According to the Centers for Disease Control and Prevention (CDC), antibiotics are among the most frequently prescribed medications in nursing homes, with up to 70 percent of residents in a nursing home receiving one or more courses of systemic antibiotics when followed over a year. Additionally, the CDC reports that studies have shown that 40 percent to 75 percent of antibiotics prescribed in nursing homes may be unnecessary or inappropriate.

In 2018, the New England Quality Innovation Network-Quality Improvement Organization (QIN-QIO)—which serves the states of Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island and Vermont—partnered with the Massachusetts Department of Public Health (DPH) to improve antibiotic stewardship and infection control in nursing homes throughout the state of Massachusetts.

The QIN-QIO and DPH developed a no-cost educational webinar series called “Navigating Infection Control and Antimicrobial Stewardship in Long-Term Care.” Hosted monthly for infection prevention specialists in nursing homes, the webinars featured subject matter experts from Tufts Medical Center as speakers. The series consisted of nine, hour-long webinars on varied topics, including infection control and antimicrobial stewardship, surveillance and monitoring, strategies for implementation, and prevention and management.

“In this ever-changing environment with new changes that seem to happen daily, it is nice to have a knowledgeable source that you can count on to have the latest up-to-date information.”

To supplement the virtual series, the New England QIN-QIO held “Ask the Expert” calls with the experts from Tufts. These quarterly calls served as an extended Q&A session on the webinar topics and offered an opportunity to discuss overcoming barriers. The New England QIN-QIO is in the process of converting the sessions into virtual learning modules so that nursing home staff can access and use them in the future.

Jan Tomachick, Director of Nursing at Broad Reach Healthcare-Liberty Commons in Massachusetts, led an initiative with the Infection Control team and medical staff to prevent the transmission of Clostridium difficile spores in the facility, supported by technical support, education, and new tools from the New England QIN-QIO. “In this ever-changing environment with new changes that seem to happen daily, it is nice to have a knowledgeable source that you can count on to have the latest up-to-date information,” said Tomachick.

Based on positive feedback from the first virtual series, the New England QIN-QIO’s educational program will continue in 2019, with the addition of prescriber and pharmacy-specific webinars. Including these stakeholders is an important next step as the QIN-QIO recognizes that adequately addressing the antimicrobial stewardship issue requires educating multiple stakeholders.