The Strengthening Antimicrobial Stewardship for Skilled Nursing Facilities Program is an initiative of the Fairfax County Health Department in collaboration with the Virginia Department of Health. This program seeks to support skilled nursing facilities in the Fairfax Health District. We also are available to consult with other health districts in Virginia (contact taylor.crosby@fairfaxcounty.gov), and all program strategies and materials are freely available for use. Program components include:
Strengthening infrastructure, capabilities, and effectiveness of facility-based antimicrobial stewardship programs
Improving diagnostic and antimicrobial stewardship for commonly occurring infections through:
Improving assessment of residents with suspected infection
Reducing use of cultures when not necessary
Improving prescribing practices
Implementing systematic antibiotic time-outs
Educating prescribers and nursing staff
Educating and providing materials for residents and family members
Monitoring antimicrobial use and using quality improvement approaches to increase impact
Seeking to support skilled nursing facilities in the Fairfax Health District to improve antimicrobial use practices
Importance
Antimicrobial resistance happens when germs like bacteria and fungi develop the ability to defeat the drugs designed to kill them. Resistant infections can be more difficult to treat, leading to longer hospitalizations and more deaths. Addressing this threat requires continued aggressive action to:
Prevent infections in the first place
Improve antimicrobial use to slow the development of resistance
Stop the spread of resistance when it does develop
If antimicrobials lose their effectiveness, then we lose the ability to treat infections and control these public health threats.
Benefits
Stewardship improves outcomes for residents. It also prevents both the development of antimicrobial resistant bacteria and the replacement of normal bacteria with those that may cause infections.
This program helps facilities:
Increase resident safety by appropriately treating true infections while avoiding antibiotic side effects
Reduce the risk of drug resistant infection and multi-drug resistant organism outbreaks
Strengthening Antimicrobial Stewardship in Skilled Nursing Facilities Program
The SASS program is a collaboration between the Fairfax County Health Department and the Virginia Department of Health (VDH) to improve antimicrobial use practices at Fairfax County skilled nursing facilities. The program, with funding from VDH, is projected to last through July 2027.
The Health Department will provide facilities with individual, tailored, consultation and support to build an antimicrobial stewardship program, including:
Guidance for facility antimicrobial stewardship team leaders
Sharing materials and resources, including those from CDC and VDH
Building capacity to measure antimicrobial use
Supporting development and implementation of interventions to improve antimicrobial use practices
Skilled nursing facilities participate in two ways. Advance to learn more about:
Tier 1 – Program Strengthening
Tier 2 – Quality Improvement Collaborative
This program is designed for all skilled nursing facilities.
Support facility in achieving self-identified antimicrobial stewardship program strengthening goals
Strengthen antibiotic tracking and use of data to improve stewardship
Provide education and materials to support stewardship activities
Facilities participating in the collaborative use quality improvement approaches to improve diagnostic and antimicrobial stewardship for common infection types. The initial focus is on urinary tract infections (UTIs), the most frequent reason for antimicrobial use in older adults.
Improve diagnostic and antimicrobial stewardship for UTIs by:
Improving nursing assessment of residents with suspect UTI and communication with prescribers
Providing guidelines for more judicious ordering of urinalysis and culture
Following guidance for selection of antibiotic drug and duration
Reassessing antibiotic use at 48-72 hours based on lab test results and clinical course
Monitor data to assess impact on diagnosis and treatment
Identify challenges, explore root causes, develop and implement improvement strategies, and measure impacts
Share with and learn from peers
Leadership commitment: Demonstrate support and commitment to safe and appropriate antibiotic use in your facility
Accountability: Identify physician, nursing and pharmacy leads responsible for promoting and overseeing antibiotic stewardship activities in your facility
Drug expertise: Establish access to consultant pharmacists or other individuals with experience or training in antibiotic stewardship for your facility
Action: Implement at least one policy or practice to improve antibiotic use
Tracking: Monitor measures such as adherence to guidelines for assessment and diagnostic testing, and rates of antibiotic use and resistance
Reporting: Provide regular feedback on tracked measures to prescribers, nursing staff, and facility leadership
Education: Provide resources to clinicians, nursing staff, residents and families about antibiotic resistance and opportunities for improving antibiotic use
The Strengthening Antimicrobial Stewardship for Skilled Nursing Facilities Program is an initiative of the Fairfax County Health Department in collaboration with the Virginia Department of Health. This program seeks to support skilled nursing facilities in the Fairfax Health District. We also are available to consult with other health districts in Virginia (contact taylor.crosby@fairfaxcounty.gov), and all program strategies and materials are freely available for use. Program components include: