906

Assessing the Current Status of Antimicrobial Stewardship in Your Hospital
Edward J. Septimus, MD, FIDSA, FACP, FSHEA (38:44)
Proceed to post-test: Module 5
http://ccpd.uc.edu/activity/13908

Management of Asymptomatic Bacteriuria in Hospitalized Patients: Room for Improvement
Sara E. Cosgrove, MD, MS, FSHEA (36:31)
Proceed to post-test: Module 7
http://ccpd.uc.edu/activity/13910

The CMS Core (Performance) Measures for Community-Acquired Pneumonia (CAP): Relating to Antimicrobial Stewardship
Thomas M. File Jr, MD, MSc, MACP, FIDSA, FCCP (41:11)
Proceed to post-test: Module 9
http://ccpd.uc.edu/activity/13912

Antimicrobial Prophylaxis in the Surgical Setting: Practical Application in Smaller Hospitals
Joseph S. Solomkin, MD, FACS, FIDSA (25:25)
Proceed to post-test: Module 2
http://ccpd.uc.edu/activity/13905

The Face of Stewardship in Community Hospitals Today
Elizabeth Dodds Ashley, PharmD, MHS, BCPS (29:00)
Proceed to post-test: Module 4
http://ccpd.uc.edu/activity/13907

Implementing an Antimicrobial Stewardship Program: The Pivotal Role of the Hospital Pharmacist
Robert C. Owens Jr, PharmD (36:39)
Proceed to post-test: Module 6
http://ccpd.uc.edu/activity/13909

Appropriate Antibiotic Usage and Public Health: The Perspective From the CDC
Arjun Srinivasan, MD, FSHEA (19:11)
Proceed to post-test: Module 8
http://ccpd.uc.edu/activity/13911

For more information about the CME accreditation of this program, please contact Susan Tyler at tylersn@uc.edu

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Faculty:

Arjun Srinivasan, MD, FSHEA (Co-chair)
CDR, USPHS
Associate Director for Healthcare Associated Infection Prevention Programs
Medical Director, Get Smart for Healthcare
Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention
Atlanta, GA
Christopher A. Ohl, MD
Associate Professor of Medicine
Section on Infectious Diseases
Wake Forest University School of Medicine
Winston-Salem, NC
Edward J. Septimus, MD, FIDSA, FACP, FSHEAClinical Professor of Internal Medicine
Texas A&M Health Science Center
Medical Director
Infection Prevention and Epidemiology
HCA Healthcare System
Houston, TX
Elizabeth S. Dodds Ashley, PharmD, MHS, BCPS
Associate Director of Clinical Pharmacy Services
University of Rochester Medical Center
Rochester, NY
John G. Bartlett, MD
Professor of Medicine and Epidemiology
Johns Hopkins University School of Medicine
Baltimore, MD

Robert C. Owens Jr., PharmD (Co-chair)
Co-Director, Antimicrobial Stewardship Program
Clinical Pharmacy Specialist, Infectious Diseases
Department of Pharmacy Services and Division of Infectious Diseases
Maine Medical Center
Portland, ME
Joseph S. Solomkin, MD, FACS, FIDSA
Professor Emeritus of Surgery
Department of Surgery
University of Cincinnati College of Medicine
Cincinnati, OH
Sara E. Cosgrove, MD, MS, FSHEA
Associate Professor of Medicine
Division of Infectious Diseases
Director, Antibiotic Management Program
Associate Hospital Epidemiologist
Johns Hopkins Medical Institutions
Baltimore, MD
Thomas M. File Jr., MD, MSc, MACP, FIDSA, FCCP
Professor, Internal Medicine
Head of Infectious Disease Section
Northeastern Ohio Universities
Colleges of Medicine & Pharmacy
Rootstown, OH
Chief, Infectious Disease Service
Summa Health System, Akron, OH

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Target Audience:

This CME initiative is intended for health–system pharmacists and infectious disease clinicians

Learning Objectives:

This activity was designed to address the following IOM competencies: provide patient-centered care; work in interdisciplinary teams; employ evidence-based practice; and apply quality improvement techniques.
Upon completion of this activity the participants should be better able to:

Evaluate the principles and objectives of an antimicrobial stewardship program
Identify the barriers to implementing a successful stewardship program in a community hospital
List the key elements of an antimicrobial stewardship program for a community hospital
Integrate evidence-based practices and resources to improve antimicrobial use
Facilitate interaction with the medical staff at the health care facility to promote acceptance of a stewardship program

Accreditation Statement:

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The University of Cincinnati College of Medicine and Rockpointe Corporation. The University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education to physicians.

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Designation Statement:

The University of Cincinnati College of Medicine designates each module of this enduring material for 1.0 AMA PRA Category 1 Credits(s)™. Participants can earn a maximum of 9.0 AMA PRA Category 1 Credit(s)™if they view each module in its entirety. Physicians should only claim credit commensurate with the extent of their participation in each activity.

Disclosure Information:

The University of Cincinnati adheres to the policies and guidelines, including the Standards for Commercial Support, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous.
All persons in a position to control the content of a continuing medical education program sponsored by the University of Cincinnati are required to disclose any relevant financial relationships with any commercial interest to the University of Cincinnati as well as to learners. All conflicts are identified and resolved by the University of Cincinnati in accordance with the Standards for Commercial Support in advance of delivery of the activity to learners.
The faculty reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
John G. Bartlett, MD: Advisory Board: Tibotec, Salient, Optimer; Honoraria: Abbott, Merck
Sara Cosgrove, MD, MS, FSHEA: Advisory Board: Forest, Rib-X; Consultant: Merck; Grant Recipient: Cubist, Astellas, Advan-Dx
Elizabeth S. Dodds Ashley, PharmD, MHS, BCPS: Consultant: Pfizer; Speakers Bureau: Merck
Thomas M. File Jr., MD, MSc, MACP, FIDSA, FCCP: Advisory Board: GlaxoSmithKline, Pfizer, Merck, Novartis, Cerexa, Forest, Protez, Nabriva, Tetraphase; Research Grant Recipient: Cerexa, Forest, Pfizer, Boehringer Ingelheim, Gilead, Tibotec
Christopher A. Ohl, MD: Advisory Board: Johnson & Johnson; Consultant: Johnson & Johnson; Speakers Bureau: Pfizer, Cubist
Robert C. Owens Jr., PharmD: Consultant: TheraDoc, Premiere
Edward J. Septimus, MD, FIDSA, FACP, FSHEA: Grant Recipient: AHRQ/CDC; Speakers Bureau: Cubicin, Merck, Sage
Joseph S. Solomkin, MD, FACS, FIDSA: Advisory Board: Johnson & Johnson, Merck, Optimer; Consultant: Cubist; Grant Recipient: Pfizer
CDR Arjun Srinivasan, MD, FSHEA: Nothing to Disclose

Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
Otto Ratz, MD; Josh Paul; Bradley Pine; Blair St. Amand; Jay Katz; Kay Weigand; Paula Larson; Nothing to Disclose

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Jointly Sponsored by:

University of Cincinnati and Rockpointe Corporation

Co-sponsored by:

Potomac Center for Medical Education and Rockpointe Corporation

Supported by:

An educational grant from Ortho-McNeilTM, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc., administered by Ortho-McNeil Janssen Scientific Affairs, LLC.

CDC - Antimicrobial Stewardship - Get Smart for Healthcare