Failure to Monitor and Document Antibiotic Stewardship
Penalty
Summary
The facility failed to ensure staff adhered to the principles of antibiotic stewardship by not monitoring the appropriate use of antibiotics prescribed to residents, which is necessary to prevent antibiotic resistance and the spread of multidrug resistant organisms. The facility, with a census of 20 residents and a sample of 13, was unable to provide antibiotic and infection surveillance logs upon request. During an interview, the Infection Preventionist stated there were no electronic or paper records documenting the collection and analysis of data to track or monitor antibiotics ordered and laboratory reports received. Instead, the Infection Preventionist relied on daily review of the Electronic Medical Record for new antibiotic orders and provided only verbal reports of infections and antibiotic use at Quality Assurance meetings. The facility's policy required the Infection Preventionist to monitor every antibiotic ordered, complete antibiotic time-outs, summarize antibiotic use and resistance, and track outcome measures, but these actions were not documented or evidenced.