期刊
CLINICAL INFECTIOUS DISEASES
卷 64, 期 3, 页码 377-383出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciw787
关键词
antimicrobial stewardship; patient safety; process measure; outcome measure; quality metrics
资金
- CDC Foundation
- Agency for Healthcare Research and Quality [K08 HS023866]
- National Institutes of Health [K23 AI095357]
- CDC
Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. An expert panel rated 90 candidate metrics on a 9-point Likert scale for association with 4 criteria: improved antimicrobial prescribing, improved patient care, utility in targeting stewardship efforts, and feasibility in hospitals with electronic health records. Experts further refined, added, or removed metrics during structured teleconferences and re-rated the retained metrics. Six metrics were rated > 6 in all criteria: 2 measures of Clostridium difficile incidence, incidence of drug-resistant pathogens, days of therapy over admissions, days of therapy over patient days, and redundant therapy events. Fourteen metrics rated > 6 in all criteria except feasibility were identified as targets for future development.
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