Purpose

To improve patient outcomes, promote optimal antimicrobial use, and reduce healthcare resources related to the prophylaxis and treatment of infectious diseases at Vanderbilt University Hospital (VUH). The Vanderbilt Antimicrobial Stewardship Program (VASP) provides oversight of antimicrobial therapy for patients within the institution.

Policy

VASP employs a multifaceted, systematic approach to the use of antimicrobials, including, but not limited to, prospective monitoring of antimicrobials and providing feedback and recommendations to clinicians regarding antimicrobial use. The program collaborates with the Division of Infectious Diseases, Infection Control and Prevention, Clinical Microbiology, and Department of Pharmaceutical Services.

Procedures

A. Monitoring

  1. The Antimicrobial Stewardship pharmacist(s) reviews pertinent positive cultures for patients hospitalized to VUH and the utilization of antimicrobials to ascertain if Standard Clinical Practice is achieved.

  2. The Antimicrobial Stewardship pharmacist(s) reviews patients identified by and in collaboration with MDMT for whom optimization of anti-infective treatment may be possible.

  3. The Antimicrobial Stewardship pharmacist(s) discusses the patient, and any recommendations with the primary team, and provides feedback regarding treatment of the patients infectious condition(s), as necessary.

B. Formulary revision recommendations by the VASP are evaluated by the VUMC Antimicrobial Subcommittee with final approval by the Pharmacy and Therapeutics Committee.

C. Education of practitioners about the selection and use of antimicrobials may be conducted through various means including, but not limited to:

  1. Use of computerized physician order entry (CPOE)/electronic medical records (EMR);

  2. Real-time case by case physician/provider education;

  3. Didactic lectures; and

  4. Other mechanisms, such as newsletters, as deemed necessary.

D. Antimicrobial guideline development may include, but is not limited to, implementation of computerized antimicrobial prescribing procedures.