Collection:  Antibiotic Stewardship Guidelines and Algorithms Compendium

Compiled by IPRO HQIC

Urinary Tract Infection

UTI Guideline-6.9.21.pdf (mi-hms.org)

UTI.Complicated.Protocol.pdf (umich.edu)

clinicpath-nm-updated-uti-guidance_final-1.pdf (unmc.edu)

International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases | Clinical Infectious Diseases | Oxford Academic (oup.com)

Urinary Tract Infection (UTI) | Agency for Healthcare Research and Quality (ahrq.gov)

Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections – PMC (nih.gov)

Urinary Tract Infections – Adult (umich.edu)

Toolkit for Reducing CAUTI in Hospitals | Agency for Healthcare Research and Quality (ahrq.gov)

Appendix K. Infographic Poster on CAUTI Prevention (ahrq.gov)

Clinical-Pearl-Single-dose-Aminoglycosides-for-Cystitis-1.17.23.docx.pdf (kymdro.org)

Staphylococcus-aureus-in-urine-culture-4.26.23.pdf (kymdro.org)

Clinical-Pearl-Aminopenicillins-for-Enterococcus-cystitis-7.19.23.docx.pdf (kymdro.org)

Skin and Soft Tissue Infection

Cellulitis: A Review (JAMA)

Cellulitis: A Review (NIH)

Cellulitis: Information for Clinicians (CDC)

IDSA Skin & Soft Tissue guidelines 2014

Skin and Soft Tissue Infections: Treatment Guidance Updated May 2018 Jasmine R Marcelin MD, Trevor Van Schooneveld MD, Scott Bergman PharmD Reviewed by: Mark E Rupp MD, M. Salman Ashraf MBBS University of Nebraska. KALYANAKRISHNAN RAMAKRISHNAN, MD, ROBERT C. SALINAS, MD, AND NELSON IVAN AGUDELO HIGUITA, MD. Am Fam Physician. 2015;92(6):474-483

AAFP patient education materials

UCSF Medical Center Guideline for the Management of Suspected Skin and Soft Tissue Infections in Adults Original Author(s): Jennifer S. Mulliken, MD and Sarah M. Doernberg, MD, MAS

SHC Clinical Guideline: Outpatient Management of Skin and Soft Tissue Infections

Prophylaxis/SSI

Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update with essential practices. 

Additional guidelines (all adapted from consensus guidelines):

ASHP Clinical Practice Guidelines for Prophylaxis in Surgery.

Stanford Health Care- Surgical Prophylaxis Guidelines

University of Michigan- Surgical Prophylaxis Guidelines

University of California San Francisco- Surgical Prophylaxis Guidelines

ICHE Compendium 2022- Updated Surgical Site Infection Prevention Compendium

IV to PO Conversion

Article – Intravenous-to-Oral Switch Therapy: Overview, Antibiotics, Antidepressants (medscape.com)

Article – (2023) – Switching patients from IV to oral antimicrobials – The Pharmaceutical Journal (pharmaceutical-journal.com) (from the UK)

Guidelines

Galway Antimicrobial Prescribing Policy / Guidelines (GAPP) – Galway: GAPP (megsupporttools.com)

 (2018) Intravenous to Oral Conversion for Antimicrobials (northernhealth.ca)

SHC-IV-to-PO-Interchange-Protocol.pdf (stanford.edu)

A Resource To Help With Changing From IV To PO Antibiotics (idstewardship.com)

Public Health Ontario: https://www.publichealthontario.ca/-/media/documents/A/2016/asp-iv-oral-conversion.pdf

C Difficile

Clinical-Pearl-CDI-Risk-2.8.23.pdf (kymdro.org)

CDI Prevention Strategies- https://www.cdc.gov/cdiff/clinicians/cdi-prevention-strategies.html

MN Department of Health C difficile guidelines  https://www.health.state.mn.us/diseases/cdiff/hcp/guidelines.html

UC Davis Guidelines 2021  https://health.ucdavis.edu/antibiotic-stewardship/pdfs/cdi_tx_ucd.pdf

University of Nebraska  2021 https://www.unmc.edu/intmed/_documents/id/asp/clinicpath-cdi_final.pdf

UNC Medical Center 2022  https://www.med.unc.edu/pediatrics/cccp/wp-content/uploads/sites/1156/gravity_forms/1-c06e424ddddee8826f29e1bc5926a251/2022/11/CASP-UNCMC-CDI-Guideline_FINAL.pdf

AHRQ  Best Practices in the Diagnosis and Treatment of C difficile 2019  

Management of C difficile in adults: review and comparison of IDSA/SHEA, ESCMID and ASID guidelines

IDSA C difficile clinical practice guidelines in adults: 2021 Update by SHEA/IDSA

Managing Opioids Safely After Discharge: A Communication Tool for Patients and Care Partners

Prepared by IPRO HQIC

The goal of this tool is to help you communicate with your healthcare team about the opioids you will be taking after you are discharged from the hospital. You and your doctor have decided that you should continue taking opioids after you leave the hospital as part of your pain management plan. A pain management plan lists the ways in which you can control your pain. The plan may include prescribed opioids and over-the-counter medicines and when you should take them, as well as other things you can do (e.g., ice, massage). You and your clinician may need to adjust your plan as you recover.

