Prevalence of Antimicrobial Use and Opportunities to Improve Prescribing Practices in U.S. Nursing Homes.
Nicola D Thompson, Lisa LaPlace, Lauren Epstein and 10 others
PMID 27751803WHAT IT FOUND
Antimicrobials were used by 11.1% of nursing home residents on survey days, and use was highest among short-stay residents and residents with devices.
Only 62% of antimicrobials had all five prescribing details documented.
Key findings
01Antimicrobial use was 11.1% overall, with highest prevalence among short-stay residents (21.2%) and residents with devices (23.5%).
0262% of antimicrobials had all five prescribing elements documented, with per-nursing-home variation from 50% to 84%.
03The urinary tract was the most common documented treatment site (32%, 52 antimicrobials), followed by skin (29%, 19) and respiratory tract (26%, 42).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The survey was a convenience sample of nine nursing homes that were voluntary, had at least 120 beds, and were surveyed on one day. Only residents who had been in the facility for more than 24 hours before the survey date were included. Findings were based on chart abstraction and facility records, so unclear or missing documentation was counted as not documented. The study described prescribing at one time and did not test whether an intervention reduced antimicrobial use. Oseltamivir use was influenced by confirmed influenza in one nursing home, so it may not reflect routine practice in all facilities.
Declared interests
All authors reported no relevant financial support and no conflicts of interest.
The easy way to misread this
Do not read these results as evidence that a stewardship intervention reduced antimicrobial use. The surveys describe prescribing at a single time in a convenience sample, and the study did not test an improvement strategy.