Failure to Implement Antibiotic Stewardship Program per McGeer Criteria
Penalty
Summary
The facility failed to properly implement its antibiotic stewardship program, resulting in the inappropriate use of antibiotics for two out of three residents reviewed for antibiotic use. For one resident with dementia, hypertension, and anxiety, a urine culture showed 10-15,000 CFU/ml of two organisms, but antibiotics were administered despite not meeting the McGeer criteria, which require at least 100,000 CFU/ml. The Assistant Director of Nursing (ADON) confirmed that the criteria were not met and incorrectly believed that the presence of two organisms justified treatment. Another resident with chronic respiratory failure, type II diabetes, and morbid obesity received antibiotics on two occasions for urine cultures that also did not meet the McGeer criteria, as both cultures showed less than 100,000 CFU/ml. The ADON acknowledged that antibiotics were given despite the cultures not meeting the required threshold. Review of facility documentation and policy revealed that while a checklist referencing the McGeer criteria was in use, the facility's antibiotic stewardship policy lacked guidance on implementing these criteria for monitoring antibiotic use.