elyse sincler ferris state university nurs 450. learn about the issue of antibiotic overuse and how...
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ANTIBIOTIC OVERUSE AND SUPERBUGS
Elyse SinclerFerris 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=rIfvLp1YHmE
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, 13Hart, A., Patti, A., Noggle, B., Haller-Stevenson, E., & Hines, L. (2008) Acute respiratory
infections and antimicrobial resistance. American Journal of Nursing, 108, 56-65Maslow, A. (1943). A theory of human motivation. Retrieved from:
http://psychclassics.yorku.ca/Maslow/motivation.htmNursing Theory (2013). Environmental Theory. Nursing Theory Retrieved from:
http://www.nursing-theory.org/theories-and-models/nightingale-environment-theory.php