Importance of Communication about Antibiotic Use

Susanne Salem-Schatz, Sc. D.

Collaborative Director

Massachusetts Coalition for the Prevention of Medical Errors

Communication about medications on transitions of care

What “Receivers” Want to Know*

    indication     dose start and end date     date and time of last dose     heads-up re potential adverse effects     pre-admission med list     current active med list pending lab tests

*Adapted From Terrance O’Malley, MD

April 25, 2012

In your handouts: a good place to start

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Cross-facility teamwork

Resources in your facility and partners: C. difficile prevention partnership collaborative

team leaders in hospitals and long term care facilities

STate Action on Avoidable Rehospitalizations (STAAR) team in hospitals and long term care facilities

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Communication about antibiotics with Residents and Families

Did you ever have a time when:

You didn’t think antibiotics were the best answer, but you prescribed them (or called the request in to the provider) What happened? So what?

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Now what?

Hippocrates or Nike?

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Persuasive Communication “Tips”

Provide reassurance Engage families /residents in conversation Establish Credibility Brief Graphic Printed Materials Offer Practical Alternatives Keep it simple

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Provide Reassurance

What do you do?

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Establish Credibility

Refer to credible sources of data Centers for Disease Control (CDC) Federal Drug Administration (FDA Published literature

Refer to credible individuals Their physician or nurse practitioner

If you have changed your thinking share how you changed your mind

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Reference experts to enhance credibility

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Engage in conversation

Put yourself in their shoes Address common myths

Reference with evidence Let them know there is a plan, even if

antibiotics aren’t the answer.

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The power of caring

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Brief Graphic Printed Materials

Use educational materials to reinforce your points

Point to key messages as you talk

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Practical Alternative?

Watch closely for new symptoms

Increase fluids Monitor I/0 Check vital signs more

frequently

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Keep it simple

Keep it simple--try to get across only a few major points

Use the power of metaphor Give yourself a script / practice

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Next Steps

TODAY : Practice AT WORK:

Share with your colleagues (MD/NP, RN) Think small tests of change

Try it, tweak it, try it again, share and expand Make notes for your script, your pamphlet

TELL US WHAT HAPPENED Let’s learn together. What did you change? What worked best

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Time to Practice

You are:The daughter of a resident at the Pleasant Valley skilled

nursing facility. You notice that your mother’s behavior is a little “off” and think it is probably because of a UTI (she has had them before)

ORThe nurse making rounds at the beginning of the evening

shift. This resident had been discussed at the change of shift report. Mild mental status changes, weakness, fatigue, and general malaise were observed with no no symptoms of UTI

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Upcoming Events

May 16 (if you have colleagues who couldn’t attend today) April 30th 8AM-Noon, Newton MA Repeated May 16 8AM-Noon, Sturbridge MA

Ask the expert Focus on Diagnosis and Treating UTI Communication strategies to promote appropriate medication use

June 22nd C. Difficile Prevention Partnership Collaborative Learning and Sharing Workshop

Learn additional strategies for C. diff prevention from local and national experts, and your Massachusetts colleagues.

Contact Fiona Robertsfroberts@macoalition.org

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