Incorporating pharmacy student activities into an antimicrobial stewardship program in a long-term acute care hospital

Abstract

Purpose: The impact on antimicrobial costs of an antimicrobial stewardship program (ASP) that integrated pharmacy students as integral members was evaluated.

Methods: Demographic and discharge disposition data and antimicrobial acquisition cost data were retrospectively collected for all patients admitted to Promise Hospital of Salt Lake between June 1, 2009, and May 31, 2012. During this study, the primary role of pharmacy students in the ASP was to monitor all infection-related patient problems in the facility and meet daily with the infectious diseases pharmacist and clinical pharmacist to develop recommendations for optimizing antimicrobial use. The primary outcome measure was the mean antimicrobial acquisition cost per patient per day, calculated before ASP implementation (baseline period) and two years after ASP implementation (intervention period). The acquisition costs of antimicrobial agents per patient day were compared before and two years after implementation of the ASP involving pharmacy students. Statistical significance was determined using Student's t test for continuous data and the chi-square test for nominal data.

Results: The rate of patient discharge to skilled nursing facilities was significantly higher during the intervention period versus the baseline period (p = 0.016); no other significant comparisons were found. The mean ± S.D. antimicrobial costs per patient day were $75.37 ± $11.85 in the baseline period and $64.13 ± $13.78 in the intervention period (p = 0.022). This difference represents a cost savings of $261,630 during the two-year intervention period.

Conclusion: Decreased antimicrobial costs were observed over a two-year period after implementation of an ASP that incorporated pharmacy students as integral members of the program.