Antimicrobial Stewardship: What Are You Waiting For?
Has your medical center developed an antimicrobial stewardship program (ASP)? If not, they soon will. Effective January 1, 2017, the Joint Commission will be implementing Medication Management Standard MM.09.01.01, which requires that all hospitals have an ASP.1 This does not mean now is the time to panic. Rather it is time to put strategies, training, and a workforce into place to ensure our medical centers are able to meet this new standard and, quite frankly, improve the outcomes of our patients receiving antimicrobial therapy while simultaneously attempting to reduce the proliferation of antimicrobial-resistant pathogens and infection due to Clostridium difficile.
The best part of this is that pharmacists play a key role on the antimicrobial stewardship team. In fact, the two primary players on the ASP team are an infectious diseases (ID) physician and an ID pharmacist. That said, one of the first questions that pharmacists tasked with this responsibility often ask is: How can I be effective in this new role if I am not an ID pharmacist and am not going back to do a PGY2 or fellowship in ID? The fact of the matter is that there will never be enough programs in the United States to meet the needs of training an ID pharmacist for every hospital implementing an ASP. Given this, two exceptional programs have been developed to allow pharmacist to obtain certification in antimicrobial stewardship. The first developed by The Society of Infectious Diseases Pharmacists is an intensive program involving self-study, webinars, and a skills component. This program is available at proce.com under their certificate programs. The second certification program was developed by Making a Difference in Infectious Disease (MAD-ID), which includes both a basic program and an advanced program depending on the practitioner’s experience. It is available online at mad-id.org. Regardless of the route taken towards achieving certification in antimicrobial stewardship, both programs offer an exceptional learning experience that will more than prepare pharmacists to assist in the development and operationalization of an ASP.
It is also important to know that hospitals do not need to reinvent the wheel. There is a substantial amount of resources available to medical centers to assist in the development of programs. These include: the American Society of Health-Systems Pharmacists (ASHP), the Centers for Disease Control (CDC), the Infectious Diseases Society of America (IDSA), and the Society for Healthcare Epidemiology of America (SHEA). The IDSA and SHEA also just recently released recommendations for implementing an ASP in inpatient populations, including long-term care, which I will review in an upcoming blog.2
So, what are you waiting for? Now is the time to dive in and start preparing for this important new Joint Commission Medication Management Standard. I would love to hear from medical centers that do not have an ID trained pharmacist on staff about how they are developing their ASP.
In health and pharmacy,
Randolph V. Fugit, PharmD, BCPS
Randolph V. Fugit, PharmD, BCPS, is an internal medicine/infectious diseases clinical specialist, Denver VA Medical Center in Colorado. He is also an associate professor of clinical pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado in Aurora.
References:
1. The Joint Commission. Prepublication Standards – New Antimicrobial Stewardship Standard. www.jointcommission.org. June 22, 2016.
2. Barlam TF, Cosgrove SE, Abbo LM, at al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016;62(10):e51-e77.
_________________________________________________________________________________________
Pharmacy Learning Network is coming to Dr. Fugit’s hometown of Denver on September 23rd! This 1-day regional meeting will provide practicing pharmacists with 6.5 live contact hours on critical topics such as Preventing Medication Errors and Protecting Yourself from Hazardous Drugs. This meeting is presented in partnership with the Colorado Pharmacists Society (CPS). Don’t miss out on your chance to discuss pharmacy practice in person with Dr. Fugit and our Advisory Board—register for these valuable educational opportunities now to get the lowest rate available! Rates increase August 9th.
