Q: Can you tell me what is involved in an antibiotic time-out?
A: Antibiotic time-outs provide an active assessment of an antibiotic prescribed that occurs 48 to 72 hours after the resident’s first dose. The assessment considers any lab results, culture and sensitivity results, the resident’s response to the antibiotic treatment therapy, the resident’s condition and the facility needs (for example an outbreak).
The point of this time-out is to ensure antibiotics are used only when meeting criteria and given for the least amount of time indicated. Most electronic health records can be set up to alert the facility when a time-out is due. This can include:
• Providing an automatic alert at 48 or 72 hours after initial antibiotic administration.
• Generating a list of all residents in need of an antibiotic time-out on any given day.
• Documenting completion assessments and the next action to be taken, such as continuing or discontinuing the antibiotic.
The CDC estimates 25% to 75% of antibiotic prescribing in nursing homes is inappropriate, and approximately half of nursing home residents are affected by a multiple drug-resistant organism. The CDC attributes resistance to historic misuse of antibiotics.
It’s more important than ever to prescribe an antibiotic only if the criteria for infection is substantiated, and then for the least amount of time possible.
Often, families insist on the use of an antibiotic. The CDC has a “Communications Strategy” document that can help defuse this.
Sometimes it is the medical director who is the one inappropriately prescribing. In those cases, request a meeting to discuss misuse and the risks involved.
Misuse or overuse of antibiotics is a frightening statistic. It is our responsibility to assure the care we provide meets the current standards of practice, which includes antibiotic stewardship.
Nancy Tuders, FACDONA, AS-BC, IP-BC, QAPI-BC, is the assistant director for education at NADONA.
Send her your resident care-related questions at [email protected].
From the July/August 2024 Issue of McKnight's Long-Term Care News
