Antibiotic Prescribing in 4 Assisted-Living Communities: Incidence and Potential for Improvement

摘要: Objective. To describe the prevalence, characteristics, and appropriateness of systemic antibiotic use in assisted living (AL) to conduct a preliminary quality improvement intervention trial reduce inappropriate prescribing. Design. Pre-post study, with 13-month period. Setting. Four AL communities. Participants. All prescribers, all staff who communicate patients had an infection during baseline periods. Intervention. A standardized form for staff, online education course 5 practice briefs monthly meetings staff. Measurements. Monthly inventory prescriptions; interviews prescriber, member, closest family patient (when capable) regarding 85 prescribing episodes (30 baseline, 55 intervention), data review by expert panel determine appropriateness. Results. The mean number prescriptions was 3.44 per 1,000 resident-days at 3.37 intervention, nonsignificant change (P = .30). Few prescribers participated training. gradually increased program. proportion rated as probably 26% 15% trend .25). Drug selection largely appropriate both time Conclusions. rates appear be approximately one-half those seen nursing homes, up quarter being potentially inappropriate. Interventions improve must reach physicians most likely will require long periods have optimal effect.