7 steps to follow when initiating or strengthening AS

(Source: Australia Antimicrobial Stewardship 2011 )

1. Collect baseline information relevant to the institution

  • antimicrobial use and trends over time
  • antimicrobial expenditure and trends over time
  • the institution’s microbial susceptibility patterns.

2. Assess organisational culture regarding AS

  • conduct an AS readiness survey, including the local ‘drivers’ are (e.g. financial savings, antimicrobial resistance), and the level of executive support or commitment to the program.

3. Assess what assets and resources are available/accessible

  • assets: interested personnel, trained personnel, information technology support and willingness to look at new systems, microbiology, ID physician and pharmacy availability and support).
  • resources: look for guidelines, web sites, other groups.

4. Review existing antimicrobial prescribing and management policies

  • Assess if they are current, comprehensive, and whether they have been audited and cover all the necessary issues or not
  • Ensure that the policy nominates a person and their position within the hospital who has executive responsibility for the policy content, implementation and monitoring, and that this person will be involved in future AS activities.
  • Ensure the policy is readily available to all healthcare professionals in hard copy or online.

5. Review the existence, accessibility and acceptance of the organization’s antimicrobial treatment and surgical prophylaxis guidelines

  • Assess whether or not the guidelines:
  1. are consistent and evidence based
  2. realect agreed best practice
  3. specify recommended agent, dose, route and duration of empirical antimicrobial treatment for the major infection categories.

6. Review existing groups or committees with an interest in AMS

  • For example: safety and quality, drug and therapeutics, infection prevention and control, postgraduate medical education committees). Their responsibilities and reporting structures should be understood, as well as how they might impact or interact with AS work.

7. Review the organisation’s existing communication strategies

  • particularly those aimed at prescribers (e.g. access and use of email, newsletters, departmental meetings, mobile phones).


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