Antimicrobial Stewardship (AMS)
AMS is a term used to describe a variety of clinical interventions where the sole purpose is to improve and measure the appropriate use of antimicrobial agents (e.g. antibiotics, antifungals, antivirals). Bacterial resistance and adverse effects from antimicrobials are growing concerns in the general public and health care systems nation-wide. We are losing our antimicrobials to multi-drug resistant bugs.
Not only do we need to change prescribing practices to minimize unnecessary or excessive antimicrobial exposure for the sake of our patients, we need to be responsible for our own health and that of our families in the future (when antibiotics might be needed). We also want to reduce adverse events such as C. difficile infection.
NH AMS Program Goal
To improve patient care related to antimicrobial use in all NH facilities through collaboration with healthcare providers in order to:
- Successfully treat infections
- Reduce inappropriate antimicrobial use
- Minimize toxicities and adverse events
- Limit selection of antimicrobial resistant strains
NH AMS Program Background
Northern Health’s Antimicrobial Stewardship (AMS) Program development began in November 2014. Research was done to find out what was happening within BC as well as across Canada with regards to the development and operations of an AMS program within the acute care setting. A case was built based on the standards set by Accreditation Canada and the structure of Northern Health. Resource allocation was granted in October 2015 for a full time pharmacist lead (the AMS program Coordinator), data analyst support and a 0.4 FTE equivalent Medical Co-lead position with shared interest between the AMS program and the Infection Prevention and Control (IPC) program.
In the beginning an AMS working group was established with interdisciplinary and regional representation to help guide and support the lead pharmacist in establishment of the framework for the AMS program. Now the AMS working group has become a permanent committee under the NH Medication Safety and Quality Committee and as the AMS Subcommittee. The position of Medical co-Lead for the AMS program and IPC was filled by our infectious disease expert Dr. Abu Hamour in March 2017. Plans for collaborative work with the co-leads will be commencing in quarter 1 of the 2017/18 FY.
The AMS program is fortunate to have the opportunity to collaborate with the Infection Prevention and Control Program lead by Regional Manager, Deanna Hembroff. Discussions between the co-leads have commenced and plans for staff education and quality improvement have begun. Readers will be able to find on the AMS page information relating to infection prevention reporting, accreditation, and online resources.
Alicia Rahier, BSc. Pharm. ACPR
NH AMS Program Coordinator
Dr. Abu Hamour, MBBS, MSc, DTM&H, MRCP(UK), CCST (UK), FRCP (Edin), FRCPC
Internal Medicine, Infectious Disease Specialist, AMS Medical Co-Lead
Regional Manager, Infection Prevention & Control Program
- Clostridium Difficile infection treatment for adult inpatients
- Adult Sepsis
- Adult Febrile Neutropenia
- Community Acquired Pneumonia
- Initiation of Aminoglycosides for Adult Inpatients
- Initiation of Vancomycin for Adult Inpatients
- IV Antimicrobial Therapy for Outpatients and Home IV
- COPD Acute Exacerbation - Admission Orders
- COPD Acute Exacerbation - 48 hours after admission
- COPD Acute Exacerbation -Discharge Orders
- Oseltamivir for Influenza Outbreak Declared by Medical Health Officer
- Antibacterial Dosing Guidance from BC Children's Hospital
- Antimicrobial Stewardship Program adult dosing guidelines
- Empiric Treatment Guidelines for Common Infections in Adults
- NH Antibiogram
- BC Children’s and Women’s Antimicrobial Guidelines
- Association for Medical Microbiology and Infectious Disease of Canada (Canadian)
- Bugs & Drugs book (Canadian)
- BC Centre for Disease Control (Canadian)
- Centre for Disease Control (American)
- Infectious Disease Society of America (American)
- OurNH Infection Prevention and Control page (to view this page you must log in using your NH username and password)
The Antimicrobial Stewardship Program has two courses (Urinary Tract Infections and Pneumonia) available on the Learning Hub platform. Each course consists of 3 modules that should take approximately 20 to 30 minutes to complete.
The courses provide a general overview of the pathophysiology, common causative pathogens, signs/symptoms, as well as how and when to treat these conditions. Course content incorporates NH-specific information on antimicrobial susceptibilities as per the current NH antibiogram, and there are links to additional AMS resources as well.
Courses searchable as "NHA – AMS – Urinary Tract Infections" and "NHA – AMS – Pneumonia".
Smart Phone Applications
At this time NH does not have resources available to provide this application with NH specific data, however the application is free to download and users may choose any of the institutions currently providing information, including Providence Health and Fraser Health.
- 2019-2020 Mid-year report (unavailable)
- 2018-2019 Mid-Year Report (unavailable)
- 2017-2018 Mid-Year Report