One project is an evaluation of the impact of the Centers for Medicare & Medicaid Services sepsis core measures on broad-spectrum antibiotic use. For hospitals to meet the measures, one of the elements they need to fulfill is initiation of antibiotics within three hours of sepsis diagnosis. While timely antibiotic initiation is important, there could be unintended consequences in the form of continued broad-spectrum agent use once the bacterial pathogen and susceptibilities are known. Identification of prolonged durations of broad agents when a narrow-spectrum agent would be appropriate would have implications for antimicrobial stewardship program strategies.
My collaborators and I studied whether two different hospital measures of quality, the Leapfrog Hospital Safety Grade and the Magnet Recognition Program (representing nursing excellence), were associated with the number of cases of the healthcare-associated infections, Clostridium difficile and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections. Hospitals that had a safety grade of A had fewer cases of C. difficile infection as compared to B, C, and D-and-F hospitals, while hospitals that had Magnet designation had fewer cases of MRSA than non-Magnet hospitals. These mixed results suggest that more precise organizational measures of hospital quality are needed for measuring hospital safety in terms of infection occurrence.
Earning each degree has aided me in accomplishing my career goals as they have evolved over time. For example, earning my doctor of pharmacy degree and completing a fellowship enabled me to serve as a clinical pharmacy specialist in infectious diseases. Receiving a master’s degree in health evaluation sciences and a Ph.D. in health-services organization and research have enhanced my skill set in the areas of quantitative data analysis and organizational-focused research. This enhances my research efforts related to antibiotic stewardship, healthcare-associated infections and patient safety in my research-focused academic position.