CDC Issues Urgent Recommendation for Nursing Homes: Improve Antibiotic Use Immediately

By on 6:12 PM

As the Affordable Care Act (ACA) continues to promote patient safety, including preventing healthcare-associated infections and reducing multidrug resistant organism acquisition, governing agencies continue to provide guidance and recommendations across the continuum of care. Acute care, outpatient surgery and, most recently, the nursing home industry are mandated and/or advised about patient practices that drive change for the benefit of the patient and facility.

The Centers for Disease Control and Prevention (CDC) have released new recommendations this week for nursing homes, advising facilities to "improve antibiotic prescribing practices and reduce their inappropriate use to protect residents from the consequences of antibiotic-resistant infections, such as C. difficile." The CDC applied core elements recommended last year for an antibiotic stewardship program in acute care facilities. Nursing homes are "urged to implement at least one core element immediately."

The nursing home resource details steps and processes for facilities to follow and emphasizes the need for nursing homes to begin small and expand. In summary, the core elements suggested by CDC at a minimum and highlighted in the media release include:
  1. Leadership commitment: Demonstrate support and commitment to safe and appropriate antibiotic use.
  2. Accountability: Identify leaders who are responsible for promoting and overseeing antibiotic stewardship activities at the nursing home.
  3. Drug expertise: Establish access to experts with experience or training in improving antibiotic use.
  4. Action: Take at least one new action to improve the way antibiotics are used in the facility.
  5. Tracking: Measure how antibiotics are used and the complications (e.g., C. difficile infections) from antibiotics in the facility.
  6. Reporting: Share information with healthcare providers and staff about how antibiotics are used in the facility.
  7. Education: Provide resources to healthcare providers, nursing staff, residents and families to learn about antibiotic resistance and opportunities for improving antibiotic use.
A stepwise approach is important, especially for those nursing homes that have never entertained an antibiotic usage program in the past.

Phenelle Segal of Infection Control Consulting Services (ICCS) plays a large role in antimicrobial stewardship programs, including a recent contract with the Health Care Improvement Foundation in Philadelphia. She assisted the Foundation with developing clinical outcome and process measures for an antimicrobial stewardship collaborative which included nursing homes. If you require assistance with developing an antibiotic stewardship program and would like a complimentary initial phone call to discuss your needs, contact ICCS at by filling out the form here, emailing info@iccs-home.com or calling (215) 692-3485.

Phenelle Segal, RN, CIC, FAPIC

Phenelle Segal, RN, CIC, FAPIC, is the founder and president of Infection Control Consulting Services LLC (ICCS). Phenelle has more than 30 years' experience providing customized comprehensive infection control and prevention services to healthcare facilities nationwide. Her services focus on assisting hospitals, ambulatory surgery centers, dental office and oral surgery practices, doctor's offices, nursing homes and other organizations with implementing and maintaining an infection control program that: complies with The Joint Commission, AAAHC, Centers for Medicaid and Medicare Services (CMS) and other regulatory agencies; respond to situations of noncompliance; and improve the processes for reducing risk.