English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background Healthcare facilities without access to infectious diseases (ID) expertise may struggle to implement effective antibiotic stewardship programs. In August 2016, we launched a pilot project using the Veterans Affairs (VA) telehealth system to form a Videoconference Antimicrobial Stewardship Team (VAST) to connect a multidisciplinary team from a rural VA medical center with ID physicians at a remote site to support antibiotic stewardship. Here, we present preliminary outcomes summarizing antibiotic use at a rural VA medical center with 27 acute and 162 long-term care beds before and after the VAST implementation. Methods Weekly VAST meetings began in August 2016. Using VHA databases, we determined the agent days (number of days a patient received a particular agent), the antibiotic days (the number of days a patient received any antibiotic) and length of therapy. We compared the rates of agent days and antibiotics days per 1000 bed days of care (BDOC) in the pre- implementation (January 2016–July 2016) and post- implementation periods (September 2016–March 2017) for acute and long-term care units. Results In acute care, agent days, antibiotic days and length of therapy did not change notably after VAST implementation (table). For long-term care, agent days decreased by 45%, antibiotic days by 42% and length of therapy by 37%. Also, the ratio of agent days to antibiotic days reveals that in acute care patients received on average 1.5 antibiotics (pre- and during the VAST) compared with 1.2 (pre-VAST) and 1.1 (during the VAST) in long-term care. Acute Care Long-Term Care Outcomes Measures Pre-VAST VAST Reduction Pre-VAST VAST Reduction Agent Days/1000 BDOC 1008 996 12 (1%) 62 34 28 (45%) Antibiotic Days/1000 BDOC 653 644 9 (1%) 52 30 22 (42%) Mean Length of Therapy (days) 4.57 4.46 0.12 (3%) 8.93 5.60 3.33 (37%) Conclusion Weekly multidisciplinary VAST meetings led to decreased rates of antibiotic use and length of therapy in the long-term but not acute care units of a rural VA medical center. Reasons for these differences may relate to the long-term care setting, which is an environment that permits active monitoring off antibiotics. Other possible reasons include differences in patient acuity and provider practice patterns. Disclosures All authors: No reported disclosures.

At a Rural Veterans Affairs Medical Center, Telehealth Decreased Antibiotic Use in Long-Term, but not Acute Care