Antibiotic use is common in long-term care facilities (LTCF) with 70% of residents receiving at least one course of systemic antibiotic every year.  A significant proportion of this antibiotic use (40% to 75%) is either unnecessary or inappropriate.  Centers for Medicare and Medicaid Services (CMS) will require all LTCF to have an antimicrobial stewardship program (ASP) by November 28, 2017 as part of the requirements for participation.  However, most nursing homes lack both the experience and the expertise required to develop a comprehensive ASP.

Nebraska ASAP (Antimicrobial Stewardship Assessment and Promotion Program), which represents a partnership between the University of Nebraska Medical Center, Nebraska Medicine and Nebraska Department of Health and Human Services, is focused on helping LTCF across Nebraska develop their own ASP.

ASAP team includes experienced infection preventionists, infectious diseases trained medical directors and pharmacists, and professional educators.  Last year, Nebraska ASAP partnered with 5 LTCF in Nebraska for a pilot project focused on helping these facilities start their own programs.  All 5 have made significant progress in development of ASP supported by a plan developed by ASAP team after an initial on-site assessment of their needs.  To help these LTCF with implementation of certain aspects of the program, ASAP developed numerous tools and templates which were shared with them.  The team then created a website (https://asap.nebraskamed.com) which compiled these resources along with numerous other free resources so that all LTCF in the state and region can now benefit from ASAP efforts.

Faculty members in the Division of Infectious Diseases of the University of Nebraska Medical Center, who are also the medical directors for Nebraska ASAP, are now developing educational training program for consultant pharmacists.  The program focuses on arming the consultant pharmacists with knowledge of antimicrobial stewardship implementation so they can become the local drug experts for the nursing home ASP.

Nebraska ASAP is enthusiastic about promoting appropriate antibiotic use in LTCF across the state, but to achieve this goal they need a contact person from each nursing home (such as infection preventionists, director of nursing, administrator or medical director) to sign up for a free email distribution list of Nebraska ASAP by sending an email to pchung@nebraskamed.com.  This will allow Nebraska ASAP to communicate when new tools or resources are made available.  They will also share important news regarding antibiotic use and ASP with key personnel in the nursing homes.

Nebraska ASAP is looking forward to working with all of you during and after this Antibiotic Awareness Week.