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2052. Characterizing Nursing and Provider Social Networks to Develop an Instrument to Improve Antibiotic Stewardship Efforts in Nursing Homes

BACKGROUND: Inappropriate antibiotic use is a common problem in nursing homes (NHs). Antibiotic decision-making in NHs is complex. Characterizing the patterns and nature of social interactions between providers and nursing staff may offer insights into the factors influencing antibiotic decisions an...

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Autores principales: Ewers, Tola, Mundt, Marlon P, Crnich, Christopher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810447/
http://dx.doi.org/10.1093/ofid/ofz360.1732
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author Ewers, Tola
Mundt, Marlon P
Crnich, Christopher
author_facet Ewers, Tola
Mundt, Marlon P
Crnich, Christopher
author_sort Ewers, Tola
collection PubMed
description BACKGROUND: Inappropriate antibiotic use is a common problem in nursing homes (NHs). Antibiotic decision-making in NHs is complex. Characterizing the patterns and nature of social interactions between providers and nursing staff may offer insights into the factors influencing antibiotic decisions and opportunities to improve their quality in NHs. METHODS: Chart reviews and interviews with key informants were used to identify social interactions between nursing staff and providers associated with antibiotic prescribing decisions in three NHs. Data collection was restricted to provider-nurse exchanges following a resident change in condition recognition up to receipt of an order for an antibiotic. A survey administered to nursing staff was used to collect information on employment tenure and their perceptions about facility team climate. UCINET software was used to describe network characteristics, including density and centrality. RESULTS: Urinary tract infections (UTIs) accounted for nearly 40% of antibiotic events across all sites. The number of contacts between nursing staff and providers was approximately two-times greater for treated UTI events when compared with treated soft-tissue infections and were four-times as great as for treated pneumonia events. Network structures were different at each study NH with varying numbers of core team members and network density (Figure 1). Team climate survey responses across SNFs demonstrate generally positive climates (4.1 on a scale of 1 to 5, 5 reflects positive). CONCLUSION: NHs have unique network structures; however, more complex social interactions associated with UTI events were common across all sites. Future studies should examine influences of different social network structures on antibiotic decision-making in NHs and whether modification of network structures or their characteristics is amenable to change. [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68104472019-10-28 2052. Characterizing Nursing and Provider Social Networks to Develop an Instrument to Improve Antibiotic Stewardship Efforts in Nursing Homes Ewers, Tola Mundt, Marlon P Crnich, Christopher Open Forum Infect Dis Abstracts BACKGROUND: Inappropriate antibiotic use is a common problem in nursing homes (NHs). Antibiotic decision-making in NHs is complex. Characterizing the patterns and nature of social interactions between providers and nursing staff may offer insights into the factors influencing antibiotic decisions and opportunities to improve their quality in NHs. METHODS: Chart reviews and interviews with key informants were used to identify social interactions between nursing staff and providers associated with antibiotic prescribing decisions in three NHs. Data collection was restricted to provider-nurse exchanges following a resident change in condition recognition up to receipt of an order for an antibiotic. A survey administered to nursing staff was used to collect information on employment tenure and their perceptions about facility team climate. UCINET software was used to describe network characteristics, including density and centrality. RESULTS: Urinary tract infections (UTIs) accounted for nearly 40% of antibiotic events across all sites. The number of contacts between nursing staff and providers was approximately two-times greater for treated UTI events when compared with treated soft-tissue infections and were four-times as great as for treated pneumonia events. Network structures were different at each study NH with varying numbers of core team members and network density (Figure 1). Team climate survey responses across SNFs demonstrate generally positive climates (4.1 on a scale of 1 to 5, 5 reflects positive). CONCLUSION: NHs have unique network structures; however, more complex social interactions associated with UTI events were common across all sites. Future studies should examine influences of different social network structures on antibiotic decision-making in NHs and whether modification of network structures or their characteristics is amenable to change. [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810447/ http://dx.doi.org/10.1093/ofid/ofz360.1732 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Ewers, Tola
Mundt, Marlon P
Crnich, Christopher
2052. Characterizing Nursing and Provider Social Networks to Develop an Instrument to Improve Antibiotic Stewardship Efforts in Nursing Homes
title 2052. Characterizing Nursing and Provider Social Networks to Develop an Instrument to Improve Antibiotic Stewardship Efforts in Nursing Homes
title_full 2052. Characterizing Nursing and Provider Social Networks to Develop an Instrument to Improve Antibiotic Stewardship Efforts in Nursing Homes
title_fullStr 2052. Characterizing Nursing and Provider Social Networks to Develop an Instrument to Improve Antibiotic Stewardship Efforts in Nursing Homes
title_full_unstemmed 2052. Characterizing Nursing and Provider Social Networks to Develop an Instrument to Improve Antibiotic Stewardship Efforts in Nursing Homes
title_short 2052. Characterizing Nursing and Provider Social Networks to Develop an Instrument to Improve Antibiotic Stewardship Efforts in Nursing Homes
title_sort 2052. characterizing nursing and provider social networks to develop an instrument to improve antibiotic stewardship efforts in nursing homes
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810447/
http://dx.doi.org/10.1093/ofid/ofz360.1732
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