Antibiotic Policy

Emergence of antibiotic resistance in pathogens is a global threat to human health and a matter of grave public health concern. Resistance of micro-organisms towards an antibiotic renders it ineffective in curing any disease caused by those organisms. Some micro-organisms develops resistance to a wide range of antibiotics including even to newer and more potent antibiotics such as Carbapenems, making treatment of patient difficult, costly and sometimes impossible.  Due to this antibiotic resistant micro-organisms leads to increased mortality, morbidity and healthcare costs.  

A major reason of emergence of antibiotic resistant strains of micro-organism is indiscriminate and irrational use of antibiotics. It is estimated 50% of antibiotic usage in Indian hospitals are inappropriate and irrational. Hence, there is an urgent need that hospitals formulate and implement appropriate Antibiotic Policy that ensures rational use of antibiotics and prevent any indiscriminate use.  This post describes how should be a hospital’s Antibiotic Policy and what should it contain.

Antibiotic Policy serves as a guideline for doctors to decide which antibiotic shall be used for treating a specific infectious condition. It also states practices that must be followed while using Antibiotics on patients. The antibiotic policy must ideally be developed collaboratively. Pharmacotherapeutic committee or the Infection control committee can take a lead role in formulation of this policy, with inputs from all clinical departments.

An antibiotic policy must include following sections

Standard Precautions for Infection Control in Hospitals

Standard precautions are the basic infection control practices which must be adhered to while caring any patient in hospital. If fully implemented, standard precaution can drastically reduce the risk of infection to healthcare providers and patients. They are minimum level of precaution and may not be sufficient for special situations which requires special precautions. As these precautions should be taken in all kinds of patient care process they are also called as universal precautions.

Elements of standards precautions are as follows

      

Quiz 3 – Infection Control

1.       Which Patient shall be placed in a ‘negative pressured room’, to prevent transmission of the patient’s infection to others?

a.  An HIV +ve patient                                            

b. Patient suffering from infection that can be transmitted through airborne route

c. Patient suffering from infection that can be transmitted through ‘droplet’ route

d. All of the above patients

Infection control care bundles

Care bundles is an effective way of preventing healthcare associated bundles (HAI) amongst high risk patients. A ‘bundle’ is a set of practices that, when performed collectively, reliably and continuously, have been proven to improve patient outcomes. While there are care bundles for various clinical care processes, it is very popularly used in prevention of HAIs. Care bundles for preventing common HAIs are given below (Reference – WHO and CDC guidelines)

Infection control checklist for NABH accreditation preparation

Healthcare Associated Infections (HAI) can easily qualify as the most important patient safety concerns in hospitals. To address the menace of HAI, infection control is kept as one of the main objectives, while designing any healthcare delivery structure, policies and processes. Almost all activities that are done within hospital has a bearing on infection control and there are a large number of studies that has resulted in various good practices for controlling infections. NABH has also dedicated a full chapter on Infection Control, while standards and objective elements under various other chapters also incorporates infection control aspects in it. A list of all infection control measures, grouped under appropriate heading is given below for hospitals to keep a check on.

CASE STUDY - The Operational riddle of a health insurance company

(This case study can be used for quantitative reasoning ability for healthcare managers. It is based on price decision of a health insurance product.)

Background situation

‘Health4all’ a health insurance company, discovered a town in sub-urban area with a population of 1 lac people. They found that no health insurance company has so far tapped this area and a significant number of people are desirous of buying a health insurance product. Buoyed by the business opportunity, the CEO asked the operations head to start working on selling your insurance plan here, with a clear stated objective of maximizing profit.

As an operations head you made all arrangement to launch your flagship health insurance policy in the town, which gives the customer a cover of 1 lac rupees for a premium of Rs. 1000/-. Customer have to undergo a health check-up (paid by the company) to determine any pre-existing diseases. Company doesn’t pay for the treatment of pre-existing diseases found in health check-up.