P-858. Antibiotic Stewardship Needs Assessment in Long-term Care Facilities in Florida

TL;DR

This study assesses antibiotic stewardship programs in Florida's long-term care facilities, finding that skilled nursing facilities are more likely to have such programs than assisted living facilities.

Contribution

The study provides a needs assessment of antibiotic stewardship implementation in Florida's long-term care facilities.

Findings

Skilled nursing facilities were significantly more likely to have an antibiotic stewardship plan than assisted living facilities.

Most facilities used Antibiotic Days of Therapy to track antibiotic use.

Infection preventionists rated antibiotic stewardship training as more important than other staff roles.

Abstract

The Centers for Disease Control and Prevention’s Core Elements of Antibiotic Stewardship for Nursing Homes is a guide for antibiotic stewardship (ABS) efforts in long-term care facilities and recommends that the core elements be implemented in a stepwise fashion. To understand the depth of ABS programs in long-term care facilities in Florida, an infection prevention and control needs assessment which included questions about the core elements that have been implemented was conducted.

The needs assessment was conducted through an online survey from December 6, 2022, through February 9, 2023. Of 302 total respondents, 73 responded to questions about antibiotic stewardship: 80.8% were from skilled nursing facilities/nursing homes (SNF/NH), 15.1% were from assisted living facilities (ALF), and 4% were from continuing care retirement communities or other facilities. Descriptive statistics and bivariate analysis using Fisher’s exact test or chi-square test to compare SNF/NH with ALF were conducted.

SNF/NH were significantly more likely to have an ABS plan than ALF (p< 0.001). While inclusion of core elements varied, those included most by SNF/NH were “Facility has a written statement of support for antibiotic stewardship” (96.6%) and “Facility has an individual who is responsible for stewardship efforts who has training in antibiotic stewardship” (96.6%). Those included least by SNF/NH were “Facility provides education to families on antibiotic use” (73.2%), and “Facility reports antimicrobial stewardship outcome data to staff and providers” (81.0%). The most-used method of tracking antibiotic use was Antibiotic Days of Therapy (75% of responding ALF and 85.5% of responding SNF/NH). Infections preventionists (95.7%) were more likely to rate ABS training as important for themselves than administrators (71.4%) or Assistant/Directors of Nursing (77.8%) were (p=0.055).

All responding SNF/NH in the state had ABS programs that incorporated several of the core elements but few ALF reported having an ABS plan. While facility-specific antibiotic use may not be as high in an ALF as in a SNF/NH, there are over 106,000 ALF beds in the state so implementation of AMS best practices in those facilities may have a positive influence on antibiotic use.

Cindy Prins, PhD, MPH, Becton, Dickinson and Company: Advisor/Consultant Venugopalan Veena, PharmD, Merck: Grant/Research Support