title: Implementation of antimicrobial stewardship policies in U.S. hospitals: findings from a national survey.
abstract: OBJECTIVE
  To describe the use of antimicrobial stewardship policies and to investigate factors associated with implementation in a national sample of acute care hospitals.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Infection Control Directors from acute care hospitals participating in the National Healthcare Safety Network (NHSN).
  
  
  METHODS
  An online survey was conducted in the Fall of 2011. A subset of hospitals also provided access to their 2011 NHSN annual survey data.
  
  
  RESULTS
  Responses were received from 1,015 hospitals (30% response rate). The majority of hospitals (64%) reported the presence of a policy; use of antibiograms and antimicrobial restriction policies were most frequently utilized (83% and 65%, respectively). Respondents from larger, urban, teaching hospitals and those that are part of a system that shares resources were more likely to report a policy in place (P<.01). Hospitals located in California were more likely to have policy in place than in hospitals located in other states (P=.014).
  
  
  CONCLUSIONS
  This study provides a snapshot of the implementation of antimicrobial stewardship policies in place in U.S. hospitals and suggests that statewide efforts in California are achieving their intended effect. Further research is needed to identify factors that foster the adoption of these policies.
authors.affiliation: 1Thomas Jefferson University,Jefferson School of Nursing,Philadelphia,Pennsylvania.
authors.forename: Monika
authors.initials: M
authors.lastname: Pogorzelska-Maziarz
authors.affiliation: 2Columbia University,Mailman School of Public Health,School of Nursing,Center for Health Policy,New York,New York.
authors.forename: Carolyn T A
authors.initials: CT
authors.lastname: Herzig
authors.affiliation: 3Columbia University,Mailman School of Public Health,School of Nursing,Center for Health Policy,New York,New York.
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
authors.affiliation: 4Columbia University College of Physicians & Surgeons,NewYork-Presbyterian Hospital,New York,New York.
authors.forename: E Yoko
authors.initials: EY
authors.lastname: Furuya
authors.affiliation: 5University of Iowa,Carver College of Medicine,Iowa City,VA,Iowa City,Iowa.
authors.forename: Eli N
authors.initials: EN
authors.lastname: Perencevich
authors.affiliation: 6Columbia University,School of Nursing,Center for Health Policy,New York,New York.
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Stone
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004352:Drug Resistance, Microbial; D019538:Health Care Surveys; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D017053:Infection Control / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D016134:Organizational Policy; D014481:United States
chemical_list: D000890:Anti-Infective Agents