Evaluating and prioritizing antimicrobial stewardship programs for nursing homes: A modified Delphi panel.

摘要: Background Antibiotic use in nursing homes is often inappropriate, terms of overuse and misuse, it can be linked to adverse events antimicrobial resistance. Antimicrobial stewardship programs (ASPs) optimize antibiotic by minimizing unnecessary prescriptions, treatment cost, the overall spread Nursing home providers residents are candidates for ASP implementation, yet guidelines implementation limited. Objective To support with selection adoption interventions. Design setting A multiphase modified Delphi method assess 15 interventions across criteria addressing scientific merit, feasibility, impact, accountability, importance. This study included surveys supplemented a 1-day consensus meeting. Participants 16-member multidisciplinary panel experts resident representatives. Results From highest lowest, 6 were prioritized panel: (1) empiric prescribing, (2) audit feedback, (3) communication tools, (4) short-course therapy, (5) scheduled reassessment, (6) clinical decision systems. Several not endorsed: antibiograms, educational interventions, formulary review, automatic substitution. lack resources was noted, which could impede multifaceted Conclusions should consider key ASPs. Such may feasible settings impactful improving use; however, merit supporting each variable. approach necessary long-term improvement but difficult implement.