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Consensus development of quality indicators for hospital antibiotic use: the ABS International Quality Indicators Sub-Project

Abstract number: O403

Struelens M.J., Buyle F., Mechtler R., Metz-Gercek S., Kern W., Lechner A., Mittermayer H., Allerberger F.

Objectives: To develop valid Quality Indicators (QI) to assess clinical performance of antibiotic use, as part of the Antibiotic Strategy International, an EU-Project aiming at improving antibiotic therapy in hospital care.

Methods. An international team of 12 experts in four disciplines developed and selected QIs for structure (hospital organisation and resources), processes of care (diagnostic, treatment and prophylactic practice) and outcome (drug use). The development of QIs was achieved in 3 steps: a) identification of QIs in the literature; b) multi-criteria scoring and ranking based on scientific value and applicability; c) general discussion and final consensus QIs selection.

Results: Based on 105 potential QIs, 55 structural, 13 process and 3 outcome QIs were selected and developed. Structural QIs described the organisation and resources as well as communication and evaluation tools available at hospital level for implementing a multimodal, multidisciplinary antibiotic stewardship programme. Process QIs focussed on four care processes: 1) surgical prophylaxis (indication, drug choice, timing and duration of administration); 2) management of community-acquired pneumonia (blood culture and Legionella antigen tests and drug choice for empirical treatment); 3) management of Staphylococcus aureus bacteraemia (echocardiography, IV catheter removal and duration of effective therapy); and 4) IV-PO switch for treatment with equivalent bio-available antibiotics. Outcome indicators focussed on antibiotic use.

Conclusions: This international consensus development of structural and process QIs provides tools for evaluating the intensity of hospital antibiotic stewardship programmes and auditing key treatment and prophylactic practices. Process QIs will be tested for feasibility, reliability and sensitivity to improvement in pilot hospitals.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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