Workplace Violence Mitigation & Resource Collection

Curated by IPRO HQIC

Workplace violence (WPV) is defined as an act or threat occurring at the workplace that can include any of the following: verbal, nonverbal, written, or physical aggression; threats, intimidation, harassment, or humiliating words or actions; bullying; sabotage; sexual harassment; physical assaults; or other behaviors of concern involving staff, licensed practitioners, patients, or visitors.

By assessing worksites, preparing employees through training, and providing resources such as clear reporting procedures, healthcare facilities can help to reduce the impact of this hazard on the workforce and continue to ensure a safe place to provide care for patients. Whether your facility already has a workplace violence program or is just starting to develop one, IPRO HQIC has a compendium of tools and resources to ensure that all aspects of this hazard are considered throughout the process.

This collection contains research articles, best practices webinars, planning templates, assessment tools, and online trainings related to workplace violence in healthcare settings.

Using the IPRO HQIC Planning Tool to Implement a PFAC in Your Hospital

Prepared by IPRO

The Self-Directed Learning Series for IPRO HQIC Hospitals is Now Available

  • Purpose
    • The goal of this learning series is to help a team of hospital employees and a patient and family advisors implement a functioning and sustainable patient and family advisory council or PFAC to meet PFE Best Practice.
    • You will learn the process and steps required to plan and initiate a PFAC.
    • The learning series includes an introductory video and five learning modules—one for each of the five steps of the process (illustrated below).

What is PFE Best Practice 5?
Hospitals are required to have at least one active Person and Family Engagement Committee, Patient and Family Advisory Council (PFAC), or other committee (e.g., Patient Safety) with full membership positions for patient or family representatives.

Background
The series has two major components (1) the PFAC Planning Tool which includes tools and activities that your hospital can use to create and sustain a Patient and Family Advisory Council (PFAC); (2) six pre-recorded learning modules of the Creating and Sustaining a Patient and Family Advisory Council to Improve Patient Safety and Enhance Quality Improvement.

  • How to Access
    • Go to IPRO Learn: Log in to the site to login or create a new account. More information about this process is available on the IPROLearn Account Creation Instructions.
    • Under “all courses” search for PFAC Learning Series.
    • Start with the introductory video and work your way through the five learning modules at your own pace!

View slides and the webinar recording from the Using the IPRO HQIC PFAC Learning Series to Implement a PFAC in Your Hospital to:

  • Learn about how to meet PFE Practice 5: PFAC or Representatives on Hospital Committee.
  • Learn about the new self-directed learning series on IPRO Learn, Creating and Sustaining a Patient and Family Advisory Council (PFAC) to Improve Patient Safety and Enhance Quality Improvement.
  • Discuss how your hospital can use the learning series to develop or strengthen your PFAC.

Opioid Stigma Resources Collection

Compiled by IPRO HQIC

The following are websites where you can resources related to Opioid Stigma:

Articles:

  1. CDC. “Patients’ Frequently Asked Questions | CDC’s Response to the Opioid Overdose Epidemic | CDC.” Www.cdc.gov, 19 Oct. 2021, www.cdc.gov/opioids/patients/faq.html. Spanish Language version available here.
  2. CDC. “Stigma Reduction.” Www.cdc.gov, 25 July 2023, www.cdc.gov/stopoverdose/stigma/index.html. Accessed 10 Oct. 2023.
  3. IPRO HQIC. “Naloxone Saves Lives – HQIC Resource Library.” IPRO HQIC Resource Library, 20 Sept. 2022, hqic-library.ipro.org/2022/09/20/naloxone-saves-lives/. Accessed 10 Oct. 2023. Spanish language version available here.
  4. IPRO HQIC. “People Matter, Words Matter – IPRO QIN-QIO Resource Library.” IPRO HQIC Resource Library, 28 July 2023, qi-library.ipro.org/2023/07/28/people-matter-words-matter/. Accessed 10 Oct. 2023.
  5. Where Opioid Use Disorder Stigma Comes From and How to Prevent It Opioid Use Disorder Stigma: Causes, Impact, Prevention (healthline.com) 
  6. 4 Factors That Add to Stigma Surrounding Opioid Use Disorder 4 factors that add to stigma surrounding opioid-use disorder | American Medical Association (ama-assn.org) 
  7. Stop Overdose: Stigma Reduction Stigma Reduction (cdc.gov) (PDF flyer REDUCING STIGMA (cdc.gov)
  8. The stigma that undermines care The stigma that undermines care (apa.org) 
  9. Stigma: Overcoming a Barrier to Pain Treatment and Addiction Recovery Stigma: Overcoming a Barrier to Pain Treatment and Addiction Recovery | NIH HEAL Initiative 
  10. Substance Use Disorder Stigma: What it is and How You Can Prevent it Substance Use Disorder Stigma: What it is and How You Can Prevent it | USU 
  11. Punishing Drug Use Heightens the Stigma of Addiction Punishing Drug Use Heightens the Stigma of Addiction | National Institute on Drug Abuse (NIDA) (nih.gov) 
  12. Medical Stigma and Patients with Substance Abuse Disorder Medical Stigma and Patients with Substance Abuse Disorders | Psychology Today 
  13. Panel Discussion: Stigma Around Opioid Use Disorder Presents Challenges to Treatment Stigma Around Opioid Use Disorder Presents Challenges to Treatment | The Pew Charitable Trusts (pewtrusts.org) 
  14. Stigma of opioids a hurdle to solving crisis Stigma of opioids keeps users from seeking help, taints views of medical professionals – Harvard Gazette 
  15. Why Opioid Addiction Should Be Viewed-And Treated-Like a Chronic Disease Opioid Use Disorder: Managing Stigma & Treatment | The Well by Northwell 

