Stewardship: Practical Approaches And Applications

Unique challenges can occur when outbreaks take place in long-term care settings. This podcast will address those challenges and how to manage and prevent outbreaks in this specialized setting. Speakers: - Ellie J. Goldstein, MD - Ravina Kullar, PharmD, MPH, FIDSA - Cindy Prins, PhD, MPH, CIC, CPH (moderator)

Transmission and management of MDROs in the long-term care setting may occur quite differently than in acute care or other healthcare settings. This podcast will cover the best practices for reducing transmission of MDRO in LTC. Speakers: - Teena Chopra, MD, MPH - Cindy Prins, PhD, MPH, CIC, CPH

According to IDSA Guidelines (2019), the prevalence of asymptomatic bacteriuria (ASB) in residents of long-term care facilities ranges from 15% to 50%. But screening for and treating ASB these residents is not recommended. This podcast will review the evidence and rationale for those recommendations. Speakers: - Manisha Juthani, MD - Christopher Crnich, MD, PhD - Cindy Prins, PhD, MPH, CIC, CPH (moderator)

Learning Objectives: - Identify the role of the Hospital Epidemiologist in both preventing and responding to outbreaks in the healthcare setting - Discuss ways patients and the public can help prevent the spread of infection in the hospital - Discuss key resources for infection prevention programs to be able to both identify and respond to outbreaks in healthcare settings Resources: https://www.richmond.com/opinion/their-opinion/gonzalo-bearman-and-richard-p-wenzel-column-new-threats-to/article_43e4bf40-62f0-570b-82f9-6f84832fdad9.html

Speakers: - Trevor Van Schooneveld, MD - Nicholas Moore, PhD, MLS(ASCP)CM - Moderator: Krystina Woods, MD Summary: With the recent availability of BioFire FilmArray Assay, there is now the ability to detect 22 gastrointestinal pathogens from a single patient sample and obtain results within an hour. However, there have been multiple recent publications that have argued it has limited utility at 72 hrs after admission and upon repeat testing. Additionally, there are questions regarding what to do with unexpected results. This has led to some institutions limiting the availability of the assay, and others providing extensive education to clinicians in the hope that it will curb ordering of the assay. This podcast will focus on the utility of the assay, its strengths and weaknesses and whether or not clinicians should have unlimited access to ordering it.

Speakers: - Tom File, MD, MSc, MACP, FIDSA, FCCP - Shira Doron, MD, FIDSA - Moderator: Whitney Buckel, PharmD Summary: Procalcitonin has been shown in numerous trials to reduce unnecessary antibiotic use associated with sepsis and respiratory infections and is a diagnostic tool that antibiotic stewardship programs can use to improve antibiotic use. This episode discussed the role of procalcitonin in antibiotic stewardship programs and examples of intervention to improve the use of procalcitonin.

Speakers: - Barbara Trautner, MD, PhD - Mohamad Fakih, MD, MPH - Moderator: Krystina Woods, MD Summary: Availability of urine cultures has led to a culture of culturing. As a result, over-treatment of asymptomatic bacteriuria has become common. Additionally, especially in catheterized patients, this may be leading to an increase of labeling of “catheter associated urinary tract infections.” This episode will focus on strategies to better target patients for urine cultures, when appropriate.

Speakers: - Michael Calderwood, MD, MPH - Curtis Donskey, MD - Moderator: Whitney Buckel, PharmD Summary: Under-diagnosis of Clostridioides difficile infection leads to worse patient outcomes and increased transmission. However, with sensitive nucleic acid amplification tests, over-diagnosis of C. diff has become more common. Specifically, overdiagnosis of asymptomatic C. diff colonization could lead to increased costs, over-reporting of hospital-acquired infection rates, and further disruption of patients’ microbiomes if treated. This podcast will focus on finding the sweet spot for C. diff testing.

