After almost a year of planning, the First Annual Nebraska Antimicrobial Stewardship Summit convened on Friday, June 1st, 2018 in La Vista, NE.  This conference is the first of its kind in Nebraska in which information on antimicrobial stewardship in various healthcare settings is the focus of the meeting.  The conference center was abuzz with excitement as close to 270 healthcare professionals attended the Summit that included over 130 nurses, 80 pharmacists, and 30 providers.  While the majority of the attendees were from Nebraska, healthcare professionals from neighboring states such as Iowa, Kansas, Missouri and South Dakota also attended the Summit.

Following a warm welcome from Dr. Maureen Tierney (Director of the HAI/AR Program, Nebraska DHHS), Dr. Srinivasan (Associate Director for Healthcare-Associated Infection Prevention Programs, CDC) gave an Update on National Antimicrobial Stewardship Activities in acute, long-term and ambulatory care settings.  His concluding message was that the question now is not if we need antimicrobial stewardship but what is the most efficient and effective way to accomplish it because stewardship is about more than just antibiotic resistance, it is a matter of patient safety.

The morning session continued with presentations from Dr. Diekema (Professor, University of Iowa Carver College of Medicine) on the Role of the Laboratory in Antimicrobial Stewardship; Drs. Vivekanandan (Associate Professor of Medicine, Creighton University) and Horne (Assistant Professor of Medicine, Creighton University) on Is Antibiotic Stewardship the Answer to C. difficile; and Kate Tyner, RN, CIC (Nurse Coordinator, Nebraska ASAP and ICAP) on the Role of the Infection Preventionist in Antimicrobial Stewardship.  The morning session concluded with a presentation from Drs. Tierney and Pedati (Medical Epidemiologist, Nebraska DHHS) on Public Health Support for Antimicrobial Stewardship in which they discussed the state MDRO outbreak detection and management protocols as well as the state antimicrobial susceptibility registry and antibiogram.

During lunch, Summit attendees had the opportunity for roundtable discussions with Summit speakers, Planning Committee members, and HAI Antimicrobial Stewardship Advisory Committee members during the Meet-the-Expert session.  The goal of this activity was to promote networking and stimulate discussion on solutions to overcome antimicrobial stewardship challenges.  Lively discussions ensued between antimicrobial stewardship experts and attendees over hoagies and subs!

Education in antimicrobial stewardship continues in the afternoon with breakout sessions in the Acute and Ambulatory Track and the Post-Acute and Long-Term Care Track at the Summit.  Dr. Bergman (Pharmacy Coordinator, Antimicrobial Stewardship Program, Nebraska Medicine) started the acute and ambulatory session with his presentation on Regulatory Requirements for Hospitals and Outpatient Antimicrobial Stewardship.  This was followed by presentations from Dr. Van Schooneveld (Medical Director, Antimicrobial Stewardship Program, Nebraska Medicine) on Antimicrobial Stewardship Interventions in Acute Care Hospitals; Dr. Kuper (Senior Clinical Manager, Infectious Diseases, Vizient) on Antibiotic Stewardship Metrics: How Do You Measure Up?; and Drs. Marcelin (Associate Medical Director, Antimicrobial Stewardship Program, Nebraska Medicine) and Green Hines (Medical Director, Antimicrobial Stewardship Program, Children’s Hospital & Medical Center) on Antimicrobial Stewardship in the Outpatient Setting (#OutptASP).  The session was well attended and appreciated by Summit attendees.

Equally well attended is the post-acute and long-term care session that was opened with a presentation from Dr. Crnich (Chief of Medicine and Hospital Epidemiologist, Williams S. Middleton VA Hospital) on Regulatory Requirements for Post-Acute and Long-Term Care Antimicrobial Stewardship Programs.  This afternoon session continued with Dr. Ashraf (Co-Medical Director, Nebraska ASAP and Medical Director, Nebraska ICAP) speaking on Antimicrobial Stewardship Implementation in Post-Acute and Long-Term Care Facilities; Dr. Crnich on Management of Common Infections in Long-Term Care Facilities; and Tammi Schaffart, RN (Infection Control Nurse and QAPI Coordinator, Douglas County Health Center) and Dr. Ortmeier (Consultant Pharmacist Team Lead, Community Pharmacy Services) on the Role of Nurses and Consultant Pharmacists in Antibiotic Stewardship in Post-Acute and Long-Term Care Facilities.

When asked about take-home points on establishing antimicrobial stewardship programs in long-term care facilities, speakers from the Post-Acute/Long-Term Care Track shared their thoughts.  Dr. Crnich said it takes a team to establish a stewardship program while Dr. Ashraf echoed a similar sentiment that no one is alone in this journey.  Tammi emphasized to the many nurses in the audience the importance of documentation to show their efforts in the numerous clinical activities they performed in nursing facilities, including antimicrobial stewardship.  Dr. Ortmeier stressed the importance of persistence and the need to continue to ‘keep at it’ for eventual success.

We genuinely appreciate the support Summit attendees expressed.  It is our hope that this type of Summit will continue annually in the future and that new topics and updated contents in antimicrobial stewardship will be presented.  Additionally, we hope to make many more connections with healthcare professionals in Nebraska and neighboring states to improve the care and safety of our patients and residents by improving prescribing of this precious resource, antimicrobials, through antimicrobial stewardship.

To access the educational materials from the Summit, please go to: https://asap.nebraskamed.com/2018-summit-slides/.

Written by Phil Chung, PharmD, MS, BCPS