Minnesota Antibiotic Stewardship
Long-term Care Honor Roll

Application

• Long-term care facilities will be eligible for one of three levels of recognition (bronze, silver, gold).
• Facilities may submit materials at any time, and updates to the Honor Roll will be made quarterly.
• Honor roll membership will be renewable every two years.

Step 1: Collect your information

• Download the Minnesota Antibiotic Stewardship Long-term Care Honor Roll Application (PDF). 
  Use this document as a guide to help you collect the information you need for your application. 
  NOTE: This document is for your planning purposes only. This is not a fillable form, and is not intended to be turned in with your application.

Step 2: Fill out the application

• Fill out the Minnesota Antibiotic Stewardship Long-term Care Honor Roll Application. 
  This application mirrors the document from Step 1. 
  NOTE: Applicants are now able to save and return to their application if they need to complete it at a later time.

Renewal Process

• Honor Roll membership will be renewable every two years. Renewal applications will be sent out two year after the initial online application was completed.
• Renewal applications contain the responses from the initial application. Those renewing will review the initial information for accuracy and add all renewal application information on the same form.
  NOTE: Applicants are now able to upload their letters of commitment and antibiotic stewardship policies directly into their application.

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Brittany Schmidt, RN
  • Physician Leader: Emma Erickson, MD
  • Pharmacist Leader: Jenny Konrad, PharmD
• Highlighted Antibiotic Stewardship Action: 
  Bethany on the Lake collects and documents data daily throughout the month, allowing for the identification of trends, patterns, and potential infection spread. A facility map monitors and prevents transmission between rooms, whether through staff movement or resident interactions. During monthly QAPI meetings, these findings are presented along with a root cause analysis to address any underlying issues. Based on these insights, education to staff, the medical director, local clinics, and the ER is provided. Additionally, audits are conducted to verify the effectiveness of education and to break the chain of infection.
• Highlighted Collaborative Activity: 
  • Effective communication is essential to providing exceptional care for the residents at Bethany on the Lake. Their approach is highly collaborative, involving the admissions team, social workers, floor nurses, nurse managers, weekly lab technicians, housekeepers, dietary, and rounding providers.
  • When residents are admitted from other facilities or hospitals, Bethany on the Lake ensures a thorough nurse-to-nurse report is completed, including all pertinent information necessary for safe and effective care. The same level of detail is maintained when transferring residents to a higher level of care with EMS. Custom tools and check lists created by leadership are utilized to ensure nothing is missed and encourage creative thinking when it comes to healthcare management and safety for all residents.
  • When residents are discharged, they are provided with comprehensive education regarding their medications and strategies to prevent future infections. This education is also shared with caregivers, including family members, hospice teams, and home health agencies. 

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Deborah Morell, RN
  • Physician Leader: Eric Scrivner, MD
  • Pharmacist Leader: Sara Elioff, PharmD, RPh, PIC
• Highlighted Antibiotic Stewardship Action: 
  • Bigfork Valley Long-term Care has created an EMR-generated Prescriber Antibiotic Stewardship Performance Report that details patient, drug, frequency, stop/start dates, clinical indication, and ordering provider. This report is reviewed by the antibiotic stewardship team and shared with prescribers as needed. It can be used to identify opportunities for improvement in prescribing practices.
  • The clinical team is educated on beta-lactam allergies in the setting of surgical prophylaxis. A pharmacy-driven ordering process has been implemented based on early assessment of patient allergies and reduced patient exposure to broad spectrum antibiotics.
• Highlighted Collaborative Activity: 
  • Bigfork Valley Long-term Care works closely with the hospital and assisted living facility through regular infection prevention meetings. In addition to their regular IP meetings, Bigfork Valley LTC holds regular antibiotic stewardship meetings. Bigfork Valley LTC also maintains good relationships with neighboring LTC facilities and their community clinic.
  • The Medical Director and Education Nurse at Bigfork Valley LTC personally see to staff education, both with providers and nursing staff related to prescribing practices and good Antibiotic Stewardship. 
  • Staff at Bigfork Valley Long-term Care have presented on antibiotic stewardship at the MDH Antibiotic Stewardship Conference. Bigfork Valley LTC has also had other facilities be referred to them to assist in issues related to antibiotic stewardship.

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Kristi Mienert, RN
  • Physician Leader: Cheryl White, MD 
  • Pharmacist Leader: Justice Witt, PharmD
• Highlighted Antibiotic Stewardship Action: 
  Essentia Health First Care Living Center evaluates antibiotic-use data to identify areas of focus and opportunity for improving processes and practices as a system and individually.
• Highlighted Collaborative Activity: 
  Essentia Health First Care Living Center prioritizes antibiotic stewardship during care transitions through ongoing collaboration with area nursing homes and other health care facilities. 

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Lisa Wood, BSN, RN
  • Physician Leader: Jay Schmidt, MD
  • Pharmacist Leader: Kari Johnson, PharmD
• Highlighted Antibiotic Stewardship Action: 
  Essentia Health Grace Home utilizes an antibiotic time out process tool per policy. They also use an internal tracker to provide areas of focus and opportunities for improving processes. As part of Essentia Health, the facility specific antibiograms are a piece of the organizations market specific antibiotic stewardship data and processes.
• Highlighted Collaborative Activity: 
  Essentia Health Grace Home collaborates with area nursing homes and other health care facilities to advance antibiotic stewardship during care transitions with ongoing, formal communication.

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Lauren Hughes, BSN, RN
  • Physician Leader: Dr. Kion Hoffman
  • Pharmacist Leader: Nicholas Rickoff, PharmD
• Highlighted Antibiotic Stewardship Action: 
  Essentia Health Homestead evaluates antibiotic-use data to identify areas of focus and opportunity for improving processes and practices as a system and individually.
• Highlighted Collaborative Activity: 
  Essentia Health Homestead prioritizes antibiotic stewardship during care transitions through ongoing collaboration with area nursing homes and other health care facilities. 

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Laurie O'Laughlin, RN, BHA, CBIC
  • Physician Leader: Christopher Whiting, MD
  • Pharmacist Leader: Jacob Keller, PharmD
• Highlighted Antibiotic Stewardship Action: 
  • To reduce unnecessary antibiotic prescribing for asymptomatic bacteriuria, Essentia Health Northern Pines had urinalysis (UA) testing removed from routine standing orders. This ensures antibiotics are only initiated when clinically indicated.
  • Additionally, regularly scheduled review of ongoing antibiotic therapy ("antibiotic time-outs") is performed to assess:
    • Indication for continuation
    • Appropriateness of drug choice, dose, and duration
    • Opportunities for de-escalation or discontinuation
  • These time-outs foster real-time provider feedback and support guideline-concordant prescribing.
• Highlighted Collaborative Activity: 
  • Essentia Health Northern Pines provides guidance and mentorship to neighboring long-term care facilities. Assisting with implementation of stewardship practices, staff education, and guideline adoption.
  • Northern Pines participates in regional benchmarking by sharing facility-specific antibiotic use and resistance data with other local facilities. This collaboration allows comparison of prescribing patterns, identification of trends, and development of joint strategies to optimize antibiotic use.
  • Ongoing communication with area nursing homes, clinics, and hospitals are maintained to ensure antibiotic prescribing is consistent during care transitions. When patients transfer between facilities, recent culture results, medication reconciliation, and recommendations for continuation or de-escalation of therapy are discussed between facilities.

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Barbara Forrest, MSN
  • Physician Leader: Parul Gupta, MD
  • Pharmacist Leader: Eric Christianson, PharmD
• Highlighted Antibiotic Stewardship Action: 
  Essentia Health Oak Crossing uses a campus antibiogram which includes hospital and clinic data. Oak Crossing also monitors for trends and analyzes outcomes. They meet monthly with providers and medical directors to discuss the data, outcomes, and identify action opportunities. 
• Highlighted Collaborative Activity: 
  Essentia Health Oak Crossing provides mentorship and consultations to infection preventionists and directors of nursing at other facilities in their health system. As the largest of six skilled nursing facility in their system, Oak Crossing collaborates with the other five facilities to provide their resources and expertise to advance antibiotic stewardship.

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Stephanie Novak, RN
  • Physician Leader: Michelle Oman, MD
  • Pharmacist Leader: Nicholas Rickoff, PharmD
• Highlighted Antibiotic Stewardship Action: 
  The facility infection preventionist (IP) reviews all data for infections including antibiotic prescribing and usage. For any additional review, the IP contacts appropriate providers and discusses indications, lab reporting, and the antibiotic utilized for infection. Essentia Health staff collaborate through monthly IP meetings along with the leadership team, where all information is reviewed monthly for quality improvement measures. To determine if an antibiotic is appropriate, an antibiotic timeout is enacted within 48-72 hours after prescribing. Immunization status of all residents is followed closely as an infection prevention measure. Additionally, enhanced barrier precautions are utilized to prevent spread of MDROs.
• Highlighted Collaborative Activity: 
  Virginia Care Center coordinates within Essentia regionally and other like facilities. The regional infection prevention specialist attends the antimicrobial stewardship committee as well as the sepsis committee to assist in improving best practices and promote change as needed.

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Laura Hanson, RN, BSN 
  • Physician Leader: James Surdy, MD
  • Pharmacist Leader: Nicole Johnson, PharmD
• Highlighted Antibiotic Stewardship Action: 
  Kittson Memorial Nursing Home analyzes their antibiotic-use data against their compliance with completed SBARs and Loeb criteria for initiating antibiotics.
• Highlighted Collaborative Activity: 
  Kittson Memorial Nursing Home, despite their small size, utilizes an antibiogram through collaboration with a larger health care facility in the region. Additionally, the providers will consult via telephone with Infectious Disease at a larger health care facility, as needed.

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Roxann Kjos, RN
  • Physician Leader: Dr. Allen Grillo
  • Pharmacist Leader: David Simmons, PharmD, BCPS
• Highlighted Antibiotic Stewardship Action: 
  Over the past two years LifeCare Greenbush Manor has focused frontline staff education on the following topics.
  • Staff members role in antibiotic stewardship
  • MDH Antibiotic Use Tracking Tool including how an Infection meets criteria
  • Hand hygiene 
  • Enhanced barrier precautions
• Highlighted Collaborative Activity: 
  LifeCare Medical Center shares Greenbush Manor’s internal data and resources across the organization, including the acute care hospital, long-term care, and clinics. This data is collected using the MDH Antibiotic Use Tracking Tool – infection rates by disease, antibiotic use, and infections meeting surveillance criteria. LifeCare Medical Center has implemented collaborative treatment algorithms that are utilized throughout our entire organization. These include sinusitis, CAUTI, SSI, influenza, COVID, and pneumonia. 

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Julie Phalen, RN, PHN, BS
  • Physician Leader: Dr. Allen Grillo
  • Pharmacist Leader: David Simmons, PharmD, BCPS
• Highlighted Antibiotic Stewardship Action: 
  Over the past two years LifeCare Roseau Manor has focused frontline staff education on the following topics.
  • Staff members role in antibiotic stewardship
  • MDH Antibiotic Use Tracking Tool including how an Infection meets criteria
  • Hand hygiene 
  • Enhanced barrier precautions
• Highlighted Collaborative Activity: 
  LifeCare Medical Center shares Roseau Manor’s internal data and resources across the organization, including the acute care hospital, long-term care, and clinics. This data is collected using the MDH Antibiotic Use Tracking Tool – infection rates by disease, antibiotic use, and infections meeting surveillance criteria. LifeCare Medical Center has implemented collaborative treatment algorithms that are utilized throughout our entire organization. These include sinusitis, CAUTI, SSI, influenza, COVID, and pneumonia. 

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Marquita Anderson, RN
  • Physician Leader: Bruce Meyer, MD
  • Pharmacist Leader: Andrew Weir, PharmD
• Highlighted Antibiotic Stewardship Action: 
  MDVA Minneapolis educates staff and providers during annual education and throughout the year to support goals identified during quarterly ASP meetings. The IP team shares antibiotic use data at monthly QAPI meetings. In addition to the QAPI meetings, the IP team meets monthly with the medical director and quality director for antibiotic focus meetings to review any antibiotic not meeting McGeers or Loeb criteria. Allowing them to identify areas for increased education, system improvement and monitoring the effectiveness of their interventions.
• Highlighted Collaborative Activity: 
  MDVA Minneapolis participates in a monthly infection preventionist meeting with all the Minnesota Veterans Homes (including the Domiciliary), allowing for collaboration between all sites. They also collaborate and participate with the Hennepin County Long-Term Care Infection Prevention Program and Coalition. The infection preventionist at MDVA was asked to attend Family Council, where they provide education on infection prevention, including ways family and residents can aid the facility in being good stewards of antibiotics. 

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Rennae Houle-Burns, MSN, RN, CIC
  • Physician Leader: Bruce Meyer, MD 
  • Pharmacist Leader: Rebecca Wright, PharmD
• Highlighted Antibiotic Stewardship Action: 
  Silver Bay Veterans Home recently did a quality improvement project to improve hand hygiene compliance within the facility. This project involved frontline staff, residents, supply change, nursing leadership, and maintenance departments. This project trialed four different waterless hand hygiene products and selected the product that had the highest favorability and easiest access. Staff and residents identified best placement of this new product, allowing for ready access to hand hygiene products and improved compliance. There was a 67% increase in hand hygiene compliance after installation with ongoing improvement in both compliance and staff/resident satisfaction.
• Highlighted Collaborative Activity: 
  Silver Bay Veterans Home works with the local critical access hospital and clinic system to obtain antibiograms for our community to assist in prescribing decisions. Silver Bay Veterans Home is participating in an 18-month AHRQ Safety Program for MRSA prevention. The program focuses on improving skin care and MDRO prevention in long-term care and is led by the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality and NORC. This project provides monthly educational opportunities, teachable moments, and resources for staff/leadership on ways to improve infection prevention strategies. 

• Antibiotic Stewardship Leaders:
  • Nursing Leader: Tonia Yates, RN
  • Physician Leader: Kim Wernsing, MD
  • Pharmacist Leader: Jodi Meerbeek, PhamD, BCPP 
• Highlighted Antibiotic Stewardship Action: 
  St. Peter Regional Treatment Center uses a key process management system. They focus on quality by promoting rational and appropriate antimicrobial therapy. The services they provide improve clinical outcomes and minimize unintentional adverse effects related to antimicrobial use.
• Highlighted Collaborative Activity: 
  St. Peter Regional Treatment Center has a multidisciplinary DCT ASP workgroup which met multiple times last year to help standardize and improve the processes across the different DCT sites. DCT is comprised of several facilities across the state, and all have contributed and worked together to improve education/yearly CBTs and customize them for specific roles. St. Peter Regional Treatment Center has also updated their ASP policy to ensure best practices are being met.