Blogs Posts:

  1. Part 1: Guiding Principles for Addressing the Stigma on Opioid Addiction Guiding Principles for Addressing the Stigma on Opioid Addiction | Bloomberg American Health Initiative (jhu.edu) 
  2. Part 2: A Roadmap to Reduce Stigma on Opioid Addiction A Roadmap to Reduce Stigma on Opioid Addiction | Bloomberg American Health Initiative (jhu.edu) 

Journal Articles:

  1. Confronting the Stigma of Opioid Use Disorder- and Its Treatment Confronting the Stigma of Opioid Use Disorder—and Its Treatment | Substance Use and Addiction Medicine | JAMA | JAMA Network 
  2. Social Stigma Toward Persons with Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health-Oriented Policies Social Stigma Toward Persons With Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health–Oriented Policies | Psychiatric Services (psychiatryonline.org) 
  3. Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination – ScienceDirect 
  4. The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy – PubMed (nih.gov) 
  5. Stigma, discrimination and the health of illicit drug users Stigma, discrimination and the health of illicit drug users – PubMed (nih.gov) 
  6. The role of stigma in U.S. primary care physicians’ treatment of opioid use disorder The role of stigma in U.S. primary care physicians’ treatment of opioid use disorder – ScienceDirect 
  7. Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review – PubMed (nih.gov) 
  8. Opioid use-related stigma and healthcare decision-making Opioid use-related stigma and health care decision-making – PubMed (nih.gov) 

Ready or Not, Here it Comes: Preparing to Submit the CMS Health Equity Structural Measure

Prepared by IPRO

Hospitals participating in the CMS Inpatient Quality Reporting (IQR) Program are required to submit structural measures for CY2023 into the CMS Hospital Quality Reporting system. Submissions are due between April 1, 2024 – May 15, 2024.

One of the required structural measures is the Hospital Commitment to Health Equity. In this 30-minute session, IPRO will share what you will need to report to CMS, which documentation you will need to support your submission, the optional Social Drivers of Health process measures, and what’s coming related to health equity for the CY2024 Hospital Quality Reporting programs.

Watch Presentation

Presentation Slides

Hospital Commitment to Health Equity Submission Tool: This fillable PDF resource created by IPRO may be helpful for preparing for attestation of the CMS Hospital Commitment to Health Equity Measure.

IPRO HQIC Fall and Injury Prevention: A 6-Part Webinar Series

Prepared by IPRO in collaboration with Dr. Pat Quigley

Falls represent a major public health problem around the world and continue to be the most common adverse event in healthcare settings. The IPRO Hospital Quality Improvement Contractor (HQIC), in collaboration with Dr. Pat Quigley, Nurse Consultant, invites you to participate in a patient safety webinar program beginning May 3, 2023.

The Fall and Injury Prevention webinar series features six monthly webinars, each followed by open forum/coaching sessions from May through October 2023.

Communicating With Doctors and Nurses While in the Hospital: A Tool for Patients and Family Caregivers to Improve Patient Safety

Prepared by the IPRO HQIC Patient Safety Committee

Two-way communication between clinicians and patients plays a critical role in delivering high-quality care and ensuring a positive experience. Developed by the IPRO HQIC Patient Safety Committee*, the goal of this tool is to help patients and their care partners clearly communicate with their healthcare team. Patients can use this tool to plan for and document conversations with a doctor or nurse. The tool has three sections: (1) a set of communication tips for patients; (2) a guide to help patients plan for conversations with their healthcare team; and (3) suggestions for how patients can use their notes from conversations with their health care team. Clinicians can also use this tool to invite and encourage patients to communicate clearly with their healthcare team so that they are partners in their care.

*The IPRO HQIC Patient Safety Committee is composed of patients, family caregivers, and quality improvement specialists from states participating in the IPRO HQIC.