Table 9.

Core elements of hospital antibiotic stewardship programs in hospitals, 2022.

Category	Questions	Responses
		FHCSH		TGSH
		Yes	No	Yes	No
Leadership support and commitment	1.Does your facility have a formal, written statement of support from leadership that supports efforts to improve antibiotic use (ASP)?	✓		✓
	2.Does facility leadership provide stewardship program leader(s) dedicated time to manage the program and conduct daily stewardship interventions?		✓	✓
	3.Does facility leadership provide stewardship program leader(s) any budgeted financial support including for resources (e.g., IT support, training) to effectively operate the program?		✓		✓
	4.Does your facility demonstrate leadership support for antibiotic stewardship?		✓		✓
	5.Does your ASP have a senior executive that serves as a point of contact or “champion” to help ensure the program has resources and support to accomplish its mission?	✓			✓
	6.Do stewardship program leader(s) have regularly scheduled meetings with facility leadership and/or the hospital board to report and discuss stewardship activities, resources and outcomes?		✓		✓
	7.Does your facility leadership ensure that staff from key support departments and groups has sufficient time to contribute to stewardship activities?		✓		✓
	8.Does facility leadership ensure that ASP activities are integrated into other quality improvement and patient safety efforts, such as sepsis management and diagnostic stewardship?		✓		✓
Accountability	9.Does your facility have a leader or co-leaders responsible for program management and outcomes of stewardship activities?	✓		✓
	10.Is there a pharmacist or microbiologist or infectious disease specialist, leader responsible for working to improve antibiotic consumption for working to improve antibiotic use at your facility?	✓		✓
	11.Does your facility have a pharmacist member/leader responsible for program outcomes of stewardship activities at your facility?	✓		✓
Drug Expertise	13.Does your facility have a pharmacist(s) responsible for leading implementation efforts to improve antibiotic use?	✓		✓
	14.Do your pharmacist(s) leading implementation efforts have specific training and/or experience in ASP?	✓		✓
	15.Does your facility have access to individual(s) with ASP expertise?		✓		✓
Action: Implement ASP And improve antibiotic consumption	16.Does your facility perform prospective audit and feedback for specific antibiotic agents?		✓		✓
	17.Does your facility perform preauthorization for specific antibiotic agents?	✓			✓
	18.Does your facility have facility-specific treatment recommendations, based on national guidelines and local pathogen susceptibilities, to assist with antibiotic selection for common clinical conditions?		✓	✓
	19.Does your facility have specific interventions to ensure optimal use of antibiotics for treating the most common infections in most hospitals?		✓	✓
	20.Does your facility have specific interventions in place to ensure optimal use of antibiotics in specific infection/disease situations?		✓	✓
	21.Does your facility have a policy that requires prescribers to document in the medical record or during order entry a dose, duration and indication for all antibiotic prescriptions?	✓		✓
	22.Does your facility have a formal procedure for all prescribers to conduct daily reviews of antibiotic selection until a definitive diagnosis and treatment duration are established?		✓		✓
	23.Does your ASP assess how often patients are discharged on the correct antibiotics for the recommended duration?		✓		✓
	24.Does your ASP track antibiotic resistance?		✓		✓
	25.Does your facility have policies to improve antibiotic prescribing/use?		✓		✓
	26.Does your facility implemented practices to improve antibiotic consumption?		✓		✓
Action: Tracking	27.Does your ASP track antibiotic use?	✓		✓
	28.Does your ASP monitor prospective audit and feedback interventions by tracking the types of interventions and acceptance of recommendations?		✓	✓
	29.Does your ASP monitor preauthorization interventions by tracking which agents are being requested for which conditions?	✓			✓
	30.Does your ASP monitor adherence to facility specific treatment recommendations?		✓		✓
	31.Does your ASP monitor adherence to a documentation policy (dose, duration and indication)?		✓	✓
	32.Does your ASP monitor the performance of antibiotic timeouts to see how often these are being done and if opportunities to improve use are being acted on during timeouts?		✓		✓
	33.Does your ASP routinely perform medication use evaluations to assess courses of therapy for select antibiotics and/or infections to identify opportunities to improve use?	✓		✓
	34.Does your ASP routinely perform medication use evaluations to assess courses of therapy for select antibiotics and/or infections to identify opportunities to improve use?	✓		✓
	35.Does your ASP assess how often patients are discharged on the correct antibiotics for the recommended duration?		✓		✓
	36.Does pharmacist/s support ASP activities?	✓		✓
	37.Does your facility monitor one or more measures of antibiotic consumption?	✓		✓
	38Does your facility monitor one or more outcomes of antibiotic consumption?		✓		✓
Reporting	39.Does your ASP share facility and/or individual prescriber-specific reports on antibiotic use with prescribers?		✓		✓
	40.Does your ASP report adherence to treatment recommendations to prescribers?	✓		✓
	41.Has your facility distributed a current antibiogram to prescribers within 18–24 months?		✓		✓
Education	42.Does your ASP provide education to prescribers and other relevant staff on optimal prescribing, adverse reactions from antibiotics, and antibiotic resistance?		✓		✓
	43.Does your ASP provide education to prescribers as part of the prospective audit and feedback process?		✓		✓
	44.Does your ASP provide educational resources/materials on antibiotic resistance and opportunity to improve antibiotic consumption?		✓	✓
Additional Questions on ASP Challenges	45.Are there areas of antibiotic misuse in your facility?	✓		✓
	46.Are there barriers to starting the ASP?		✓		✓

Abbreviations: FHCSH-Felege Hiwot Comprehensive Specialized Hospital; TGSH-Tibebe Ghion Specialized Hospital.