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AHRQ’s new Toolkit To Improve Antibiotic Use in Long-Term Care offers a step-by-step approach to help facilities start or revitalize an antibiotic stewardship program. Using the Four Moments of Antibiotic Decision Making, facilities can identify critical time periods to help prescribers make decisions about antibiotic therapy. The toolkit includes various tools and resources, such as slide presentations with scripts, videos and more to train staff and antibiotic stewardship teams to ensure antibiotics are used judiciously to prevent harm and keep residents safe.

The Four Moments includes:

  • Moment One: Does my patient have an infection that requires an antibiotic?
  • Moment Two: Have I ordered appropriate cultures before starting antibiotics? What empiric therapy should I initiate?
  • Moment Three: A day or more has passed, can I stop antibiotics? Can I narrow therapy or change from IV to oral therapy? Those questions should be asked every day a patient is on an antibiotic.
  • Moment Four: What duration of antibiotic therapy is needed for my patient’s diagnosis?

The toolkit also supports antibiotic stewardship programs in complying with guidance from the Centers for Medicare & Medicaid Services and helps facilities address the Centers for Disease Control and Prevention’s Core Elements of Antibiotic Stewardship for Nursing Homes.

Medication errors, drug reactions, overdoses and allergic reactions are all types of Adverse Drug Events (ADEs). Fortunately, many ADEs are preventable, can impact positive health outcomes and decrease healthcare costs. Improving antibiotic use should be viewed as a patient safety issue. Clinicians involved in antibiotic prescribing should be encouraged to understand both the benefits and risks of antibiotic use and be engaged in reducing harm, which often requires a change in thinking and behavior. The Great Plains QIN  team works to support existing state-based and community-based efforts and coalitions in the Dakotas to improve care and offers guidance, expertise and resources to help streamline efforts, reduce duplication, connect leaders and improve the quality of care in our  communities, including medication safety. Visit the Quality Care Coalition page to learn more.