2083. A Targeted Remote Audit and Feedback Intervention Utilizing a Local Non-ID Trained Pharmacist

BACKGROUND: Tele Stewardship (tASP) is a developing model for hospitals without local ID expertise. We report results of a tASP initiative using a hospital’s local non-ID trained pharmacist to conduct ertapenem (erta) audit and feedback (A&F). METHODS: Evaluation of erta use before and after implementation of a collaborative A&F process from October 2018 to March 2019. A central ID physician and ID pharmacist with EMR access reviewed charts of patients receiving erta Mon-Fri by phone with a local Critical Care trained pharmacist. Advice was given to the local pharmacist on when and how to intervene. The local pharmacist made all interventions. Acceptance rates and time involved were recorded. Usage was tracked as DOT/1,000 PD of inpatient usage. No other new local ASP interventions were undertaken during this time. RESULTS: 120 erta orders were reviewed. Figure 1 reveals usage before and after implementation. Median usage dropped 55%. Median purchasing cost decreased by 73%. 51 unique patients received erta in the month prior to intervention, and 35 patients per month on average received erta afterwards. 30 providers ordered erta in the month prior to intervention, and 17 providers per month on average ordered erta afterwards. The overall intervention acceptance rate was 88%, and Figure 2 shows the breakdown of accepted interventions. Figure 3 describes the indications for use of erta orders after intervention started. Figure 4 shows changes in other antibiotics during this time. During this time, no patients were identified that later needed a carbapenem restarted or suffered harm due to this intervention. The average daily time required was 15 minutes for the central team and 22 minutes for the local pharmacist. CONCLUSION: Using a remote collaboration with a local pharmacist, we showed a marked decrease in the use of one targeted antimicrobial. The time commitment was minimal, and no patient harm was identified. Tele-stewardship utilizing local non-ID trained pharmacists can be a significant tool for improving antimicrobial use in community hospitals. tASP’s should monitor for compensatory increase in other broad-spectrum antibiotics. Further local education regarding proper management of UTI’s and other common conditions may provide additional improvements in use of erta. [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.