SmartSteward™’s real-time antibiogram from the facility identified isolates of carbapenem resistant Enterobacteriaceae (CRE) at the facility.
CRE cause serious infections including UTI infections, bloodstream infections, wound infections, and pneumonia.
The facility’s DON and physicians were notified about the CRE and acted to successfully prevent spread of infection.
SmartSteward™ EYE identified a new clone of ESBL in 4 separate patients in 2 wings was discovered.
Extended spectrum beta-lactamases (ESBLs) are caused by the overuse of Cephalosporins and Fluoroquinolones.
The SmartSteward™ EYE heat map function indicated patients were in close proximity and notified the facility DON.
SmartSteward™ reviewed and recommended actions to take, including suggesting potential sources, infection control practices, and guidance on future use of antibiotics.
SmartSteward™ EYE deployed a new algorithm for the detection of Carbapenem Resistant Pseudomonas (CRP) immediately identify and new CRP isolate in our pilot facility right after deployment.
Carbapenem Resistant Pseudomonas (CRP) occur in patients whose care requires devices like ventilators, urinary and intravenous catheters.
The lab report did not highlight this dangerous MDRO and no one at the facility was aware of its presence.
SmartSteward™ alerted the facility’s IPCO and medical director and sent guidance on isolation to prevent the spread of the CRP.
The facility contacted the testing lab to confirm the presence of the CRP and requested a retest which came back positive to the presence of this CRP isolate.
The facility was then able to isolate the patient to prevent the spread of this dangerous CRP.
Infections are one of the primary causes of rehospitalizations in SNFs.
Physicians are often offsite and lack information about the patient and their current condition.
SmartSteward™ allows for 24/7 surveillance of infections throughout the facility.
SmartSteward™ has a built-in communication tool that makes it easy to share information like labs, radiographic images and pictures.
Nurse was concerned about a patient with a left arm that was red, swollen, warm and tender to touch and alerted the doctor.
Doctor was not at the facility, lacked patient information and was inclined to readmit.
Nurse informed Doctor that patient had a left arm cephalic vein thrombosis before transfer from hospital.
Doctor requested more information from the nurse on current drug profile.
Nurse indicated no antibiotic treatment currently and sent a picture to attending physician.
Based on the image, doctor decided no antibiotics were needed and decided not to readmit the patient to hospital.
Communication between nurses and doctors is key to the successful management of infection events and challenging when doctors are frequently offsite.
Patient reassessment during antibiotic treatment is a critical element of antibiotic stewardship which is often neglected.
SmartSteward™ sets 24 to 72 hour timeout reminders to reassess with every antibiotic prescription.
SmartSteward™ automatically notifies nurses when it’s time to reassess the patient.
Nurse on day shift was concerned of patient’s altered mental status and used SmartSteward™ to reach out to the doctor who requested a urinary analysis.
Abnormal UA lab result was forwarded by nurse to doctor.
Doctor issued Rx Cefdinir 300 mg/5 days. Doctor also requested a 48 hr. reassessment.
Nurse on evening shift was sent reminder to reassessed at 48 hrs and found no change in patient’s condition and alerted doctor.
Doctor ordered a new urinanalysis which was positive.
Doctor discontinued cefdinir.
Started new prescription for optimal therapy – (Nitrofurantoin 100 mg/7 days).
Patient’s condition improved.
Change in Facility Resistance Patterns
Prescribing doctors often don’t have the right information in hand at the point of prescribing
Semi-annual antibiograms are outdated and difficult to interpret
Prescribing without the most up to date resistance patterns in the facility causes antibiotic resistance
The following resistance trend appeared at a facility
SmartSteward™ enables prescribers with real-time data at the point of prescribing
SmartSteward™’s customized real time antibiograms are easy to read and help prescribers optimize their prescribing
SmartSteward™’s feedback to physicians can change their prescribing habits and lower facility resistance
SmartSteward™ sent the following alert:
Notification to Facility: “Please note the rather dramatic drop in cephalosporin activity in recent cultures of gram negatives at Ayers. This is from just a few urine specimens but to prevent them from spreading I have asked Drs. Smith and Jones (via text) to avoid cephalosporin use for 6 weeks. Please note that Fosfomycin, Bactrim, and Macrodantin retain pretty good activity. This graph is on your ASP dashboard”.