ANTIBIOTIC OVERUSE AND SUPERBUGS Elyse Sincler Ferris State
ANTIBIOTIC OVERUSE AND SUPERBUGS Elyse Sincler Ferris State University NURS 450
OBJECTIVES � � � Learn about the issue of antibiotic overuse and how it is related to superbugs. Identify 2 relevant theories related to antibiotic overuse and superbugs. Learn how antibiotic overuse is relevant to nursing Walk through a Root Cause Analysis Look at inferences and implications of antibiotic overuse Identify quality and safety improvements using the ANA standards and QUSEN competencies
Classifications of Antibiotics � � � � Penicillins Cephalosporins Tetracyclines Macrolides Aminoglycosides Fluroquinolones Sulfonamides Miscellaneous
The Facts � Effects of antibiotic over use � What does it mean to be antibiotic resistant � Clostridium difficile � Nosocomial infections � What the numbers show Number of people who contract antibiotic resistant bacteria Number of people who die Increase in cost
More Facts � Rate that antibiotics are created compared to the rate of resistance in bacteria � From the CDC � http: //www. youtube. com/watch? v=r. Ifv. L p 1 YHm. E
Major Superbugs � � � Clostridium difficile MRSA – Methicillin resistant staphylococcus aureus VISA – Vancomycin intermediate resistant staphyloccus aureus VRE – Vancomycin resistant enterococci ESBL – Extended spectrum beta lactamases CRE – Carbapenem-resistant Enterobacteriaceae Erythromycin resistant staphylococcus aureus Clindamycin resistatnt staphylococcus aureus Strephtococcus Pneumoniae – drug resistatn Myobacterium tuberculosis Neisseria gonorrhoeae – drug resistant AND MANY MORE!
THEORIES � Nursing Theory � Florence � Nightingale – Environmental Theory Psychology � Maslow Hierarchy of needs
ROOT CAUSE ANALYSIS Jamie Robinson a 83 year old women went into see her primary care physician after not felling well for a few days. She complained of fever, sore throat, head and body aches. After a brief exam by the physician she was diagnosed with strep throat, prescribed Penicillin, and sent home. A few days later, Jamie still not feeling better called the office requesting another antibiotic. The physician authorized a script for cephalexin, but just a few days later Jamie called the office a second time still having symptoms, and she was prescribed Biaxin. Four days after starting the third antibiotic and over a week after starting the first Jamie went into the emergency room with complaints of frequent watery diarrhea, abdominal pain, and fever for over a day. Jamie was diagnosed with Clostridium difficile and was admitted due to extreme dehydration. A strep test while in the emergency room came back negative. Two days later Jamie passed away.
INFERENCES & IMPLICATIONS � Fighting against antimicrobial resistance Prevention Education Monitor Collaboration � People at high risk � Get Smart Program � Safety
QUALITY AND SAFETY � American Nurses Association � Standard 1 Assessment � Standard 8 Education � Standard 13 Collaboration � QSEN � Teamwork and Collaboration � Quality improvement � Evidence Based Practice
QUESTIONS?
REFERENCES Adams, M. and Holland, L. (2011). Pharmacology for Nurses. New Jersey: Pearson Education, Inc. American Nurses Association (2010). Scope and Standards of Practice: Nursing. Silver Spring, MD: Author. Bartelt, D. (2014). Antibiotic-resistant pathogens: a future at risk. The Nurse Practitioner, 39, 19 -21 Centers for Disease Control and Prevention (2013). Antibiotic resistance threats in the united states, 2013. http: //www. cdc. gov/drugresistance/threat-report-2013/index. html Centers for Disease Control and Prevention (2014). Making health care safer. Vital signs. http: //www. cdc. gov/vitalsigns/antibiotic-prescribing-practices/index. html Colatrella, S. , Claire J. (2014) Adapt of perish – a relentless fight for survival. Critical Care Nursing Quarterly, 37, 251 -267 Cronenwett, L. , Sherwood, G. , Barnsteiner J. , Disch, J. , Johnson, J. , Mitchell, P. , Sullivan, D. , Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3)122 -131. Retrieved from: http: //qsen. org/competencies/pre-licensure-ksas/ Fraser, K. (2009). Multi-drug resistant organisms sup-bugs on the prowl. The Dissector, 37, 26, 29, 31, 33 Hart, A. (2006). Against antibiotic overuse. American Journal of Nursing, 106, 13 Hart, A. , Patti, A. , Noggle, B. , Haller-Stevenson, E. , & Hines, L. (2008) Acute respiratory infections and antimicrobial resistance. American Journal of Nursing, 108, 56 -65 Maslow, A. (1943). A theory of human motivation. Retrieved from: http: //psychclassics. yorku. ca/Maslow/motivation. htm Nursing Theory (2013). Environmental Theory. Nursing Theory Retrieved from: http: //www. nursingtheory. org/theories-and-models/nightingale-environment-theory. php
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