Antibiotic stewardship for nurses: Using e-learning modules to bridge the education gap.

Objective: The Centers for Disease Control and Prevention has called for an interdisciplinary approach to antibiotic stewardship implementation that includes front-line nurses. The literature to date has identified key factors preventing uptake by nurses: lack of education, poor communication among providers, and unit culture. Three e-learning modules were developed to address the nurses' education regarding the roles nurses play in antibiotic stewardship, antibiotic resistance, allergy assessment, medication side effects and interactions, pharmacokinetics-pharmacodynamics, culture interpretation, specimen collection, and the antibiogram.

Two-State Collaborative Study of a Multifaceted Intervention to Decrease Ventilator-Associated Events.

Objectives: Ventilator-associated events are associated with increased mortality, prolonged mechanical ventilation, and longer ICU stay. Given strong national interest in improving ventilated patient care, the National Institute of Health and Agency for Healthcare Research and Quality funded a two-state collaborative to reduce ventilator-associated events. We describe the collaborative's impact on ventilator-associated event rates in 56 ICUs.

Measurement of implementation components and contextual factors in a two-state healthcare quality initiative to reduce ventilator-associated pneumonia.

Objective: To develop and field test an implementation assessment tool for assessing progress of hospital units in implementing improvements for the prevention of ventilator-associated pneumonia (VAP) in a two-state collaborative, including data on actions implemented by participating teams and contextual factors that may influence their efforts. Using the data collected, learn how implementation actions can be improved and analyze effects of implementation progress on outcome measures.

Design: We developed the tool as an interview protocol that included quantitative and qualitative items addressing actions on the Comprehensive Unit-based Safety Program (CUSP) and clinical interventions for use in guiding data collection via telephone interviews.

Real-time polymerase chain reaction testing for Clostridium difficile reduces isolation time and improves patient management in a small community hospital.

Background: The impact of a switch from a toxin A/B enzyme immunoassay (EIA) to a polymerase chain reaction (PCR) method for detection of toxigenic Clostridium difficile was assessed for C difficile infection (CDI) rates, patient isolation-days, and CDI-related treatment.

Methods: A 6-month retrospective study was done on symptomatic patients tested by the toxin A/B EIA and PCR assays. Data on the number of C difficile tests ordered, patient isolation-days, and treatment with metronidazole or vancomycin were collected.