Speakers: - Louise Dembry, MD, MS, MBA - Christopher Beebe, RPh, MBA - Lisa Waldowski, DNP, APRN, CIC - David Pegues, MD Summary: This podcast will discuss how Infection Control is required and expected to provide oversight of major areas of hospital, including Pharmacy, OR, Sterilization, HLD, Material Management, and Environmental Services. Learning Objectives: - What is oversight responsibility - Pharmacy 797 / 800 standards - OR, Sterilization and HLD oversight - Role in Materials management - Environmental services oversight

Speakers: Dr. Doug Salvador, MD, MPH and Dr. Waleed Javaid, MD Summary: This podcast will discuss how to run the infection control program, evaluate resources and lead. Learning Objectives: - The ask to lead - How to build the IC program - Know the team, Know the importance of the program - The role of hospital leadership

Speakers: Dr. Arjun Srinivasan, MD and Dr. Sarah Haessler, MD, MS Summary: Exploring NHSN, Definitions, HAI, CMS and regulatory agencies Learning Objectives:     - Understand NHSN program - Understand HAI program - Understand the HAI definitions  - Understand how to communicate the definitions and difference - How to use the data to evaluate and improve the program

"Outbreak Communications," produced by the Society for Healthcare Epidemiology of America (SHEA), discusses lessons learned in communicating with healthcare personnel, patients, and others during recent infectious diseases outbreaks. Moderator: Judith Guzman-Cottrill,DO, Professor of Pediatrics at Oregon Health & Science University and consultant for the Oregon Health Authority’s HAI Program, where she serves as the Medical Director for Ebola and Emerging Pathogen Preparedness. Speaker: Zachary Rubin, MD, Specialist in Infectious Diseases and Medical Director of Clinical Epidemiology and Infection Prevention at the University of California, Los Angeles. Before coming to UCLA in 2006, he was a guest researcher at the CDC in the Division of Healthcare Quality Promotion for the last 2 years of his ID fellowship at Emory.

"HICS: The Insider's Perspective," produced by the Society for Healthcare Epidemiology of America (SHEA), discusses the Hospital Incident Command System - what HICS is, who's involved, when to activate, and why it's important. Moderator: Judith Guzman-Cottrill,DO, Professor of Pediatrics at Oregon Health & Science University and consultant for the Oregon Health Authority’s HAI Program, where she serves as the Medical Director for Ebola and Emerging Pathogen Preparedness. Panelists: Kristina Spurgeon, MPH, Emergency Manager at UC Davis Health, with experience including a decade at Kaiser Permanente specializing in emergency management. Pritish Tosh, MD, infectious diseases physician and the medical director for Emergency Management at Mayo Clinic in Rochester, MN. His prior training includes the Epidemic Intelligence Service at the Centers for Disease Control and Prevention (CDC) and as a fellow with the Center for Infectious Diseases Research and Policy (CIDRAP) at the University of Minnesota.

The last podcast in the series "Stewardship: Practical Approaches and Applications", produced by the Society for Healthcare Epidemiology of America (SHEA). This episode focuses on how to impact antibiotic prescribing practices using Antimicrobial Stewardship Interventions targeting providers and patients in the outpatient setting. Panelists: Debra Palazzi, MD, MEd, Associate Professor of Pediatrics in the Infectious Diseases Section at Baylor College of Medicine, and the Medical Director of the Antimicrobial Stewardship Program at Texas Children’s Hospital; and Ellen Wald, MD, Professor and Chair of the Department of Pediatrics at the University of Wisconsin School of Medicine and Public Health and an internationally recognized expert on the diagnosis and treatment of pediatric infectious diseases.

The third podcast of the series “Stewardship: Practical Approaches and Applications”, produced by the Society for Healthcare Epidemiology of America (SHEA). This episode focuses on the leading cause of antibiotic use with UTI over diagnosis in the Adult and Pediatric populations.

The second podcast of the series "Stewardship: Practical Approaches and Applications", produced by the Society for Healthcare Epidemiology of America (SHEA). This episode focuses on integrating technological and sociobehavioral approaches to diagnostic stewardship, with a specific focus on improving blood culture ordering practices.

The first podcast of the series "Stewardship: Practical Approaches and Applications", produced by the Society for Healthcare Epidemiology of America (SHEA). This episode focuses on demonstrating how to impact the rates of Clostridium Difficile infections using antimicrobial stewardship interventions targeting providers in various practice settings. Panelists: Libby S Dodds-Ashley, PharmD, MHS with the Duke Antimicrobial Stewardship Outreach Network, and Dr. Larissa May, MD, MSHS, MSPH, an Associate Professor and Director of Emergency Department Antibiotic Stewardship at UC Davis Health System.