Making It Work:
How to Avoid the Harms of Antibiotic Overuse
The “Making It Work” column provides additional information to help facility leaders implement effective strategies and
achieve project goals to reduce HAIs/CAUTI and improve resident safety culture.
Training Module #4 includes information on reasons to avoid antibiotic overuse, communication strategies to encourage
antibiotic alternatives with providers, residents and family, and education for all staff about the importance of avoiding
antibiotic overuse. Below are some additional ideas to keep staff engaged and excited about learning how to reduce
antibiotic overuse to prevent CAUTIs and other HAIs.
1. Conduct a baseline assessment. Use the CDC’s The Core Elements of Antibiotic Stewardship for Nursing Homes
Checklist to conduct a baseline assessment of policies and practices in your facility. Identify activities for each
element and implement small tests of change to improve over time. The core elements include leadership
support, accountability, drug expertise, actions to improve use, tracking antibiotic use, education and reporting
information to staff on improving antibiotic use and resistance.
2. Share evidence-based practices. Use evidence-based materials to engage professionals responsible for ordering
antibiotics. Ask the medical director, admitting physicians, nurse practitioners and physician assistants to
participate in antibiotic stewardship efforts. Share the CDC’s Get Smart: Know When Antibiotics Work web page.
Use CDC’s The Core Elements of Antibiotic Stewardship for Nursing Homes and AHRQ’s Nursing Home
Antimicrobial Stewardship Modules to expand your antimicrobial program. Partner with antibiotic stewardship
program leaders at hospitals and in the community and share your facility’s efforts to reduce antibiotic overuse.
3. Create a recognition program. Acknowledge physicians and staff who demonstrate support and interest in
reducing antibiotic overuse during staff meetings, huddles and/or rounds. Include stories of how antibiotics
were avoided due to the application of appropriate criteria for antibiotic use.
4. Practice teamwork and communication strategies. Schedule practice sessions with staff to learn the
TeamSTEPPS techniques “SBAR” and “CUS”. Provide staff with a resident scenario and ask staff how they would
use SBAR to communicate a recommendation for or against antibiotic use. Encourage staff to use the CUS
technique when they need to report a potential resident safety situation. Reinforce the importance of open
communication and teamwork among all staff when addressing opportunities to promote antibiotic
stewardship.
5. Engage residents and families. Schedule time at the next resident and family council meeting to distribute and
discuss the CDC’s What You Need to Know About Antibiotics in a Nursing Home brochure. Review signs and
symptoms of urinary tract infections, when antibiotics are not helpful and how residents and family members
can talk with their doctor or nurse about the benefits and harms of antibiotics.
Resources/Tools
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Training Module #4: How to Avoid the Harms of Antibiotic Overuse
Take the Pledge Tool
TeamSTEPPS for Long-term Care
Nursing Home Antimicrobial Stewardship Modules (AHRQ)
Get Smart About Antibiotics: Resources for Health Care Professionals (CDC)
The Core Elements of Antibiotic Stewardship for Nursing Homes (CDC)
When Do You Need An Antibiotic? brochure (HRET)
Antibiotic Resistance poster (WHO)