CE Questions - Antimicrobial Stewardship Integration in Electronic Medical Records 1. Which of the following describes the role of information technology in stewardship programs? B, Decrease documentation processes C. Impede tracking and reporting D. Increase time to interventions The role of information technology in antimicrobial stewardship programs includes improvements in efficacy of interventions, tracking and reporting facilitation, and improvements in documentation Processes. 2. What of the following is a benefit of clinical decision support systems (CDSS)? A. Increases use of broad-spectrum antibiotics C. Increases duration of therapy D. Increases resistance ‘The impact of CDSS includes reduction in the use of broad-spectrum antibiotics, decreased resistance, appropriate selection of antibiotics, increased interventions, less adverse effects, reduced duration of therapy, reduced cost 3. The CDC Core Elements include? B. Accountability, Teamwork, and Education C. Education, Leadership Commitment, and Nursing Expertise D. Education, Surgical Committee Involvement, and Pharmacy Expertise ‘The CDC core elements are Hospital Leadership Commitment, Accountability, Pharmacy Expertise, ‘Action, Tracking, Reporting, Education 4, Which action reviews antibiotic therapy with suggestions to optimize use? A. Preauthorization 8, Antibiotic timeouts D. Hospital leadership commitment Prospective audit and feedback reviews antibiotic therapy with suggestions to optimize use 5. SCisa 62 y.0.f that presents to the ED with altered mental status and burning sensation during urination. She is started on ceftriaxone 1g q24h. A rapid diagnostic blood culture test shows ESBL infection in the bloodstream. Which alert would be fired in this scenario? A. De-escalation alert B. Inappropriate double coverage alert ._Unlikely infection alert ‘The patient's current antibiotics would not cover this specific organism (ESBL); the “bug” drug mismatch alert would fire due to the resistant organism requiring an alternative antibiotic,6. ABisa 32 y.o on piperacilin/tazobactam and metronidazole for an intraabdominal infection. Which alert would be fired in this scenario? A. De-escalation alert Unlikely infection alert D. “Bug” drug mismatch alert Piperacilin/tazobactam and metronidazole both coveranaerobes (8.fragilis) we would be concerned about with intraabdominal infections; this would be unnecessary double coverage of anaerobes. In this scenario an inappropriate double coverage alert would be fired. 7. What is true about third party CDSSs? B. Does not include a large financial commitment C. Cannot generate real-time alerts D. Allinclude prescriber metrics Third party CDSS programs are add-on CDSSs that work parallel with electronic medical records (such as EPIC and Cerner), they include a large financial commitment. There are multiple third party CDSSs available with differing tools/characteristics that make them unique, lke prescriber metrics, however all of them include real time alerts. & Which action reassesses the continued need and choice of antibiotics after a specified timeframe? A. Preauthorization C. Prospective audit and feedback D. Reporting Antibiotic Timeouts reassess the continued need and choice of antibiotics after they have been active for a specific timeframe (example: active for 48-72 hours). 9. What is one benefit of tracking and enrolling in the NHSN AU Option? 8, Easily miss improvement opportunities C. Does not monitor or benchmark antibiotic use D. Alerts an action to either stop or deescalate antibiotics Tracking helps assess the impact of interventions to identify improvement opportunities; they also monitor and benchmark antibiotic use. 10. What is a challenge of all CDSS programs? B. Nopositive outcomes C. Do not require Information Technology services staff D. CDSS programs have no challengesCDSS challenges include a large financial and time commitment, they require skilled IT staff, physician buy-in, and can result in alert fatigue within the medical teams. Multiple positive outcomes have been evaluated and found for CDSS in many studies, some of which are discussed within the presentation.