Expert Consensus on Metrics to Assess the Impact of Patient-Level Antimicrobial Stewardship Interventions in Acute-Care Settings
Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision...
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| Veröffentlicht in: | Clinical infectious diseases 2017-02, Vol.64 (3), p.377-383 |
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| creator | Moehring, Robekah W. Anderson, Deverick J. Cochran, Ronda L. Hicks, Lauri A. Srinivasan, Arjun Ashley, Elizabeth S. Dodds |
| description | Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. An expert panel rated 90 candidate metrics on a 9-point Likert scale for association with 4 criteria: improved antimicrobiol prescribing, improved patient care, utility in targeting stewardship efforts, and feasibility in hospitals with electronic health records. Experts further refined, added, or removed metrics during structured teleconferences and re-rated the retained metrics. Six metrics were rated >6 in all criteria: 2 measures of Clostridium difficile incidence, incidence of drug-resistant pathogens, days of therapy over admissions, days of therapy over patient days, and redundant therapy events. Fourteen metrics rated >6 in all criteria except feasibility were identified as targets for future development. |
| doi_str_mv | 10.1093/cid/ciw787 |
| format | Article |
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Dodds</creator><creatorcontrib>Moehring, Robekah W. ; Anderson, Deverick J. ; Cochran, Ronda L. ; Hicks, Lauri A. ; Srinivasan, Arjun ; Ashley, Elizabeth S. Dodds ; Structured Taskforce of Experts Working at Reliable Standards for Stewardship (STEWARDS) Panel ; Structured Taskforce of Experts Working at Reliable Standards for Stewardship (STEWARDS) Panel ; for the Structured Taskforce of Experts Working at Reliable Standards for Stewardship (STEWARDS) Panel</creatorcontrib><description>Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. An expert panel rated 90 candidate metrics on a 9-point Likert scale for association with 4 criteria: improved antimicrobiol prescribing, improved patient care, utility in targeting stewardship efforts, and feasibility in hospitals with electronic health records. Experts further refined, added, or removed metrics during structured teleconferences and re-rated the retained metrics. Six metrics were rated >6 in all criteria: 2 measures of Clostridium difficile incidence, incidence of drug-resistant pathogens, days of therapy over admissions, days of therapy over patient days, and redundant therapy events. Fourteen metrics rated >6 in all criteria except feasibility were identified as targets for future development.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciw787</identifier><identifier>PMID: 27927866</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Anti-Infective Agents - therapeutic use ; Antimicrobial agents ; Clostridium difficile ; Communicable Diseases - drug therapy ; Communicable Diseases - epidemiology ; Delphi method ; Disinfection & disinfectants ; Drug Prescriptions - standards ; Drug Resistance, Bacterial ; Enterocolitis, Pseudomembranous - drug therapy ; Enterocolitis, Pseudomembranous - epidemiology ; HEALTHCARE EPIDEMIOLOGY ; Humans ; Incidence ; Inpatient care ; Intervention ; Invited ; Likert scale ; Patient Admission ; Patient Care - standards ; Patient Safety ; Program Evaluation - methods ; Treatment Outcome ; United States</subject><ispartof>Clinical infectious diseases, 2017-02, Vol.64 (3), p.377-383</ispartof><rights>Copyright © 2017 Oxford University Press on behalf of the Infectious Diseases Society of America</rights><rights>Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.</rights><rights>Copyright Oxford University Press, UK Feb 1, 2017</rights><rights>Published by Oxford University Press for the Infectious Diseases Society of America 2016. 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| fulltext | fulltext |
| identifier | ISSN: 1058-4838 |
| ispartof | Clinical infectious diseases, 2017-02, Vol.64 (3), p.377-383 |
| issn | 1058-4838 1537-6591 |
| language | eng |
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| source | Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Anti-Infective Agents - therapeutic use Antimicrobial agents Clostridium difficile Communicable Diseases - drug therapy Communicable Diseases - epidemiology Delphi method Disinfection & disinfectants Drug Prescriptions - standards Drug Resistance, Bacterial Enterocolitis, Pseudomembranous - drug therapy Enterocolitis, Pseudomembranous - epidemiology HEALTHCARE EPIDEMIOLOGY Humans Incidence Inpatient care Intervention Invited Likert scale Patient Admission Patient Care - standards Patient Safety Program Evaluation - methods Treatment Outcome United States |
| title | Expert Consensus on Metrics to Assess the Impact of Patient-Level Antimicrobial Stewardship Interventions in Acute-Care Settings |
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