ANTIBIOTIC OVERUSE AND SUPERBUGS

Elyse SinclerFerris State University

NURS 450

OBJECTIVES

Learn about the issue of antibiotic overuse and how it is related to superbugs.

Identify 2 relevant theories related to antibiotic overuse and superbugs.

Learn how antibiotic overuse is relevant to nursing

Walk through a Root Cause Analysis Look at inferences and implications of

antibiotic overuse Identify quality and safety improvements using

the ANA standards and QUSEN competencies

Classifications of Antibiotics

Penicillins Cephalosporins Tetracyclines Macrolides Aminoglycosides Fluroquinolones Sulfonamides Miscellaneous

The Facts

Effects of antibiotic over use What does it mean to be antibiotic resistant Clostridium difficile Nosocomial infections

What the numbers show Number of people who contract antibiotic

resistant bacteria Number of people who die Increase in cost

More Facts

Rate that antibiotics are created compared to the rate of resistance in bacteria

From the CDC

http://www.youtube.com/watch?v=rIfvLp1YHmE

Major Superbugs

Clostridium difficile MRSA – Methicillin resistant staphylococcus aureus VISA – Vancomycin intermediate resistant staphyloccus

aureus VRE – Vancomycin resistant enterococci ESBL – Extended spectrum beta lactamases CRE – Carbapenem-resistant Enterobacteriaceae Erythromycin resistant staphylococcus aureus Clindamycin resistatnt staphylococcus aureus Strephtococcus Pneumoniae – drug resistatn Myobacterium tuberculosis Neisseria gonorrhoeae – drug resistant AND MANY MORE!

THEORIES

Nursing Theory Florence Nightingale – Environmental Theory

Psychology Maslow Hierarchy of needs

ROOT CAUSE ANALYSIS

Jamie Robinson a 83 year old women went into see her primary care physician after not felling well for a few days. She complained of fever, sore throat, head and body aches. After a brief exam by the physician she was diagnosed with strep throat, prescribed Penicillin, and sent home. A few days later, Jamie still not feeling better called the office requesting another antibiotic. The physician authorized a script for cephalexin, but just a few days later Jamie called the office a second time still having symptoms, and she was prescribed Biaxin. Four days after starting the third antibiotic and over a week after starting the first Jamie went into the emergency room with complaints of frequent watery diarrhea, abdominal pain, and fever for over a day. Jamie was diagnosed with Clostridium difficile and was admitted due to extreme dehydration. A strep test while in the emergency room came back negative. Two days later Jamie passed away.

INFERENCES & IMPLICATIONS

Fighting against antimicrobial resistance Prevention Education Monitor Collaboration

People at high risk

Get Smart Program

Safety

QUALITY AND SAFETY American Nurses Association

Standard 1 Assessment

Standard 8 Education

Standard 13 Collaboration

QSEN Teamwork and Collaboration Quality improvement Evidence Based Practice

QUESTIONS?

REFERENCES

Adams, M. and Holland, L. (2011). Pharmacology for Nurses. New Jersey: Pearson Education, Inc.

American Nurses Association (2010). Scope and Standards of Practice: Nursing. Silver Spring, MD: Author.

Bartelt, D. (2014). Antibiotic-resistant pathogens: a future at risk. The Nurse Practitioner, 39, 19-21

Centers for Disease Control and Prevention (2013). Antibiotic resistance threats in the united states, 2013. http://www.cdc.gov/drugresistance/threat-report-2013/index.html

Centers for Disease Control and Prevention (2014). Making health care safer. Vital signs. http://www.cdc.gov/vitalsigns/antibiotic-prescribing-practices/index.html

Colatrella, S., Claire J. (2014) Adapt of perish – a relentless fight for survival. Critical Care Nursing Quarterly, 37, 251-267

Cronenwett, L., Sherwood, G., Barnsteiner J., Disch, J., Johnson, J., Mitchell, P., Sullivan, D., Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3)122-131. Retrieved from: http://qsen.org/competencies/pre-licensure-ksas/

Fraser, K. (2009). Multi-drug resistant organisms sup-bugs on the prowl. The Dissector, 37, 26,29,31,33

Hart, A. (2006). Against antibiotic overuse. American Journal of Nursing, 106, 13Hart, A., Patti, A., Noggle, B., Haller-Stevenson, E., & Hines, L. (2008) Acute respiratory

infections and antimicrobial resistance. American Journal of Nursing, 108, 56-65Maslow, A. (1943). A theory of human motivation. Retrieved from:

http://psychclassics.yorku.ca/Maslow/motivation.htmNursing Theory (2013). Environmental Theory. Nursing Theory Retrieved from:

http://www.nursing-theory.org/theories-and-models/nightingale-environment-theory.php