Pediatric ASP Toolkit

Methods to Collect Data

Medication Administration Record Data

Best data to show if a patient receives an antibiotic. This data is recorded often through bar code medication administration.

Pharmacy Dispensing Data

Less preferable than Medication Administration Record Data

Pharmacy Charge Data

NHSN Antibiotic Use and Resistance Modules

• Through the National Healthcare Safety Network (NHSN), healthcare facilities can now electronically monitor antibiotic resistance and antibiotic prescribing data. This data would be provided to the CDC and could allow for benchmarking antibiotic use and resistance data.
• Participation in these modules would also provide the participating institution with SAARs (for more information please refer to ‘Process Measures’ located under Inpatient Settings ‘Tracking Data’).

Pediatric Health Information Systems Database

• Has been utilized to demonstrate the amount of antibiotics used in free-standing children’s hospitals in the United States. (Gerber JS, et al. Variability in antibiotic use at children’s hospitals. Pediatrics. 2010 Dec;126(6):1067-73.). Additionally PHIS data has been used to show the impact of formal ASPs on improving antibiotic use among these hospitals. (Hersh AL et al. Antibiotic stewardship programs in freestanding children’s hospitals. Pediatrics. 2015 Jan;135(1):33-9)

Methods to Present the Data (PIDS and AAP do not endorse any commercial products)

• Tableau
• Qlik
• For guidance on what to report with regards to reducing meat purchases raised with routine non-therapeutic antibiotics and suggestions for both internal and external outlets to consider sharing information, see the “Reporting” section of the Antibiotic Stewardship Through Food Animal Agriculture Module produced by CCCAS.
• Use of third party vendors for performing antibiotic stewardship. These software programs work in conjunction with an institutions electronic health record to provide a platform to more easily perform antibiotic stewardship and/or infection prevention and control. Examples include:
  • Theradoc® (Premier, Inc.)
  • Vigilanz® Intelligence Platform (Vigilanz Corp.)
  • Sentri7® Clinical Surveillance Software (Pharmacy OneSource®)
    • Case Study: Optimizing Antimicrobial Stewardship with Sentri7® at Texas Health Arlington Memorial Hospital 
  • BD HealthSight™ Clinical Advisor (Becton, Dickinson, and Company)
  • Computerized physician order entry adaptation
    • Cerner Powerchart® (Cerner® Corporation) modifications¹¹
    • Ref: Pogue JM, Potoski BA, Postelnick M, et al. Bringing the “Power” to Cerner’s Powerchart for Antibiotic Stewardship. Clin Infect Dis. 2014; 59: 416-24.

Notes:

For those seeking to establish an ASP at their institution, a number of hospitals already utilize these tools for non-stewardship purposes:

• Infection Control – surveillance and epidemiology
• Pharmacy – workflow optimization
• Microbiology – antibiogram development/maintenance

Check with the departments in your hospital to determine if access can also be obtained for ASP purposes: one way to offset ASP start-up expenditures.

Methods to Analyze and Compare Data

Pediatric Health Information Systems Database

NHSN AUR Modules

Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) Collaborative

Antimicrobial stewardship collaborative among children’s hospitals located throughout the U.S. and internationally.

• The collaborative’s mission is to utilize prescribing data for development of interventions to improve the safety and clinical outcomes of children who receive antimicrobials and to decrease the rate at which antimicrobial resistance develops.
• Member institutions share antimicrobial use data to develop customized antimicrobial use reports for benchmarking. SHARPS also provides opportunities for shared learning with monthly webinars, an email listserv for participants to ask stewardship-related questions of peers, and an annual in-person meeting at the International Pediatric Antimicrobial Stewardship Conference.

Newland JG, Gerber JS, Kronman MP, et al. Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS): A Quality Improvement Collaborative. J Pediatric Infect Dis Soc. 2018; 7(2): 124-128.

McPherson C, Lee BR, Terrill C, et al. Characteristics of Pediatric Antimicrobial Stewardship Programs: Current Status of the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) Collaborative. Antibiotics(Basel). 2018; 7(1).

Tribble AC, Lee BR, Flett KB, et al. Appropriateness of Antibiotic Prescribing in United States Children’s Hospitals: A National Point Prevalence Survey. Clin Infect Dis. 2020; 71(8): e226-e234.

McPherson CC, Vesoulis ZA, Metjian TA, et al. Utilization of the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) Collaborative Electronic Mailing List (listserv) by Healthcare Professionals. Infect Control Hosp Epidemiol. 2020 Dec 23; 1-3. doi: 10.1017/ice.2020.1352. Published online ahead of print.

Children’s Hospitals’ Solutions for Patient Safety (SPS) Antimicrobial Stewardship Program Cohort

SPS is a collaborative of children’s hospitals located throughout the U.S. and Canada focused on reduction of harms via cooperative approaches to patient care.

• The collaborative’s mission is to work together to eliminate serious harm across all children’s hospitals, so that every child receives safe care every time.
• Antimicrobial Stewardship Program Cohort member institutions work together to develop, implement and test antimicrobial stewardship interventions and submit monthly usage data pertaining to the interventions. Participation in monthly webinars and sharing of successes/challenges related to intervention implementation is expected.

SPS Antimicrobial Stewardship Operational Definition