Adherence to Evidence-Based Outpatient Antimicrobial Prescribing Guidelines at a Tribal Health System
1Indian Health Service, Whiteriver Service Unit, Arizona.
Insights
Facility-wide outpatient antimicrobial guidelines were established in 2019. Adherence reached 86% by 2021, falling short of the 90% goal, but prescriber willingness to use guidelines increased post-intervention.
Area of Science:
- Infectious Diseases
- Public Health
- Health Policy
Background:
- Tuba City Regional Health Care Corporation implemented evidence-based outpatient antimicrobial guidelines in 2019.
- These guidelines cover the Navajo Reservation in northeastern Arizona.
Purpose of the Study:
- To evaluate adherence to facility-wide, evidence-based outpatient antimicrobial guidelines.
- To assess prescriber behavior regarding antimicrobial prescribing.
Main Methods:
- Retrospective electronic health record review from August 2020 to August 2021.
- Assessed appropriateness of antimicrobial prescriptions against facility guidelines.
- Conducted an educational intervention and prescriber survey in March 2022.
Main Results:
- Overall adherence to prescribing guidelines was 86%, below the 90% target.
- Pre-intervention, 61.5% of prescribers used guidelines; post-intervention, 87.1% expressed willingness to use them.
- The study aimed to evaluate adherence to antimicrobial prescribing guidelines.
Conclusions:
- Facility adherence to antimicrobial guidelines was high at 86%.
- Educational interventions were conducted, but their impact on adherence was not fully assessed due to study time constraints.
Background:
In 2019, the Tuba City Regional Health Care Corporation on the Navajo Reservation in northeastern Arizona established facility-wide, evidence-based outpatient antimicrobial guidelines. We aimed to evaluate adherence to these guidelines.
Methods:
A retrospective chart review of the electronic health record for all ages was conducted from August 1, 2020, to August 1, 2021, to evaluate antimicrobials prescribed for indications covered by the facility prescribing guidelines. The appropriateness of the antimicrobial prescribed was assessed and reported as a percentage. An educational intervention and a survey were then distributed from March 2, 2022, to March 31, 2022, to all prescribers.
Results:
Overall adherence to prescribing guidelines over the period assessed was 86%, 4% short of the study goal of 90%. Before the educational intervention, 61.5% of prescribers used the prescribing guidelines to guide their antibiotic choice, while after the educational intervention, 87.1% of prescribers indicated a willingness to use the guidelines to guide their antibiotic choice.
Conclusions:
Adherence to the facility guidelines was already high at 86%. Educational interventions were performed but their efficacy could not be assessed within the time constraints of the study.
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