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Table 5 Potential areas of focus for antimicrobial stewardship interventions as proposed by study participants

From: Antimicrobial stewardship in residential aged care facilities: need and readiness assessment

AMS interventions Potential areas of focus
Nursing staff education and training -Reinforcement of issues about antibiotic use, antibiotic resistance and benefits of antimicrobial stewardship
-Education sessions as part of in-service training, via online training modules, awareness campaigns, etc.
Aged care-specific infection management algorithms for nursing staff -Flow charts to guide appropriate initial testing of residents, as well as guidance with regard to conditions that may be observed versus those requiring immediate contacting of prescribers
-Targeted management of common infections, in particular, urinary and respiratory tract infections
Aged care-specific antibiotic treatment guidelines -Development of evidence-based aged care antibiotic treatment guidelines (with recommendations about appropriate dosages and duration of therapy)
-Education to prescribers through online updates or distribution of newsletters, highlighting evidence-based prescribing practices
Regular surveillance of antibiotic use by consultant pharmacists -Passive surveillance and audit of antibiotic use, with regular feedback to the prescribers
-Documentation of individual residents’ prior antibiotic exposure over time, supplemented by antibiotic susceptibility results to guide prescribing decisions
Improved communication about decisions related to antibiotic prescribing -Early discussion with residents and/or families about antibiotic use during acute events and terminal illness as part of advanced care planning
-Proper handover from locum doctors to regular GPs regarding antibiotics prescribed after hours for further review
  -Faxing of treatment plans for phone ordering of antibiotics via antibiotic ordering form with clear indications for treatment and planned duration of treatment