Global Center for Scientific Affairs, Merck & Co., Inc., Kenilworth, New Jersey.
Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles.
Clin Infect Dis. 2018 Apr 3;66(8):1304-1312. doi: 10.1093/cid/cix1041.
Effective 28 November 2017, the Centers for Medicare & Medicaid Services (CMS) mandated long-term care facilities (LTCFs) to have antimicrobial stewardship programs (ASPs) in place. Although guidance exists for establishing ASPs in LTCFs, limited data exist on the "how." As comprehensive ASPs already exist in many acute-care hospitals (ACHs) and with the known "sharing of patients" between both settings, extending ACH ASP expertise to LTCFs will not only aid LTCFs in complying with the CMS mandate but will likely also facilitate in decreasing multidrug-resistant organisms and Clostridium difficile infection rates in patients at both organizations. Here, we provide a roadmap on how to implement ASPs in LTCFs, using examples from our own ACH's collaboration with local LTCFs to develop and sustain LTCF ASPs. We discuss critical elements to achieving successful LTCF ASPs, including the potential barriers and how to overcome them.
自 2017 年 11 月 28 日起，医疗保险和医疗补助服务中心（CMS）要求长期护理机构（LTCF）建立抗菌药物管理计划（ASPs）。尽管已经有关于在长期护理机构建立 ASP 的指南，但关于“如何”建立的相关数据有限。由于许多急性护理医院（ACH）已经建立了全面的 ASP，并且这两种环境之间存在“患者共享”的情况，因此将 ACH ASP 专业知识扩展到 LTCF 不仅将有助于 LTCF 遵守 CMS 的规定，还有可能降低这两个机构患者的耐多药菌和艰难梭菌感染率。在这里，我们提供了一个在 LTCF 中实施 ASP 的路线图，使用了我们自己的 ACH 与当地 LTCF 合作来开发和维持 LTCF ASP 的例子。我们讨论了实现成功的 LTCF ASP 的关键要素，包括潜在的障碍以及如何克服这些障碍。
