Impact of a Prospective Audit and Feedback Antimicrobial Stewardship Program at a Veterans Affairs Medical Center: A Six-Point Assessment

Prospective audit and feedback is a core antimicrobial stewardship program (ASP) strategy; however its impact is difficult to measure. Our quasi-experimental study measured the effect of an ASP on clinical outcomes, antimicrobial use, resistance, costs, patient safety (adverse drug events [ADE] and...

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Bibliographic Details
Published in:PloS one 2016-03, Vol.11 (3), p.e0150795-e0150795
Main Authors: Morrill, Haley J, Caffrey, Aisling R, Gaitanis, Melissa M, LaPlante, Kerry L
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Analysis
Anti-infective agents
Anti-Infective Agents - therapeutic use
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
Audits
Bacteria
Biology and Life Sciences
Clostridium difficile
Clostridium infections
Control
Costs
Disease control
Dosage and administration
Drug resistance
Drug stores
Drug therapy
Epidemiology
Feedback
Feedback (Communication)
Female
Guidebooks
Hazards
Health care costs
Health care facilities
Health surveillance
Hospital stays
Hospitals
Hospitals, Veterans
Humans
Infections
Infectious diseases
Influenza
Long term
Male
Management
Management Audit
Measurement methods
Medicine and Health Sciences
Microbial drug resistance
Middle Aged
Mortality
Patients
People and Places
Pharmacists
Prospective Studies
Public health
Regression analysis
Regression models
Studies
Time series
Urinary tract infections
Veterans
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Description
Summary:Prospective audit and feedback is a core antimicrobial stewardship program (ASP) strategy; however its impact is difficult to measure. Our quasi-experimental study measured the effect of an ASP on clinical outcomes, antimicrobial use, resistance, costs, patient safety (adverse drug events [ADE] and Clostridium difficile infection [CDI]), and process metrics pre- (9/10-10/11) and post-ASP (9/12-10/13) using propensity adjusted and matched Cox proportional-hazards regression models and interrupted time series (ITS) methods. Among our 2,696 patients, median length of stay was 1 day shorter post-ASP (5, interquartile range [IQR] 3-8 vs. 4, IQR 2-7 days, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0150795