Roberts Health Center is nestled in the picturesque town of Wickford, North Kingstown amid the ocean breezes of the Atlantic. In this tranquil setting, the 66-bed facility offers both short term and long-term care to residents who meet skilled or intermediate level of care criteria.
The family operated health center was built in 1982. Their mission is to provide the very best in individual rehabilitation care and nursing.
As part of their commitment to continually try to achieve the highest standards, the staff at Roberts Health Center continuously monitor and evaluate their procedures to identify and close gaps. Over the past year, they identified an inconsistency in their antibiotic stewardship program. A quality improvement team was assembled, led by the Assistant Director of Nurses with consultation of staff nurses, physician, pharmacy, laboratory, and radiology staff.
Once the team was assembled they partnered with New England QIN-QIO and took a recommended Infection Control course that was offered through the American Healthcare Association (AHCA). The team also invested in an antibiotic stewardship program through their pharmacy- Pharmerica. Baseline data was collected, a tracking mechanism was installed, and an education program was rolled out to staff.
The measurements the team collected consisted of the number of infections per 1,000 resident days at the facility, as well as by unit. The team calculated how many units met the McGeer Criteria and compliance with 48-hour antibiotic time-outs. The team also tracked the number of antibiotics distributed along with days of therapy, which was broken down by month. In addition to the data collected, it was identified that other infection control data would be useful such as the number of urinalysis/culture and sensitivity test ordered by unit and which physician placed the order. The data was then calculated and placed in a graph to share with staff and monitor trends. The trends have gone down since the implementation.
To date, the program continues to be successful. As a result of the team’s efforts, the nursing home has been able to prevent unnecessary antibiotic prescriptions. They also have discontinued unnecessary prescriptions through their antibiotic stewardship efforts, most specifically the 48-hour antibiotic time out.
As a sustainability method, all new staff nurses receive education during orientation and stress the importance of antibiotic stewardship and the programs that were implemented as a result of this project. The Infection Prevention Compliance Officer audits regularly and shares the results with the nursing staff.
As a result of the project, the Roberts Health Center team learned about the importance of antibiotic stewardship for individuals, and how to improve the quality of care and quality of life utilizing the best practices available in an ethical manner.