Jenny Triplett, RN, BSN, runs a tight ship on the Skilled Nursing Unit at Northern Hospital of Surry County – which serves as the temporary residence for 33 eligible individuals who require long-term care and/or special rehabilitation services. Like a mother eagle, the 56-year-old nursing director ensures that she and her staff meet the needs of their elderly “residents” with equal doses of professionalism, competence and compassion. “We all have parents and grandparents, so it’s natural for us to treat our residents with the same level of care and consideration as we would our own family members,” says Triplett.
In addition, Triplett carefully oversees the implementation of the unit’s Antibiotic Stewardship Program – which helps ensure that residents receive only the right type of antibiotic … at the right time … and in the right amount. As Triplett explains, antibiotics are powerful and effective drugs that should be used only when necessary. “All drugs, including antibiotics, have side effects – and we monitor continuously for any adverse side effects so they may be treated appropriately, as well.
“The use of antibiotics is further complicated when dealing with an older population – many of whom have multiple medical issues, all of which must be treated simultaneously with different types of therapeutic agents,” she adds.
Antibiotic Stewardship Program
According to the Centers for Disease Control and Prevention (CDC), antibiotics are the most commonly prescribed medication in long-term care facilities for the treatment of infections such as urinary-tract infections, respiratory-tract infections and skin/soft-tissue infections. That’s one reason why long-term care facilities are required by the CDC and state statutes to establish an Antibiotic Stewardship Program. “We all agree on the important role that antibiotics play in fighting bacterial infections, but we also realize that antibiotics come with side effects and complications such as allergic reactions and the possible development of Clostridium difficile, also known as C-diff, which is a potentially life-threatening condition,” explains Triplett, who has received advanced training in antibiotic stewardship and infection-control procedures.
“One way to help ensure that our residents receive antibiotics only when necessary is to do a complete culture and urinary analysis when we suspect someone may have a urinary tract infection – which is a fairly common development among elderly residents,” she says. “We then wait for the results of the culture to come in so we know exactly what the problem is and can treat it with the right medications. This process helps eliminate the use of unnecessary antibiotics – which helps reduce the chance of negative side effects and complications.”
The Yin & Yang of Antibiotics
As noted by the Centers for Disease Control and Prevention, antibiotics have transformed the practice of medicine — making once-lethal infections readily treatable and making other medical advances, such as cancer chemotherapy and organ transplants, possible. However, while the prompt initiation of antibiotics to treat infections has been proven to reduce morbidity and save lives, some 20 to 50 percent of all antibiotics prescribed in U.S. acute care hospitals are either unnecessary or inappropriate.
The CDC also cautions that the misuse of antibiotics has contributed to the growing problem of antibiotic resistance, which has become one of the most serious and growing threats to public health.
“At Northern Hospital, antibiotic stewardship programs run concurrently within the Skilled Nursing Unit and throughout the hospital,” says Ned Hill, the hospital’s Chief Executive Officer. “Research has shown that a strict adherence to the antibiotic-administration guidelines provided by these programs leads to improved patient care and patient safety.”
Educational Efforts are Paramount
Jenny Triplett says that educating others about antibiotics is an important part of her Unit’s responsibilities. “We take seriously our efforts to teach residents and their families about the need to use antibiotics judiciously,” she says. “We provide them with helpful information and also encourage them to ask questions about all the medications they receive.”
Triplett acknowledges that some individuals – particularly family members — question the need to wait before administering antibiotics. “But once they understand that treating an accurately diagnosed problem with the right medication is the best approach, they are grateful that we take the steps we do.
“Our goal is to improve the quality-of-life for our residents,” she continues, “and one way to do that is to make sure we’re giving antibiotics on an as-needed basis only.
“Of course, there’s no limit on hugs … and we give those quite frequently!” she adds with a smile.