Platinum Level Hospital Honor Roll Awardees:
Action: Mercy Hospital has updated UTI Treatment Guidelines document based on current recommendations for treating UTI. Also implemented a UTI/ASB "stop light" document in ER and an SBAR document to guide ordering UAs for suspected UTIs. This helps the nurse sort out the clinical situation before requesting a UA.
Collaboration: This hospital is partnering with a local clinic to share its antibiogram to improve empiric therapy. They are sharing antibiotic data for appropriate dosing, choice of antibiotics, and days of therapy for pneumonia and UTIs. They have also shared the antibiogram with local long-term care facilities.
Action: Essentia Hospital Fargo created a skin and soft tissue antibiotic guide that considers formulary agents and matches the sepsis order set for initial therapies, step-down antimicrobials, and durations. They are also working on creating a splenectomy vaccine workflow to improve the inpatient process and transition to post-discharge follow-up.
Collaboration: This facility is partnering with community pharmacies and outside facilities to improve transitions of care from the emergency department. They are working on providing microbiology updates and communication to facilities on treatment plans.
Action: Sanford Health Fargo created a guide for antimicrobial dosing in adults and pediatrics with obesity. These guides apply to adult patients with BMI >30 kg/m2 and pediatric patients with BMI >95th percentile. The recommendations reflect the current literature, focusing on avoiding under-dosing in patients with severe infections, critical illness, or high MICs.
Collaboration: Partnering with another hospital’s laboratory department to update cascading rules for culture results to improve use of broad-spectrum antibiotics and increase use of first line agents.
Gold Level Hospital Honor Roll Awardees:
Action: Jamestown Regional Medical Center created order sets that use evidence-based guidelines for treating sepsis, CAP, skin and soft tissue infections. The facility also started reporting to NHSN and are pulling data reports to guide stewardship actions which includes criteria for appropriate vancomycin use.
Collaboration: Partner with area clinics and long-term care centers to share antibiogram information and infectious disease resource materials.
Action: Altru Hospital implemented required entry of duration of therapy by ordering provider for all antimicrobial orders starting in July of 2024 and required indication for all outpatient antimicrobial orders as well.
Collaboration: This facility is working with 15 critical access hospitals who share software with Altru on implementing duration of therapy and outpatient indications on antibiotics.
Silver Level Hospital Honor Roll Awardees:
CHI St. Alexius Devils Lake has implemented order sets that guide antibiotic selection to less broad-spectrum antibiotics for different disease states.
Northwood Deaconess Health Center has been focusing on UTI’s this year, implementing a 48-hour time out, tracking antibiotic use and sharing weekly with interdisciplinary team, and partnered with the local clinic to create a local antibiogram.
Pembina County Memorial Hospital did a retrospective audit on antibiotic use for all outpatient respiratory illnesses, then discussed results and provided education to providers on appropriate antibiotic use in these illnesses. They also created flu care kits to provide symptom relief and prevent antibiotics from being prescribed for a viral illness.
West River Health Services developed a standing order set for sepsis to improve the care of patients. They are also working on improving prescribing of antibiotics and their duration for patients with UTIs.