The Society for Healthcare Epidemiology of America defines antibiotic stewardship as a set of coordinated strategies to improve the use of antimicrobial medications with the goal of enhancing patient health outcomes, reducing resistance to antibiotics, and decreasing unnecessary costs. Resistance to antimicrobial treatment is a critical issue, contributing to a rapid spread of multiple organisms for which few treatments are available.
New final rules were issued by CMS in September of 2019 that make changes to the Medicare Conditions of Participation for Critical Access Hospitals regarding infection prevention and control and antibiotic stewardship programs and must be implemented by March 30, 2020. Under the new requirement, CAHs must have active facility-wide programs for the surveillance, prevention, and control of HAIs and other infectious diseases and for the optimization of antibiotic use through stewardship. The programs must demonstrate adherence to nationally recognized infection prevention and control guidelines, as well as to best practices for improving antibiotic use where applicable, and for reducing the development and transmission of HAIs and antibiotic-resistant organisms.
CMS encourages CAH collaboration with other hospitals in their network for pharmaceutical support as feasible, to work with their respective quality improvement network(s)/organization(s) and health departments for additional support and resources, and to use the technical assistance available from their State Flex Program.
The new regulatory text that will appear in the Code of Federal Regulations at 42 CFR Part 485.640 requires coordination with the CAH’s newly required quality assessment and performance improvement (QAPI) program. The new regulatory text outlines the standards for infection control and prevention and antibiotic stewardship, including standards for program organization and policies and leadership responsibilities.
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