1093. Evaluation of an Antimicrobial Stewardship Elective Rotation for Medicine Residents

BACKGROUND: In 2017, an Antibiotic Stewardship (ASP) elective was established for the medicine residents to engage directly in stewardship practice, learn how to communicate recommendations effectively to their peers, and gain further understanding of the rationale for antimicrobial stewardship. Recommendations are co-formulated with the ID Pharmacist and ID Attending Physician, and documented as an ASP Note in the electronic health record. Additionally, the residents disseminate recommendations via page and verbal communication to their peers. The purpose of this study was to evaluate the response of the primary care teams to guidance formulated and communicated by the residents while on this clinical elective. METHODS: Recommendations by the medicine residents participating on the ASP elective from January 2018 to July 2018 were reviewed. Response to the recommendations was categorized as accepted, not accepted, or partially accepted with alternative change. Recommendations were considered as accepted if changes were made by the primary team within 24 hours from time of the ASP note. Responses were further reviewed based on the following medical services: medicine (including hematology/oncology), surgery, and intensive care (ICU). RESULTS: A total of 124 recommendations were reviewed for response.11 of the patients were excluded as changes either occurred prior to the documentation of the ASP note, or proposed changes did not pertain to antibiotic management. Ninety-four of the included interventions were accepted. Medicine, surgery, and ICU services accepted 84%, 82.4%, and 83.3% of recommendations, respectively. The services did not accept 5%, 11.8%, and 11.1% of recommendations, and partial acceptance with alternative changes was 11%, 5.8%, and 5.6%, respectively. CONCLUSION: Recommendations formulated and communicated by residents participating in the ASP Elective rotation resulted in a high degree of acceptance. The acceptance rates did not differ significantly between the medical services. The addition of the ASP Elective has demonstrated a benefit to the ASP program at Olive View-UCLA Medical Center, and other medical residency training programs should consider implementation of such an elective rotation to enhance stewardship efforts and medical resident education. DISCLOSURES: All authors: No reported disclosures.