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It takes a team effort to protect every patient, every day. Norton Healthcare is dedicated to taking proactive steps to make a difference. The Norton Healthcare Antimicrobial Stewardship Program was established to optimize clinical outcomes while minimizing adverse consequences of antimicrobial use. This includes consideration of toxicity, selection of pathogenic organisms and managing emergence of resistance while being effective stewards of health care resources without adversely impacting quality of care.
The Antimicrobial Stewardship Program team works with providers across the Norton Healthcare system to ensure appropriate and timely antibiotic use to prevent antibiotic resistance that can cause issues for patients in the future.
In 2023, the Norton Healthcare Antimicrobial Stewardship Program was recognized as a global center of excellence by the British Society of Antimicrobial Chemotherapy’s Global Antimicrobial Stewardship Accreditation Scheme. The program received a Level 3 accreditation, which is the highest level awarded, and is the first center of excellence in the United States. This designation acknowledges the excellent work done by the program and positions Norton Healthcare to be part of a larger conversation worldwide about antimicrobial resistance.
In December 2019, Norton Healthcare was awarded the prestigious ASHP Best Practices Award for its efforts to speed antibiotics to patients with bacterial infections that have spread to the bloodstream. The award recognized implementation of a novel rapid bacteremia response protocol.
As part of the Norton Healthcare Antimicrobial Stewardship Program efforts, the rapid bacteremia response protocol designates the pharmacy as the principal resource to get effective antibiotic treatment to patients faster. The protocol also incorporates rapid bacteria identification technology from the microbiology lab.
Implementation of this protocol reduced the average time from the moment a bloodstream infection is identified in a patient to when antibiotics are administered. A process that had taken about 10 hours was cut to 51 minutes. Improvements also were seen in antimicrobial optimization, repeat blood culture rates and prompt patient isolation in multidrug-resistant organism infections.
The award recognizes pharmacists who demonstrate leadership and innovation in enhancing patient care. Of the 77 clinical programs that applied for the award, only six in the country were honored.
The program uses a novel prospective audit and feedback approach within the electronic medical record. The innovative strategy allows for easy identification of target patients, facilitating pharmacist review and streamlining recommendation delivery. Notably, the program employs an opt-out approach, allowing stewardship recommendations to be implemented if not actively rejected by the treating provider. The use of E-ASP has led to a sustained reduction of use of broad-spectrum antimicrobials, as well as furthering the reach and impact of infectious disease pharmacists.
The stewardship program also collaborates closely with Norton Infectious Diseases Institute to advance research in antimicrobial stewardship and infectious diseases. The collaboration allows for the opportunity to evaluate stewardship interventions and generate evidence to inform clinical practice across the health system.
Jamie Montes de Oca, Pharm.D., BCIDPClinical Pharmacy Specialist – Infectious Diseases, Norton Hospital
Wes Johnson, Pharm.D., BCIDP, MPHClinical Pharmacy Specialist – Infectious Diseases, Norton Clark Hospital, Norton Scott Hospital and King’s Daughters’ Health
Elena Swingler, Pharm.D., BCIDPClinical Pharmacy Specialist –Infectious Diseases, Norton Brownsboro Hospital
Matthew Song, PharmD, BCIDPSupervisor, Pharmacist – Infectious Diseases
Carlee Berry, Pharm.D., BCIDP, AAHIVPClinical Pharmacy Specialist – Infectious Diseases, Norton Women’s and Children’s Hospital
Miranda Arzate, Pharm.D.Clinical Pharmacy Specialist – Infectious Diseases, Norton Clark Hospital, Norton King’s Daughters’ Health and Norton Scott Hospital