The Centers for Medicare & Medicaid (CMS) implemented the “Mega-Rule” a few years ago which mandated all nursing facilities that received funding from CMS to adopt and maintain an antibiotic stewardship program to monitor antibiotic use and reserve antibiotic therapy for patients that fit the required criteria. Post-acute and long-term care (PALTC) facilities have struggled to maintain compliance with the “Mega-Rule” for a number of reasons. This study was comprised of a survey of healthcare professionals with expertise in PALTC and antimicrobial stewardship (AMS) including infection prevention and control officers (IPCO), pharmacists, nurse practitioners, medical directors and directors of nursing. The survey was comprised of 32 questions which the respondents voluntarily and anonymously answered. The survey revealed that some of the barriers PALTC facilities face when implementing antibiotic stewardship programs were lack of education and training, lack of infection control consults and underdeveloped measures for collecting data about antibiotic use. Antibiotic stewardship is an important aspect of providing nursing care in PALTC facilities due to the emergence of antibiotic resistant bacterial infections that can be deadly to the vulnerable older adult population. Nurses are often on the front-lines of combating the over-use of antibiotics and should have support of the interdisciplinary team in order to protect older adult patients and maintaining compliance with the CMS’s “Mega-Rule”. fishboneMcDarisAntibioticOveruse Journal Club Critique Form McDaris

References

Fornaro, R., Heil, E., Claeys, K., Sheikh, F., Naqvi, F., Chou, J., . . . Brandt, N. (2020). Identifying and Bridging the Gaps in Antimicrobial Stewardship in Post-Acute and Long-Term Care. Journal of Gerontological Nursing, 46(1), 8-13. doi:10.3928/00989134-20191211-01