Failure to Monitor Antibiotic Use per Stewardship Program
Penalty
Summary
The facility failed to implement proper monitoring of antibiotic use as required by its Antibiotic Stewardship Program. Specifically, the Infection Preventionist (V3) stated that an infection screening evaluation assessment should be completed when a resident begins antibiotic medication. However, for one resident who was prescribed Doxycycline for a wound infection, the required assessment was not completed at the start of antibiotic therapy. The assessment, which should have been done on the day the antibiotic was ordered, was instead completed eight days later. V3 indicated that when she is not present in the facility, these assessments are not completed on time, as she is the only staff member responsible for them. The Director of Nursing (V2) confirmed that the expectation is for residents to be screened at the start of antibiotics and that the infection screening evaluation should be completed even in the absence of the Infection Preventionist. Facility policy requires that all clinical infections treated with antibiotics undergo review by the Infection Preventionist or designee, and that antibiotic usage and outcome data be collected and documented. In this case, the facility did not follow its own policy, resulting in a lapse in monitoring antibiotic use for a resident with a local skin and subcutaneous tissue infection.