Patient Safety Component—Annual Facility Survey for IRF Page 10 of 12 Antibiotic Stewardship Practices (continued) *30. Our stewardship team provides the following updates or reports, at least annually: (Check all that apply.) Updates to facility leadership on antibiotic use and stewardship  Outcomes for antibiotic stewardship interventions to  None of the  *31. Which of the following groups receive education on appropriate antibiotic use at least annually? (Check all that apply.)  Nursing   None of the  Optional Antibiotic Stewardship Practices Questions Responses to the following questions are not required to complete the annual survey. Please provide additional information about your antibiotic stewardship activities and leadership. facility’s 32. Antibiotic stewardship activities are integrated into quality improvement and/or □ □ Yes No patient safety initiatives. 33. Our facility accesses targeted remote stewardship expertise (e.g., □ □ Yes No to obtain facility-specific support for our antibiotic stewardship efforts. 34. Our facility has a clinical decision support tool embedded in the electronic □ □ health record for antibiotic use or stewardship interventions available to Yes No prescribers. Not applicable, our  35. Our stewardship team works with the microbiology laboratory to facility does not use □ □ inform cascade and/or selective reporting protocols for isolate Yes No cascade and/or selective susceptibilities. 36. Our stewardship team monitors compliance with appropriate surgical □ □ Yes No prophylaxis. 37. If you selected to question 25 (your facility has a leader (or co-leaders) responsible for antibiotic stewardship ‘Yes’ outcomes): Which committees or leadership entities provide oversight of your antibiotic stewardship efforts? facility’s (Check all that apply.) Pharmacy  Pharmacy &  Patient  Quality  Executive leadership (e.g., CEO,  Board of  Other (please specify):   Continued
Patient Safety Component—Annual Facility Survey for IRF Page 10 of 12 Antibiotic Stewardship Practices (continued) *30. Our stewardship team provides the following updates or reports, at least annually: (Check all that apply.)  Updates to facility leadership on antibiotic use and stewardship  Outcomes for antibiotic stewardship interventions to  None of the *31. Which of the following groups receive education on appropriate antibiotic use at least annually? (Check all that apply.)   Nursing   None of the Optional Antibiotic Stewardship Practices Questions Responses to the following questions are not required to complete the annual survey. Please provide additional information about your facility’s antibiotic stewardship activities and leadership. 32. Antibiotic stewardship activities are integrated into quality improvement and/or patient safety initiatives. □ Yes □ No 33. Our facility accesses targeted remote stewardship expertise (e.g., to obtain facility-specific support for our antibiotic stewardship efforts. □ Yes □ No 34. Our facility has a clinical decision support tool embedded in the electronic health record for antibiotic use or stewardship interventions available to prescribers. □ Yes □ No 35. Our stewardship team works with the microbiology laboratory to inform cascade and/or selective reporting protocols for isolate susceptibilities. □ Yes □ No  Not applicable, our facility does not use cascade and/or selective 36. Our stewardship team monitors compliance with appropriate surgical prophylaxis. □ Yes □ No 37. If you selected ‘Yes’ to question 25 (your facility has a leader (or co-leaders) responsible for antibiotic stewardship outcomes): Which committees or leadership entities provide oversight of your facility’s antibiotic stewardship efforts? (Check all that apply.)  Pharmacy  Pharmacy &  Patient  Quality  Executive leadership (e.g., CEO,  Board of  Other (please specify):  Continued
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