Antimicrobial Stewardship Honor Roll

• Action: CHI Mercy Hospital has created a sepsis protocol and built a sepsis bundle within their electronic medical record system. They are also working on lowering C. Diff cases, appropriate selection of antibiotics for pneumonia, and days of therapy for UTIs.
• Collaboration: This hospital is partnering with a local clinic to share its antibiogram to improve empiric therapy. They are sharing antibiotic data for appropriate dosing, choice of antibiotics, and days of therapy for pneumonia and UTIs. They have also shared the antibiogram with local long-term care facilities. 

• Action: Essentia Health Fargo has implemented MRSA PCR screening to support de-escalation of vancomycin and reduce risk of acute kidney injury via an automatic lab order for all vancomycin orders. They are also working on reducing carbapenem usage within the hospital. 
• Collaboration: This facility is partnering with community pharmacies and outside facilities to improve transitions of care from the emergency department. They are working on providing microbiology updates and communication to facilities on treatment plans. 

• Action: Sanford Health Fargo has created a beta-lactam allergy evaluation and assessment tool to determine if a two-step challenge, desensitization, or different antibiotic should be utilized in beta-lactam allergic patients. They have also adjusted COPD exacerbation order set due to decrease susceptibility to S. pneumoniae. 
• Collaboration: Sanford Health Fargo is providing antimicrobial stewardship education to critical access hospitals throughout North Dakota and parts of Minnesota. They are also working on decreasing antibiotic use for upper respiratory infections in urgent care clinics. 

Jamestown Regional Medical Center has implemented an IV to PO policy and has set up order set for sepsis, CAP, and SSTI's in their electronic medical record. 

Pembina County Memorial Hospital has been focusing on sepsis this year. They updated the ER sepsis order set and created an inpatient order set. They also added a sepsis triage tool linked in EPIC to assist with screening and early identification. 

West River Health Services are working on improving antibiotic selection, duration, imaging, cultures, and screenings for community acquired pneumonia. 

Northwood Deaconess Health Center has been focusing on UTIs. They are working on obtaining urine cultures, avoiding fluoroquinolones, and duration limits of no more than seven days for uncomplicated UTIs. 

Southwest Healthcare Services created facility-specific evidence-based guidelines for numerous infectious diseases and shared them with more hospital and clinic providers. They continue to work on tracking and reporting days of antibiotic therapy.