Failure to Implement Antibiotic Stewardship Policy and Analyze Antibiotic Use
Penalty
Summary
The facility failed to implement its policy and procedure on antibiotic stewardship for one of six sampled residents reviewed for antibiotic use. Specifically, the Infection Control Preventionist (ICP) nurse did not accurately analyze collected data to identify the purpose and rationale for antibiotic use, nor did she confirm whether the clinical conditions met the criteria for appropriate antibiotic therapy. For the resident in question, who had chronic respiratory failure with hypoxia and was tracheostomy dependent, physician orders included two powerful intravenous antibiotics for indications such as UTI and a resistant bacterial infection. However, documentation and analysis using the McGeer Criteria were incomplete, with key fields left blank and no clear determination of whether infection criteria were met. During interviews and record reviews, it was revealed that the ICP nurse and the Director of Nursing (DON) could not locate documented evidence in the clinical records to support whether the antibiotics were used for a true infection. The facility's antimicrobial stewardship policy required monitoring, analysis, and presentation of antimicrobial use data, but this process was not followed. The ICP nurse acknowledged that she should have conducted a thorough analysis to confirm appropriate antibiotic use, but this was not done, and the facility's policy was not adhered to.