1869. Telepharmacy Support of an Antimicrobial Stewardship Program in a Small Rural Canadian Acute Care Hospital
Bibliographic record
Abstract
In 2013 Accreditation Canada identified an Antimicrobial Stewardship Program (ASP) as a Required Organizational Practice in all acute care hospitals. A successful antimicrobial stewardship program is interdisciplinary and involves clinical pharmacists as a key member of the team. This small rural acute care hospital utilizes a telepharmacy model of care with a remote clinical pharmacist. This hospital is a 20-bed acute care hospital with no on-site clinical pharmacist and has been utilizing Telepharmacy services since 2008. To prepare for Accreditation in December 2013, the remote clinical pharmacist was requested to support and lead the antimicrobial stewardship program. The remote clinical pharmacist performed a gap analysis to identify areas requiring improvement for a successful ASP which included the need for an Antimicrobial Stewardship committee, an IV to PO conversion program for antibiotics, development of guidelines and clinical pathways for common infections, hospital specific antibiogram, and prospective audit with intervention and feedback. The remote clinical pharmacist participated in meetings with nurses, physicians, and other key stakeholders using videoconference technology to develop a plan for the ASP. The remote clinical pharmacist started prospective data collection in September 2013. Starting January 2014, the remote clinical pharmacists started providing prospective audit with intervention and feedback. The antimicrobial stewardship program was formally accepted by Accreditation Canada in December 2013. Days of Therapy (DOT) per 1,000 Patient-Days Over 4 Years Small rural and remote acute care hospitals without access to an on-site clinical pharmacist can successfully implement and maintain an ASP by seeking support from experienced remote clinical pharmacists. S. Dhaliwall, Northwest Telepharmacy Solutions: Employee, Salary. K. McDonald, Northwest Telepharmacy Solutions: Employee, Salary.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.007 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".