Project Sponsor(s): Barbara Trautner, MD, PhD
Project Title: Less is More: Improving Antimicrobial Stewardship for Asymptomatic Bacteriuria
Project Description: Antimicrobial (antibiotic) stewardship as a means to combat the spread of antibiotic-resistant bacteria has become a national priority, both within and outside the VHA. This project focuses on improving Veteran safety by reducing inappropriate use of antimicrobials for asymptomatic bacteriuria (ASB), a very common, harmless condition that leads to antimicrobial overuse in acute and long-term care. We previously conducted a successful intervention to decrease unnecessary ordering of urine cultures and antibiotics for ASB. This single site intervention, entitled “Kicking Catheter Associated Urinary Tract Infection (CAUTI): the No Knee-Jerk Antibiotics Campaign,” reduced unnecessary screening for ASB by 71% and unnecessary treatment of ASB by 75% in a large and complex VA medical center.
The objective of the current project is to implement a scaled-up version of the Kicking CAUTI campaign across four geographically diverse VA facilities while assessing what aspects of an antimicrobial stewardship intervention are essential to success and sustainability. The two main intervention tools are (1) an evidence-based algorithm that distills the guidelines into a streamlined clinical decision-making process, and (2) case-based audit and feedback to train clinicians to use the algorithm. The intervention is directed at providers in acute and long-term care. Aim 1 is to conduct baseline measurements and surveys. Aim 2 is to implement the antibiotic stewardship intervention in the four intervention sites. Aim 3 is to conduct a budget impact analysis.
Institution and Location: Center for Innovations in Quality, Effectiveness and Safety (Michael E. DeBakey VA Medical Center/Baylor College of Medicine) 2450 Holcombe Blvd Suite 01Y, Houston, TX 77021
Eligibility for international students?: Must be a US Citizen
Expectations of student:
- The student must devote 10 hours per week to the project (consistent with a 3-credit course) and will develop a timeline of activities in collaboration with supervisor(s). The student will meet at least monthly with the faculty supervisor(s) to evaluate progress.
- The student would be involved in research team meetings, helping with distribution and collection of surveys, assisting with case review, and designing teaching materials for the case-based audit and feedback intervention. Motivated students may have a role in preparation and presentation of results.
Prerequisite training: None
Knowledge and skills student can expect to gain: Understanding of guidelines implementation, both the logistics and the science behind behavior change. Interaction with a multidisciplinary research team. Ability to perform research surveys. Summarizing and presenting research data.