Good morning, ProviderNation. The fine folks at CDC are drafting providers into the war against superbugs. This morning, CDC issued a 21-page “Core Elements of Antibiotic Stewardship for Nursing Homes” report. It urges long term care professionals to:
- “Write statements in support of improving antibiotic use” for staff, residents, and families;
- “Include stewardship-related duties in position descriptions for the medical director, clinical nurse leads, and consultant pharmacists in the facility;”
- “Communicate with nursing staff and prescribing clinicians the facility’s expectations about use of antibiotics and the monitoring and enforcement of stewardship policies;” and to
- “Create a culture, through messaging, education, and celebrating improvement, which promotes antibiotic stewardship.”
Harder Than You Think
There’s a lot more along these lines, including a lot of rhetoric about “empowering” staff to set standards and to get outside of the centers to make sure everyone knows exactly what those standards are.
In some ways, the CDC is pushing on an open door: No one argues, at least in principle, against careful stewardship of antibiotics. But, as AHCA/NCAL board Chair Len Russ told us back in June (when he was invited to the White House to help address the issue), the issue is harder than you think.
For instance, Russ said, a huge role is reserved for veterinarians. “Because the food chain begins with livestock, and the use of antibiotics in the grain and the feed that we use for poultry and livestock already presents compromises … we’re already being over-exposed.”
None of the forgoing should minimize the role of providers in the new front against superbugs. Just last week, the fine folks at JAMDA raised the tough questions about why some doctors were pumping their advanced dementia patients full of antibiotics. And a Source Close to the Investigation tells me that next month’s cover of a certain glossy magazine deals extensively with antibiotic stewardship in long term and post-acute care centers.
The thing is, this is no time to sit on the fence. As CDC says, “Commit now to ensure antibiotic stewardship policies and practices are in place to protect patients and improve clinical care in nursing homes.”